(I’ll be posting this on both of my blogs, since it’s partly about health, partly about politics and current events. Pretty convenient for me, since I’m in play rehearsals and don’t have as much time to write.)

There are a lot of proposals to “fix” health care floating around, all with various cost predictions – most of which are probably about as accurate as the predictions provided by a magic 8 ball. Whatever price tags you’re seeing now, just triple them in your mind. That way, the actual cost will only be double what you expected.

I have my own proposals to address the rising costs of health care. And unlike the proposals coming out of Congress, I don’t need thousands of pages to explain them. Better yet, my proposals aren’t based on the theory that the best way to bring down health-care costs is to spend another trillion dollars or so. In fact, my proposals would actually save the taxpayers money.

Seriously, they would. And I’m not talking about the kind of pie-in-the-sky “We’ll spend billions on this program now, but it will save money in the long run” nonsense that usually comes out of Washington. (If just half of the “save money in the long run” predictions I’ve heard in my lifetime had come true, we’d be running huge surpluses right now.) Nope, I’m talking about real, spend-less-money savings.

Here’s how the federal government can realize those savings:

  • Stop telling us what to eat, and admit that the earlier attempts to tell us what to eat were a mistake.
  • Stop subsidizing corn and other grains.

These proposals would produce both short-term and, more importantly, long-term savings. The short-term savings are based on a principle of economics that’s so stupidly simple, even the average congressman can grasp it: if you stop spending money, you end up spending less.

For decades, the federal government has been employing people whose job is to tell us what they think we should eat. In addition to their salaries, taxpayers also pay for the dubious research they conduct and the mountains of literature they produce and distribute. I say “dubious” because the primary purpose of the current research seems to be to prove that their previous advice wasn’t actually wrong … which it was. We don’t need these people. And for reasons I’ll explain shortly, we would’ve been better off without them.

The taxpayers also foot the bill for billions of dollars in annual farm subsidies. These subsidies were enacted in the 1930s as a “temporary” solution to the price shocks and instability of the Great Depression – which apparently never actually ended. In our continuing efforts to lift ourselves out of the Great Depression, we now provide wealthy corporations like Archer Daniels Midland with subsidy payments. Same goes for “farmers” like Scottie Pippin, the former star forward for the Chicago Bulls, who without government checks would no doubt have to strap his trophies to the top of a rusty old truck and seek work in California.

But even as the country struggles to escape the effects of the stock market crash of 1929, it’s probably time to end those subsidies. And we’d be healthier if we did, again for reasons I’ll explain shortly. In the meantime, we’d save billions – instantly. Once again, for the benefit of any federal policy-makers out there: if you stop spending money, you end up spending less.

The long-term savings are based on another economic principle that’s not stupidly simple, but merely logical, so at this point we’ll probably lose any government policy-makers who happen to stumble across the blog. But here it is anyway: When lots and lots of people get sick, health-care costs go up.

I know, I know … you probably thought we’re just as healthy as ever, but the insurance companies keep jacking up their rates simply because nobody’s had the political will to stop them. The fact is, the profit margin in the health-insurance industry is pretty much what it’s always been: around 3%. (Actually, a report I saw recently said it’s dropped to about 2.2% in recent years.) Insurers aren’t creating the spiraling cost of health care; they’re just passing it along to us in the form of spiraling premiums.

We can sit in town hall meetings and shout all we want about pre-existing conditions, levels of reimbursement, co-payments, deductibles, portability, public versus private competition, and the true number of the uninsured. None of that changes the simple fact that when people get sick enough to require medical care, someone is going to pay for it.

Shifting the cost of being sick from one group of people to another doesn’t reduce the cost; it just sticks someone else with the bill. The only way to reduce to the real cost of medical care (aside from refusing to treat sick people, which isn’t a good idea) is to require a lot less of it.

We require much more medical treatment than we should largely because the federal government told us what we should eat, and by gosh, we listened. As you already know if you’ve seen Fat Head or read Good Calories, Bad Calories, the only macronutrient we consume more of now than in previous generations is carbohydrates. (We’ve actually cut back on fat, especially men.)

This didn’t happen by accident. It was the result of a senate committee on nutrition, headed by George McGovern, who believed everyone should switch to a low-fat, high-carbohydrate diet to prevent heart disease. Plenty of researchers and scientists, including the head of the National Academy of Sciences, tried to tell the committee they were wrong – but McGovern knew he was right because his own doctor said so. (With that kind of authority backing you, it’s just a waste of time to wait for actual scientific proof.)

And so, with a big push from the McGovern committee, the FDA and the USDA, the low-fat, high-carb diet became the rage. We became a nation of fat-phobic grain and sugar eaters.

Meanwhile, the federal government made it cheaper for us to eat sugar and starch through massive grain subsidies. As the old farmer told the stars of King Corn, “You couldn’t make any money growing corn if not for the government payments.” Those government payments are the reason we feed cattle corn instead of letting them eat grass as nature intended. Subsidies are the reason high-fructose corn syrup is in half the products you’ll find in the grocery store, including bread. Dirt-cheap subsidized corn is the reason for Big Gulps and endless refills at the soda dispenser.

And here’s the happy result of all that government involvement in food and nutrition: Nearly one-fourth of all senior citizens have type II diabetes.  Just think of the impact on Medicare expenditures. Diabetes isn’t just a disease; it’s a driver of many other ailments, including kidney failure, blindness, heart disease, cancer and Alzheimer’s. Diabetes puts senior citizens in wheelchairs. It puts them in assisted-care facilities. And as a harbinger of health-care disasters yet to come, type II diabetes is even showing up in adolescents now. That never used to happen.

You are paying the toll for the diabetes epidemic even if you’re in fine health and have private insurance. Your taxes, of course, pay for all those diabetes-related Medicare costs – but so do your health-insurance premiums, whether you realize it or not.

You’ve probably seen media stories about hospitals charging $10 for an aspirin. Perhaps you were even outraged at the very idea. But there’s a reason hospitals put $10 aspirins on your bill: Medicare, expensive as it is, doesn’t actually cover the full cost of many treatments hospitals are required to provide. So they make up for the Medicare deficits with $10 aspirins and other exorbitant charges – all billed to your insurance.

Much, if not the majority, of our ever-increasing health-care costs are driven by chronically high blood sugar and diabetes. But diabetes isn’t like the swine flu. We aren’t catching it from each other. We don’t need to spend billions of dollars to develop a type II diabetes vaccine.

What we need is for officials in Washington to stop beating up on the health-care industry, and instead call a giant press conference to make an announcement like this:

Ladies and gentlemen, the nutrition advice we’ve been handing out since the 1970s was clearly wrong. You could even say it was dead wrong. Saturated fats are not and never have been the cause of heart disease and cancer. And let’s face it, fat is delicious. We scared you away from a taste your body loves, and we feel really stupid about that. We especially feel stupid about recommending corn-oil margarine. It tastes awful and it promotes inflammation. It’s not a natural food, despite the picture of the hot-looking Native American lady on the box.

It turns out we should have been warning you about sugars and starches all along. Those are the real problem. So please, embrace your fatty foods. Enjoy your meats, your eggs, your cheeses, and be sure to drizzle lots of butter on your vegetables. We were at least right about the vegetables. But we were totally wrong about grains. They’re not a natural food for humans, and you should try to cut back on them as much as possible.

And to encourage you to do so, we’re going to cease all farm subsidies so the price of grain-based foods will reflect the actual cost of production. We suspect a lot of corn farmers will choose to retire or grow other crops, and we wish them well.

Again, we’re very sorry, and we have all turned in our resignations. Thank you, and enjoy your dinners.

No, this wouldn’t solve the problem overnight. Millions of people are already sick. Somebody is going to pay to treat them. But we could at least prevent future generations from developing the same diseases. That alone would stop the spiral.

Then, with the cost of health care held in check by actual health, we could resume debating about who’s going to pay for the costs of treating injuries and illnesses that aren’t caused by metabolic syndrome and diabetes.

I have a feeling it would be a much more civil discussion. Lower bills tend to have that effect on people.

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27 Responses to “Cheaper Health Care”
  1. SB says:

    http://www.nytimes.com/2009/09/10/opinion/10pollan.html

    You’ll find this interesting as well.

    Glad to see Pollan making the case, since he has the media’s ear right now. I’ve seen several articles extolling the affordability of government-provided care in France, and my first thought is always, “Duh … they don’t get heart disease or diabetes at anywhere near the rate we do. Of course they spend less on health care.”

    I would take issue with the idea of a soda tax. We don’t need to tax it. Just stop subsidizing it.

  2. Matt says:

    Furthermore, the group that tells us what to eat is the Department of Agriculture. Think that’s a conflict of interest?

    Yee-up. The USDA’s job is to sell grains.

  3. Dave, RN says:

    Well said. It kills me that we continue to “manage” diabetes (and all of the diseases that follow it) instead of eliminating it with a proper diet. I thank God every day that I didn’t follow conventional medical wisdom and got rid of my blood sugar issues just by eating “real food”, which by happy coincidence also took care of my borderline high blood pressure (it last measured 117/70, down from 135/90′s)
    What REALLY bothers me is that where work, patients (most of them heart failure, with a good measure of diabetes thrown in) are just treated with drugs. So many are on statins, (which is a whole ‘nother story) which is sad because I believe they contribute to heart failure due to their interruption of the CQ10 pathway, and the heart really NEEDS CQ10.
    I tell everyone I know to eliminate grains from their diet. Usually I get, “oh but I really like my muffins/donuts/bread/cookies” etc. etc.
    What bothers me more is that my moms cholesterol went over 200, and she went on statins, and I can’t convince her to get off of them.
    The Semmelweis reflex is really doing a job here. Darn doctors, even back in the 1840′s can’t STAND that they can be wrong. Dead wrong.

    I blame the doctors to an extent, but they read the medical journals and the research (if you can call it that) that comes out of NIH and other government organizations. They believe they’re doing the right thing when they prescribe statins instead of treating the source, which is diet.

  4. Ellen says:

    The Dept of Health and Human Services’ National Institutes of Health has a hand in it too, ’cause they lean heavily toward funding only the research that supports and repeats the “low fat, cholesterol is bad” message.. heck, the Nutrition and Metabolism Society had to start their own journal to get their pro-low carb studies published…

    The processed food and medical industries love all the “lowfat, eat more carbs” advice because they are making billions off the effects of the government’s campaign to sell as much grain as possible.. these companies drive what food is offered in the market place, and what gets published in the medical journals and media…

    The whole sick circle will only be destroyed when enough people on the street learn the truth about what truly causes disease and begin voting with their wallets.. if enough of us stop buying and eating processed junk in favor of clean meats, eggs, organic vegetables and other whole foods, all of these heavy players will be forced to change their tunes to match, unless they want to be brought to their knees financially.

    I envision a day when doctors have to go back to “low carb school” because their patients know more than they do about maintaining good health.. :)

    Indeed. Hate to say it, but I know more about nutrition and the true causes of heart disease and diabetes than the last few doctors I’ve had … including the one who told me to go on a lowfat diet because my cholesterol was 203. That was with HDL of 64 and triglycerides of 73.

  5. Samuel P. says:

    Soooooo true.

    The government can’t do anything right, and certainly can’t handle the health care system.

    The food pyramid is a load of @#$% and pretty much everything else the government gets involved in where it has no business.

    I don’t want the government telling me what to eat, since they have no clue what is truly healthy and I’m pretty sure has bought onto that whole saturated fat hype.

    Keep spreading the word!

    They not only bought into the saturated fat hype, they’re a primary force behind it.

  6. damaged justice says:

    They’d rather die than ever admit they were wrong. You’re more likely to see them end subsidies quietly. Of course, I wouldn’t hold my breath waiting for that either.

    Der almighty schtaat can never, ever be wrong.

    Heck, I’d settle for a quiet end to those subsidies. But I’m pretty sure the representatives of the farm states wouldn’t let it be quiet.

  7. Phyllis Mueller says:

    Good ideas, Tom.

    And don’t forget that ending the subsidies for corn and soybeans could also have the beneficial effects of reducing the amount of cheap, rancid oils in the food supply and helping to restore the proper balance of omega 3 and omega 6 fats in the diet.

    I also was glad to see Pollan’s Op Ed but felt he still gave the impression that obesity is causative, giving fuel to the “eat less, exercise more” proponents who see the problem as an individual failing–”sloth” and “gluttony”–rather than the result of bad advice and poor policy. Thin isn’t necessarily healthy.

    I noticed the blame-the-obese aspect of it too. But I was pleased to see him spell out the connection between subsidized corn and diabetes.

  8. Jesrad says:

    “I’ve seen several articles extolling the affordability of government-provided care in France”

    Err, wow, as a french citizen I wouldn’t wish our healthcare system on anyone but enemies. Our public hospitals are permanently understaffed and severly underequipped to the point where there are more and more operations that simply cannot be performed here, waiting lines for somethign as simple as a scanner extends for months, ER is overwhelmed with people too lazy to go see their doctor (since ER is “free” and they think they can drop by there anytime anyway), and the entire thing costs us as much as the combined costs of every other budget the state spends (earning a little under 20k $ a year it costs me a third of my salary already), to the point where it’s utterly bankrupt now and every politician is hopelessly scrambling to find any solution to save it.

    Little known in the US, is that pretty much every french citizen who works in a neighbouring country rushes to leave that healthcare system and use the foreign one instead. If you want a good system to copy, better look at Switzerland. It’s gotten so bad that our government has criminalized even the mere act of publicly talking about subscribing to another healthcare insurance.

    Glad to hear from someone inside the system. Most members of our media want a government-run system, so when they report on a system like yours, they seek out people who speak highly of it.

  9. gallier2 says:

    I can only confirm what jesrad says. The french system is a joke. I could compare directly because I worked for 10 years in Germany living in France. The service in Germany was light years ahead of that in France (I said was, because it has allegedly degraded since the time I worked in D).
    Then I worked in Luxembourg commuting from France. The approach in Lux. was more like in Germany, but really better than in France (furthermore one should even consider that I havened seen the real system in France, because the 3 départements of Moselle and Alsace have a different care system than the rest of France owing to the short time this region was under german rule from 1871 to 1918. We get 90% reimbursement, in the rest of France it’s only 70% and this year is the first time that our regional system is in deficit, the national one was always).

  10. Derrick says:

    Sorry, but it’s not going to work. Apparently, diets aren’t to blame for obesity, genetics are! http://www.newsweek.com/id/215115/page/1

    Was it the illuminati who forged a retrovirus, in the last 30 years, to reprogram our DNA in order to make us prone to obesity to further their nefarious plans? Was it genetic tampering by alien beings to make us more suitable for creating a hybrid organism? Or was it God, who just got tired of looking at the same old humanity and waved his almighty hand for a change of scenery?

    I am glad that Newsweek is at least pointing out the genetic component. I get very annoyed with people who can eat anything without gaining weight, yet are critical of fat people for not eating less. Most fat people have tried eating less, and it doesn’t work.

    That being said, yes, they certainly missed the point about what is driving the increase in obesity and diabetes. Genetics loads the gun, but diet pulls the trigger. We now live on trigger-happy diets.

  11. Brian says:

    Two funny things from the dietary guidelines. The first is the lady McGovern gave the green light to was a vegetarian and she had her own agenda. Didn’t she get rid of one or two guys that said what she wanted was either wrong or the research was inconclusive? I think this was in Fat Head.

    Second, a politican (maybe it was McGovern) quizzed another politician about his weight loss. And when he said he had eliminated carbs, the other politician said that is exactly the opposite of what his doctor told him to reduce his cholesterol. I think this was in Taubes book.

    You don’t use doublespeak very much, which is why you’d never win an election. But you’d be a great politician :-)

    Have fun with your play.

    Brian

    Considering how I feel about politicians and what they do, even if I got elected I’d be the least-liked guy in Congress.

  12. Laurie says:

    This isn’t original to me and I can’t remember on which blog I found it, so I apologize for no attribution. ‘The USDA food pyramid is making our kids sick, fat, deformed and crazy.’
    I found that quote because I was doing a search for ‘ gluten induced psychosis.’ Well, it was easy to find, believable and if you have not entertained this idea YET, I highly recommend you search for yourself. Wheat and its gluten is NOT suited-for-human consumption, it has opioid-like properties which make it addictive and it can pass through the blood-brain barrier where is can wreck havoc. I’m stunned but I’m beginning to discover these additional bad things. So that is the ‘crazy’ part in the above quote. The sick and fat are from the recommendations to eat sugar and grains and get on the highway to obesity and diabetes. The deformed part is from Weston Price’s studies. Traditionalists’ offsprings’ facial structure changes in as short as one generation when a Western (food pyramid) diet is adopted. I wish I was making this up. Sadly, I’m not. I’m just fortunate to be inquisitive, a voracious reader, and that I live in the time of the world wide web.

    I’ve seen research papers linking wheat to schizophrenia, including one in which a patient improved markedly after giving up wheat. I don’t think “crazy” is too much of a stretch.

  13. April says:

    Oh, Tom, you are officially my new favorite person. I COMPLETELY agree with both of your points and have ranted plenty of times on the same subjects.

    In my opinion, they should take it a step further with the farmers and subsidize them to grow other types of produce so that non-starchy fruits and vegetables would be cheaper. I know that deters a lot of people from buying them!

    I wish the government could just realize their mistakes, apologize and own up to it. People respond better to that then just trying to pass the problem onto someone or something else.

    I’m philosophically opposed to taxes being used to subsidize any business, but yes, if we’re going to do it, let’s at least not subsidize the worst choices.

  14. Steve says:

    Praise the lard !

    … and pass the ammunition?

  15. I know this is a bit off topic, but it shows much of the hypocrisy of many in the medical community with respect to current interests in “reform.” Recently I switched to a new doctor in town that supports HEALTH CARE for people with low income. He states that he works for the patient, not the insurance company. He’s bucking the “system” and I want to support that because I’m a free market individual.

    Oddly enough, he also wants national HEALTH INSURANCE. I’m okay with his views on anything as long as he is a good doctor, and he seems to be.

    His biggest concern during our first meeting was that my income had to meet the government criteria (since he provides services under medicare) before he could provide me care using his (government approved) sliding scale – otherwise the feds come down hard on him and off to jail he goes. This is amazing, you get fined and imprisoned for charging people less than government mandated rates just because you also provide services under a government contract.

    It took us about 30 minutes of factual argument, a pitiful tax return and two phone calls to other government contractor medical professionals before he was able to convince himself that my income indeed was scraping the bottom and qualified for a discount off of the GOVERNMENT established rate schedule.

    His main interest was staying out of jail. My main interest was health care services at a rate that me and my health care provider agree is reasonable. I don’t need help from the government. They have helped me quite enough over the years.

    As we finished up the appointment, I offered him two observations. First, if he talked with the average Canadian, he would find that they often come to “the states” anytime they have a serious and urgent medical condition. That attests to the huge difference between having HEALTH INSURANCE and having HEALTH CARE. Even the high court in Canada has given the “system” a thumbs down because it doesn’t allow private insurance, and that prevents people from being able to properly take care of themselves as they might care to do.

    Second, I suggested to him that it was curious to see a doctor who dreads the federal government’s punitive promises to be so enthusiastic about having more marketplace control and an even greater source of prison paranoia by supporting the idea that the entire “system” should be run by the same organization that’s interfering with his practice to begin with.

    Don’t people see that government can’t be the cure for their own ill?

    I see a man deep in a hole desperately trying to ask the federal government to help him dig his way deeper out of the hole. He knows he’s made a pact with the devil, yet he continues to embrace the devil he knows. This is the main reason we all need to simply say NO to the man at the door who says “I from the government, and I’m here to help.”

    Clair Schwan

    Well said. And I would add that in addition to confusing health care with health insurance, many people also confuse the price of health care with the cost of health care. If I make your rich neighbor subsidize your insurance policy (one of the current proposals), I’ve reduced the price for you personally, but the cost is still the same.

  16. damaged justice says:

    Laurie, is this the article you were looking for?

    http://sparkofreason.blogspot.com/2009/02/wheat-head.html

    “Wouldn’t it be fun if the food pyramid were making us fat, sick, deformed, and crazy all at once?”

  17. Grandpmnr says:

    I just watched Fathead and appreciate your take on our heath care crisis. I would just like to add that another way the Government has totally screwed our heath care system is by thoroughly flooding the sector with Government money and anti-competitive regulations. thus destroying a consumer price based market on routine health care.

    So often today, neither patient nor doctor knows or even cares what a course of treatment actually costs! Why then would any health care provider under such a system feel motivated to keep prices under control???

    The best way, the most humane way, to reduce national heath care costs is for all consumers to become informed and cost conscious.
    Reduce each consumer’s costs and collectively we will have more resources to allocate to those seriously ill.

    And it would be sooo simple to reintroduce market forces back into our health care system…….. but it will likely never happen because it would require a transfer of power from corrupt government bureaucrats back to the people.

    John Stossel’s specials from 2007, “Sick In America” illustrated the effects of introducing simple market dynamics into routine health care pretty well. I recommend that all Americans watch it! There is even a copy of “Sick In America” on youtube

    One area in which medical has actually gotten both cheaper and better is elective procedures … precisely because they’re not usually covered by insurance and there is a buyer-seller relationship, as in most other industries. My wife had Lazik — far cheaper and easier than it used to be — and the first thing they discussed was price.

  18. Lisa Sargese says:

    I’m going to have to post your blog on my Facebook wall! When I posted a link to a blog talking about real food as a solution to healthcare in America (http://hartkeisonline.com/2009/09/04/how-to-cut-the-cost-of-healthcare/) someone responded to me that obesity was the problem, that I was a part of it and my high fat diet advice was keeping America overweight 0_o I didn’t know I had that much power…lol. Glad you wrote on this topic so I can share with my fat eating ilk! lol

    Considering that we eat slightly less fat than we did a generation ago, I think we can let you off the hook.

  19. epistemocrat says:

    Great job, Tom.

    Looks like we have been ‘writing in parallel’ on this kindred notion regarding healthcare.

    Check out my latest essays on my blog, Healthcare Epistemocrat, for similar takes on health policy and health reform.

    epistemocrat.blogspot.com

    In particular, ‘Physiological Economics’ and ‘ATP: Aliens, Triangles, and Physicians’ would be the two best essays to peruse first:

    http://epistemocrat.blogspot.com/2009/09/physiological-economics-for-healthcare.html

    http://epistemocrat.blogspot.com/2009/08/atp-aliens-triangles-and-physicians.html

    I agree completely: We need health reform first. Healthcare reform can follow later.

    It’s, as Pollan states, the ‘elephant in the room’.

    I am doing my best to shine light on it.

    Or, as my good friend Keith Norris at Theory to Practice says:

    “No system can be created that will not ultimately implode under the weight of a diseased citizenry.”

    I realized this a few years ago; everything else in health policy wonkering has just been background white noise since then.

    Ancestral Fitness is health reform for me.

    Good stuff, Brent. I enjoyed Taleb’s testimony too. He’s exactly right about the disastrous combination of capitalist profits and socialized losses. A giant “everything is free” system will only socialize more losses.

    We currently have the kind of inexpensive, high-deductible policy that imposes at least some cost for bad health decisions on the consumer, where it belongs. I don’t know what’s in the final Senate bill, but an earlier version would have outlawed exactly that type of policy. All policies would’ve been required to be “comprehensive” — thus insulating even more people from the cost of their own decisions. If you ever needed proof that most politicians have no concept of economics, there it is.

  20. epistemocrat says:

    As one physician likes to say, ‘sunshine (transparency) is the best antiseptic’. Roll back the curtains please …

    Thanks, Tom.

    Best,

    Brent

  21. Ok, this is not 100% on-topic, but your “Cheaper Health Care” got me to thinking about an epiphany I had on the cost of health care (and it’s relationship to the current state of health insurance) about 20 some-odd years ago, and I wrote a post about it in my own blog. http://chl-tx.com/instructorsview/how-to-get-the-best-deal-on-health-care/

    Hope this doesn’t qualify me for lampooning in one of your “inane comments” posts…

    That’s a good post. I especially like the point that insuring against the predictable isn’t insurance; it’s pre-payment. We have exactly the type of insurance your number-crunching points out is the best deal: high deductible, low premium, pay the routine stuff yourself.

    I don’t for the life of me understand people who are willing to pay an extra $500 per month in premiums, year in and year out, because they’re afraid they might, someday, possibly, just maybe, get really sick or really hurt and have to cough up the full $10,000 family deductible.

  22. yellowduc says:

    a simple look around is evidence enough of an obesity epidemic. I’m down with ending grain subsidies, but otherwise, you’re full of sh*t.

    don’t quit your day (or night) job.

    Whatever obesity epidemic exists, we can thank the geniuses in government who told us carbs are good and fat is bad.

  23. Ohreally? says:

    “We require much more medical treatment than we should largely because the federal government told us what we should eat, and by gosh, we listened.”

    People do not eat the way they do because the government prescribes a specific diet. Conduct a poll and pose a basic question that asks which diet the government advocates, most people can barely find the United States on a map let alone guess the diet the government directly advocates. People eat the way they do because of economics and taste. The government enables food manufacturers to profitably produce certain types of foods.

    You suggest that societal behavior is predicated upon the advice of the government; however, if this were true then a mere message change from the government would alleviate the country’s obesity and health epidemic. But we know this is not the case. Even if the message changed, people eat what appeals to their tastes. Corporations have determined that people like to eat foods high in sugar, salt and fat. Hence, most of the foods in the grocery store isle comprise manufactured foods with high quantities of sugar, salt and fat. In addition, manufactured foods are engineered to increase hunger to drive the consumer to even greater levels of consumption.

    Deprivation and exercise do work. The problem is deprivation and exercise are taxing and require a certain amount of self-control, discipline and education. Yes, thanks to government and corporations the system is stacked against the average consumer. Society should not rely upon either the government or corporations to keep society’s best interests in minds. We should help our fellow citizens understand government and corporations promulgate dangerous messages.

    The answer is simple: just say no (thank you, Nancy Reagan). Third world countries do not suffer from outrageous rates of obesity because food supplies are much scarcer then the United States. You simply do not see a fat man amongst the starving complaining that he is an anomaly and his condition is the result of “genetics.”

    Ending grain subsidies is not going to change consumers’ diets, it will merely increase the size of their grocery bill (corporations will still find a way to get their profits). Diet change is a personal choice; therefore, consumers must elect to change their dietary behavior by shopping in only two isles in the grocery store: produce and proteins. Avoid any and all manufactured foods and stick to lean proteins (fish, poultry, and beef) and fresh fruits and vegetables.

    The responsibility for the health of our citizens lies with consumers, government and corporations. Though ultimately the burden is on the consumer, because we have a choice of what we put in our mouths.

    There is, in fact, quite an obesity problem in many third-world countries where people live on cheap starchy foods. It’s well documented in Good Calories, Bad Calories. My wife saw plenty of huge people during her time in the Peace Corps, living in an impoverished country. She also gained weight on the local diet, which was mostly starch.

    And yes, our consumption of carbohydrates increased dramatically once we were told by government bodies that fat is bad, low-fat(therefore usually high-carb) is good, and we should live primarily on grains. Do you really think all those “avoid cholesterol!” messages from the federal government had no effect in scaring people into choosing cholesterol-free cereals over bacon and eggs?

    The argument that no fat people walked out of concentration camps so it’s all about discipline, etc., is one I used to make, but not after reading the actual scientific evidence. You can starve people thin because in the near-total absence of food, insulin will go down and allow fat to be burned for fuel. But newsflash: starvation isn’t good for your health, and you pretty much have to imprison people to make them endure it.

    Most people try — again, government advice — to cut calories while still eating high-carb foods that raise insulin and discourage fat-burning. The result is starvation at the cellular level; that is, the cells run out of fuel because the fat they’re supposed to burn isn’t actually available. The body responds by slowing metabolism, which makes it even easier to gain weight when the dieter finally gives in to the raging internal hunger and eats more.

    This has all been documented in research going back decades.

  24. Ohreally? says:

    “There is, in fact, quite an obesity problem in many third-world countries where people live on cheap starchy foods. It’s well documented in Good Calories, Bad Calories. My wife saw plenty of huge people during her time in the Peace Corps, living in an impoverished country. She also gained weight on the local diet, which was mostly starch.

    And yes, our consumption of carbohydrates increased dramatically once we were told by government bodies that fat is bad, low-fat(therefore usually high-carb) is good, and we should live primarily on grains. Do you really think all those “avoid cholesterol!” messages from the federal government had no effect in scaring people into choosing cholesterol-free cereals over bacon and eggs?”

    So, are obesity rates in third world countries the result of the third world countries’ governments advocating for a high-carbohydrate/low fat diet? Unlikely, it is more likely the obesity rates in third world countries are the result of economic conditions. Starchy foods are cheap.

    Your wife, and in general, gained weight because she consumed more calories than she burned. This is true of any diet irrespective of the food content. A person can go to any fast food restaurant for every meal and not gain weight, so long as they exercise enough to burn-off all the calories they consume. For most people, this type of lifestyle is not practical because of the hours of cardiovascular exercise it would require. Ultimately one’s body composition is based upon whether one is in a caloric deficit or surplus. The type of food one eats controls the difficulty in maintaining either a caloric deficit or surplus.

    “The argument that no fat people walked out of concentration camps so it’s all about discipline, etc., is one I used to make, but not after reading the actual scientific evidence. You can starve people thin because in the near-total absence of food, insulin will go down and allow fat to be burned for fuel. But newsflash: starvation isn’t good for your health, and you pretty much have to imprison people to make them endure it.”

    Actually, recent studies have shown that maintaining a diet at or very near a caloric deficit prolongs life and improves health. Body composition is entirely about one’s discipline, your body reflects what you eat and how much you eat. No one but you controls what goes into your mouth. You may not control your circumstances but you certainly control the choices you make. The government is not placing food directly in your mouth, it is still a choice of free-will.

    “Most people try — again, government advice — to cut calories while still eating high-carb foods that raise insulin and discourage fat-burning. The result is starvation at the cellular level; that is, the cells run out of fuel because the fat they’re supposed to burn isn’t actually available. The body responds by slowing metabolism, which makes it even easier to gain weight when the dieter finally gives in to the raging internal hunger and eats more.”

    This is patently false. You can lose weight under a cyclical carbohydrate diet, comprising complex carbohydrates, in which you vary the level of carbohydrates throughout the week based upon activity levels. Under a high carbohydrate/low fat diet you can achieve weight loss, so long as you vary your level of carbohydrates (the complex variety) and you exercise. Carbohydrates, in general, are not the enemy. It is the choices you make in carbohydrates, some carbs are good and some bad.

    “This has all been documented in research going back decades.”

    Correlation is not causation. Your basic premise “the government spread the message of high carb/low fat, so we have an obese society” over simplifies the nuanced relationship between society and food. The government’s message was not, and will not be, the only factor in determining how people eat. The government could broadcast tomorrow that everyone should eat a diet comprising only whole foods, devoid of starches and grains, and we would still have the same problem we have today. Foods high in sugar, salt and fat cost very little and they are engineered to create hunger and over-consumption. A change in message from the government is not going to change this.

    Your premise, essentially, can be summed up as, “people are automatons and do whatever the government tells them.” If this were true, then why is only a segment of the population affected and why not everyone?

    If people listened every government message, then everyone should be able to read the nutritional labels on the back of foods because it was government mandated and the message was spread by the government. But a vast majority of people cannot read nutritional labels. In addition, the government advocates for a balanced diet with healthy portions of fruits and vegetables but how many people know what these portions are and abide by them. Again, conduct a poll and determine how many people know which diet the government advocates.

    I realize it is convenient and popular to blame the government, but to suggest that the average diet is a direct result from the diet the government advocates, as opposed to just one of many factors, is a short-sighted and misleading. Your point that it is all “the government’s fault” comes across as hyperbole, the media took the ball and ran with it. For the most part, over-weight people do not look in the mirror and contemplate, “well, this is what the government told me to eat . . . .”

    My wife gained weight because carbohydrates raised her insulin and stored calories as fat – which will cause people to eat more, because they’re running out of fuel. She lost the weight soon after returning home and dropping the starchy diet. She didn’t go from disciplined, to undisciplined, to disciplined again in three years. The diet had a biochemical effect.

    Third world governments don’t have to advocate for starchy diets, because that’s all people can afford. Our government did advocate for starchy diets — look at the Food Pyramid, for pete’s sake.

    The calories-in/calories-out theory gets the causality backwards. If you eat foods that tell your body to store calories as fat, you will end up eating more because you run out of fuel. Hunger is a function of available fuel, not calories consumed. If you eat foods that don’t tell your body to pack the calories away as fat, you will be satisfied on less food, because more of what you’re eating is available for fuel.

    Hormones have a huge effect on weight gain that is independent of calories. In lab experiments, researchers have taken animals who were reaching the hibernating season and cut their food supply in half. The result — they got just as fat as the animals who ate twice as much. The hormones ordered their bodies to get fat, and their bodies responded. Given less food, their bodies compensated with slower metabolisms, which is exactly what happens with people who eat less while excess insulin is telling them to get fat.

    Exercising for health is great, but it’s a lousy method of losing weight. Again, that’s been demonstrated over and over in research. I’ve read the papers. The body compensates for the calories lost in exercise. Hard exercise, such as lifting weights, exerts some positive effect by making the muscles more insulin-sensitive.

    What the really recent research suggests is that restricting calories long-term — which once again, is done on IMPRISONED ANIMALS, because it’s not natural to starve – works by lowering insulin levels. Insulin ages you inside. You don’t have to starve to lower your insulin levels; you just have to give up sugar and starch.

    No, it’s patently true. Read the friggin’ research. The effects of insulin, including promoting fat storage and and inhibiting lipolysis (the burning of body fat) are listed in biochemistry textbooks. That’s why type I diabetics waste away without insulin — they can’t store body fat, which insulin enables. Teenage diabetics will risk their health by giving up insulin shots because they know they’ll lose weight. Aneroxics are treated with insulin because it makes them gain weight.

    Some people can lose weight on cyclical carb diets because they’re not insulin-resistant. People who are insulin resistant lose weight much more easily by restricting carbs — again, borne out in recent controlled clinical research, which I take it you haven’t read. Given the prevalence of type II diabetes, it’s safe to say many, if not most, fat Americans are insulin-resistant.

    Correlation is not causation, and not everyone cares what the government tells them to eat. I don’t, since I know better now. But I lived on a low-fat, high-starch diet and gained weight, like many others, because the USDA and FDA told me it was the smart thing to do. It would be a heck of a coincidence if we just happened to drastically increase our consumption of carbohydrates right around the time the government, universities, doctors and countless commercials told us it was the right way to eat.

    How can you claim people eat starch because it’s cheap (which is true) and then excuse our government for making starchy foods cheap through grain subsidies, by the way? Do you honestly believe corn subsidies haven’t led to high-fructose corn syrup being added to nearly everything in the grocery store, including bread? Do you not believe the reams of research that have concluded that HFCS damages the liver and promotes weight gain?

    We are responsible for what we eat, but knowing what to eat requires information, which is why I made the film.

  25. Ohreally? says:

    “My wife gained weight because carbohydrates raised her insulin and stored calories as fat – which will cause people to eat more, because they’re running out of fuel. She lost the weight soon after returning home and dropping the starchy diet. She didn’t go from disciplined, to undisciplined, to disciplined again in three years. The diet had a biochemical effect.”

    She ate more, hence she gained weight. It was not just the macro nutrient breakdown. Many people throughout the world eat primarily a rice based diet without excess weight gain.

    “Third world governments don’t have to advocate for starchy diets, because that’s all people can afford. Our government did advocate for starchy diets — look at the Food Pyramid, for pete’s sake.”

    This is precisely my point. Society’s drive to starch based diets are a result of economic conditions, while government messages, at best, are mostly a secondary driving force.

    “The calories-in/calories-out theory gets the causality backwards. If you eat foods that tell your body to store calories as fat, you will end up eating more because you run out of fuel. Hunger is a function of available fuel, not calories consumed. If you eat foods that don’t tell your body to pack the calories away as fat, you will be satisfied on less food, because more of what you’re eating is available for fuel.”

    The causality of calories-in/calories-out is correct. You are addressing whether someone will be hungry under the philosophy of measuring calories consumed versus calories burned and be driven to eat more. That is a different question. Strict adherence to a caloric deficit will result in weight loss, even if you are hungry (it may not be easy, but it is certainly possible). If you act on that hunger and corrupt your caloric deficit, then you are going to gain weight. The issue you raise is hunger management, not whether eating under a caloric deficit will cause you to lose weight.

    “What the really recent research suggests is that restricting calories long-term — which once again, is done on IMPRISONED ANIMALS, because it’s not natural to starve – works by lowering insulin levels. Insulin ages you inside. You don’t have to starve to lower your insulin levels; you just have to give up sugar and starch.”

    Never argued to the contrary. There are people who voluntarily eat a restricted caloric diet, just because it is uncomfortable does not mean it is impossible. Recommended, probably not.

    “No, it’s patently true. Read the friggin’ research. The effects of insulin, including promoting fat storage and and inhibiting lipolysis (the burning of body fat) are listed in biochemistry textbooks. That’s why type I diabetics waste away without insulin — they can’t store body fat, which insulin enables. Teenage diabetics will risk their health by giving up insulin shots because they know they’ll lose weight. Aneroxics are treated with insulin because it makes them gain weight.

    Some people can lose weight on cyclical carb diets because they’re not insulin-resistant. People who are insulin resistant lose weight much more easily by restricting carbs — again, borne out in recent controlled clinical research, which I take it you haven’t read. Given the prevalence of type II diabetes, it’s safe to say many, if not most, fat Americans are insulin-resistant.”

    Americans are “insulin-resistant” as a result of extreme consumption diets comprised of starches and fat. For people who are not born with diabetes yet develop diabetes, it is a result of diet. And the development of diabetes is reversible, even while consuming complex carbohydrates. You can eat oatmeal, rice, and potatoes as part of a healthy weight-loss diet, so long as your consumption is structured around exercise. But soda, breads, and other such processed carbs cannot be part of that diet. You have simply lumped all carbohydrates together and pronounced them all as dangerous. That is entirely disingenuous. Even a fat American can eat cyclical carbohydrate based diet and lose weight.

    “Correlation is not causation, and not everyone cares what the government tells them to eat. I don’t, since I know better now. But I lived on a low-fat, high-starch diet and gained weight, like many others, because the USDA and FDA told me it was the smart thing to do. It would be a heck of a coincidence if we just happened to drastically increase our consumption of carbohydrates right around the time the government, universities, doctors and countless commercials told us it was the right way to eat.”

    Just because two events correlate in time does not mean that one event caused the other. People hear government messages all the time, yet choose to ignore them. An example of ignoring a government message, during the previous administration as part of sex education the government took an abstinence only position. Guess what? Teenagers still had sex and the message had virtually no measurable effect.

    The fact that you believe that the government message caused people to ramp up their consumption of carbohydrates is purely an opinion (my opinion is that is was a result of economics and advertising from industrial food manufacturers, and the government’s message was fuel for the fire but not the source). If you are able to backup your statement with scientific journals, studies or articles that show a direct causation that the government’s message was the primary factor for the increased rate of carbohydrate consumption then you can assert that relationship as fact. Otherwise you do yourself and your message a great disservice by portraying your opinion as a fact.

    If you can demonstrate with data that the government’s message was the primary factor in increased starch consumption, then I will be persuaded. But I am unwilling to accept an opinion as fact.

    Furthermore, the fact that third world countries have the same problem, as you stated above, with carbohydrate consumption lends more credibility to the idea that economics dictates diet, not the USDA’s food pyramid.

    “How can you claim people eat starch because it’s cheap (which is true) and then excuse our government for making starchy foods cheap through grain subsidies, by the way? Do you honestly believe corn subsidies haven’t led to high-fructose corn syrup being added to nearly everything in the grocery store, including bread? Do you not believe the reams of research that have concluded that HFCS damages the liver and promotes weight gain?”

    I never made an excuse for the government, their enabling of a social ill is deplorable. My point of disagreement with you is merely who owns the primary responsibility of promoting starchy based foods. Your blog contends that US citizens eat they way they do because the government promoted a high carbohydrate/low fat diet, I disagree. While the government promoted such a diet, I believe it was the industrial food industry that, not only promoted, but enabled the obesity epidemic with cheap (subsidized) starchy foods and the people willing to eat their products. And I do not think a change in the government’s message will have a substantial impact on the health and diet of this country.

    Simply, I think you overstate the effect of the government’s advice because economics play a much bigger role in determining one’s diet.

    Gosh yes, I’ll go look up those clinically controlled studies where they randomized people into groups who were either given the government’s dietary advice or not then monitored for the next 30 years to see how they ate. I’m sure there are dozens of those.

    Our grandmothers and great-grandmothers cooked with butter and lard and told their kids bread and potatoes would make them fat. Even our high-school health teacher told us that in the early 1970s, pre-McGovern Committee.

    Poke any average suburban mom in the arm today and she’ll say “Potatoes are good! More complex carbs! Fat is bad!” But that’s just an amazing coincidence. The government’s Food Pyramid and dietary recommendations had zip to do with it. And the number of nutrition articles in the media that quote government dietary guidelines as if they’re gospel have had no effect, either.

    Of course the food industry promoted cheap, starchy food. But they were only able to sell it after people were convinced carbs are good and fat is bad. That’s when every other product in the grocery store was stamped “low-fat!” or “fat-free!” And the fat was replaced with starch and sugar so the food would have a taste.

    As far as calories, take your pick: pearls before swine, can’t pour tea into a cup that’s already full, etc., etc., the point is, you’re simply repeating what you believe about calories in/calories out, and it’s clear you’re far more interested in declaring yourself right than in possibly learning something new.

    I once shared your beliefs on that issue. Then I read up on the science, which you clearly haven’t. Do yourself a favor and pick up a copy of Good Calories, Bad Calories, read the chapters on hormones and fat accumulation, including the studies where animals got fat despite having their food supply cut in half, or were starved to death without losing their body fat, then come back and explain to us how Gary Taubes got the wrong idea after reviewing 100 years’ worth of research. In the meantime, I’m not going to burn out my typing fingers trying to open a closed mind.

  26. gallier2 says:

    Ohreally there several logical fallacies in your post:

    Ohreally said:
    ‘So, are obesity rates in third world countries the result of the third world countries’ governments advocating for a high-carbohydrate/low fat diet? Unlikely, it is more likely the obesity rates in third world countries are the result of economic conditions. Starchy foods are cheap.’

    Ask you why are they cheap? Maybe it is cheaper to import (highly subsidized) wheat, rice and corn from Europe and the US and export bananas/cocoa/coffee than grow your own food.

    Ohreally said:
    ‘You can lose weight under a cyclical carbohydrate diet, comprising complex carbohydrates, in which you vary the level of carbohydrates throughout the week based upon activity levels. Under a high carbohydrate/low fat diet you can achieve weight loss, so long as you vary your level of carbohydrates (the complex variety) and you exercise.’

    Nobody said you can’t lose weight on a high-carb/low-fat diet, it is because it somehow works that it is advocated. But it doesn’t change the fact (backed by intervention studies and innumberable annecdotal evidence) that it is much much easier with a low-carb/paleo oriented diet.

    Ohreally said:
    ‘Correlation is not causation.’

    This applies only to observational studies. The research going back decades Tom was refering to is not limited to observational studies.

    Ohreally said:
    ‘Your premise, essentially, can be summed up as, “people are automatons and do whatever the government tells them.” If this were true, then why is only a segment of the population affected and why not everyone?’

    You should work on your reading skills, that’s not the message of Tom. In fact it is exactly contrary to his thinking and if you had actually seen his movie and read a little bit more his blog, that it would be in contradiction to his libertarian leaning.

    Ohreally said:
    ‘he government’s message was not, and will not be, the only factor in determining how people eat.’ and
    Again, a strawman, dismissing Toms message that government advocacy is a reason for the obesity epidemic by limiting it to being the only factor. Reread what he wrote, he doesn’t exclude other factors, but accuses the government to be a big contributor to that.
    And by the way, you should not forget that the rules put in place by government have to be followed in federal institutions (prisons, schools, hospitals, army, alphabet soup agencies…), even Bill O’Reilly got that argument when Dr.Eades was on his show.

    This said, you’re right when you say that people do not follow government advice to the lettre and fortunately so, or else the situation would be even worse.

  27. Dark-Star says:

    Just to answer your question about premiums –

    “I don’t for the life of me understand people who are willing to pay an extra $500 per month in premiums, year in and year out, because they’re afraid they might, someday, possibly, just maybe, get really sick or really hurt and have to cough up the full $10,000 family deductible.”

    Long story short, especially now in the recession, a $500 a month ‘gamble’ is a lot less ruinous then a $10,000 payout (or more!) should something bad happen.

    Yes – in strictly business terms – such monthly payouts are utter silliness. But accidents happen and diseases strike at the most unpredictable times.

    Well, the cure for that situation is to take the smaller premium and set aside some savings each month. Long term, it’s usually the better deal. I had to shell out the entire $10,000 in one year when I needed surgery and my first daughter was born. But over time, it’s still been much cheaper to take the high deductible.

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