This morning I saw a doctor on television, one of the thousands in this country, who are trying to convince the American people that with a better diet, they would be less likely to suffer from common American ailments like obesity, heart attack, high-blood pressure, diabetes and cancer. These are really wonderful doctors! And, on the other hand, we have really evil food giants, like McDonalds or Kentucky Fried Chicken, who are selling us a lot of bad unhealthful foods. We need the good to fight the bad!
Another narrative is that fat, obese and sick people have no one to blame but themselves. Don’t we live in a free country? Does not everyone have the free choice to eat the kinds of food they want to eat, and buy the foods they want to buy? This libertarian narrative is the single narrative that can most easily be dismissed. There are areas in the country where we have so-called “food deserts”, particularly in low-income neighborhoods. The promise of non-processed, all-natural fresh food is absolutely great, but only if you have the extra money to pay for that or grow it yourself. The truth is that the mass-based food, containing a significant amount of high-fructose corn syrup, which is government subsidized, can always undercut the healthy food of organic farmers in terms of price.
But what about the first narrative? Do we have good doctors and evil giant food corporations (yes, they are evil: consider Monsanto, who force farmers in developed countries to continuously buy their seeds, bring them into unrepayable debt, and suicide)? The answer is no. Even the doctors as part of a very complicated health care system, which is the most inefficient and expensive system in the world, while leaving 35 million people without any health insurance at all- despite Obamacare- contribute to the health crisis in this country.
The disorder of having so much cheap, processed foods which brings all kinds of health problems to the public have to be compensated by significant outlay in health care. Because we do not have a single-payer health care system, we also have a highly inefficient health care system, where doctors are incentivized to earn more income when the patients get really sick. It is certainly not the case that the doctors have the worst intentions in mind for their patients, but in a system, where the rewards in health care go toward greater quantity rather than quality, I am not surprised that the doctor benefit is greater when the patients are sicker. And, of course, we also have the doctors, who write their books and publish their audiotapes, thinking they are doing a great public service, but cashing in particularly on middle-class consumers, who tend to be more health-conscious anyway (and failing to reach out to lower-income, obese people, who really need it). But doctors are not the main culprits, but the many powerful administrators in the hospital, insurance and pharma bureaucracy, who also have the incentive to maximize their revenues by treating sicker patients. Health care capitalism is an internal contradiction if we define health care to be a human right with the interests of ordinary patients at heart.
Patients themselves are encouraged to delay their medical treatment as long as possible, because the high-deductible and high co-payment health care plans deter particularly lower income people from seeking medical treatment. By not bringing lingering chronic health problems under medical attention, more severe diseases develop, which require more intense and more expensive treatments in the emergency room.
And, finally, we should not omit the irrational food production system in this country, where there are no restrictions to GMO and to adding high-fructose corn syrup. All of our breads taste much sweeter than in Europe. Chickens are larger than elsewhere, and the tomatoes barely have any natural taste to them. The government really subsidizes unhealthful food, because we have giant corporations like Pepsi, Coca Cola, McDonalds, Wendy’s and others, who make sure that the politicians only pass policies which are friendly to their interests. In a capitalist society, there is a constant need to increase output, because that is the source of all profits. But producing more food to feed the growing population is apparently not enough. What they want to do is to increase the calories consumed per person. The epidemiological crisis derives from the profit logic of our capitalist economic system!
The only upside to this story is that creating and then treating many obese people is really good for the economy: agricultural companies can continue to make a giant profit, because they can receive the generous government subsidies, and sell large quantities of unhealthful (and addictive) foods to US and foreign consumers. (Though, there are not many jobs behind it, so not much trickle-down either: 99% of all new income since 2008 goes to the richest 1%.) The health care system can remain highly profitable, because in addition to the many old patients with chronic and severe illnesses, there is also a lot of health care demand from non-elderly obese populations. And the health care system, indeed, has many jobs ranging from the hospital janitors to clerks, nurses, doctors and administrators. What is good for the economy is not necessarily good for society.
So how can we disentangle this food-medical industrial complex, which works so nefariously in tandem with each other, making us physically (food) and financially (medical) poorer? The health care system should be changed by establishing a single-payer health care system. Many layers of the profit incentive should be removed out of the health care system. Physicians should join together in cooperatives, and provide low-cost medical care to more patients with the intent to maximize health and not profits. Then we can also spare ourselves the doctor TV commercials. The agricultural system should change incentives by having the government charge much higher taxes on unhealthful foods (processed, fast food, soda etc.) and use the revenues to subsidize healthful foods (organic, fruits, vegetables etc.). The agrarian lobby will kick and scream, and so will the private health insurance, hospital and pharma lobby, but people have to ask themselves whether the greater social good is more important than the private financial interest.