Saving Health Care by taxing junk food?

IHOP Bacon ‘N Beef Cheeseburger has 1,250 calories, plus 620 for onion rings. The Cheesecake Factory Farmhouse Cheeseburger has 1,530 calories, 1900 with fries. A PB&C milkshake at Cold Stone has 2010 calories; it contains peanut butter, chocolate ice cream and milk, with 68 grams of saturated fat and 153 grams of sugar. Since the new health-care law mandates calorie count information on menus, starting in 2011, will this make a difference? Most fast-food chains now offer lower calorie choices – whether this is helping people make wiser choices is not yet clear.

As readers know, the ‘standard American diet’ (SAD) of fast food laden with sugar, fat and salt, is causing an epidemic of obesity, with resultant high rates of diabetes and its many complications. Mark Bittman, a well known food writer and New York Times columnist, analyzes the impact of taxing junk food on our health and health care costs in the July 24th edition of the NYTimes. His premise is that the food industry is interested in profits, not the public health, and that the federal government should establish a bold, national fix. Much of this column is based on Bittman’s ideas. I should add that I agree with him.

The Rudd Center for Food Policy and Obesity at Yale says that taxes become a significant force in changing buying habits for soda at about a penny an ounce. The average American consumes 44.7 gallons of sweetened sodas a year, and another 17 gallons of non-carbonated sweetened drinks. With a 20% tax in the price of sugary drinks, there would be an estimated 20% decrease in consumption, resulting in the prevention of obesity of 1,500,000 Americans (over 10 years) and 400,000 fewer cases of diabetes, saving about $30 billion dollars in health care costs. The money gained in taxes could be used to subsidize the purchase of staple foods like vegetables, whole grains, dried legumes and fruit. This is an essential part of the plan: making healthy foods available and affordable, bringing grocery stores into ‘food deserts’, teaching children and adults how to shop and cook, and supporting farmers markets and community gardens.

Soda taxes have been proposed in Philadelphia, San Francisco, and New York. France and Hungary are also proposing a tax on junk food, while Brazil is subsidizing produce for the poor in its ‘Zero Hunger ‘ program. The idea is gaining ground.

Currently, instead of taxing junk food, we are paying – with tax dollars - to support corn farmers whose corn is made into high-fructose corn syrup – used to sweeten soda! So far, efforts to change what Americans eat through education and persuasion have failed, partly due to the 4 billion spent annually on advertising by the fast-food industry. Bittman says that 86% of food ads seen by children are for foods high in sugar, fat and sodium. The percentage of obese children has tripled in the last 30 years, and of obese adults has more than doubled.

Efforts to tax certain foods will be opposed by those decrying the ’nanny -state’. However, we are faced with a health crisis with serious budgetary implications. Public health regulations have been very successful in other areas.
We now tax cigarettes over $2 per pack – a combination of state and federal excise taxes – and the US smoking rate has fallen from 40% to 20%. Although over 400,000 people still die each year from tobacco, the toll was twice as high before taxation. We have government mandates for seat belts and children’s safety car seats in most states, which are estimated to save over 15,000 lives each year. Government regulation of drinking water and food safety, driving speeds, and building codes have saved countless lives and reduced health care costs.

Here in West Marin we are tremendously lucky to have organic farmers, farmers’ markets and healthy produce. We also have great tasting water. We should all thank our farmers, eat more produce and drink fewer calories, whether it’s soda, sweetened bottled tea, or beer. OK, beer drinkers, I said less, not none! And – support a tax on sweetened soda if it comes around, as it will reduce your health care costs.
Sadja Greenwood, MD, MPH back issues on this blog