Personal Responsibility for Healthcare?

[FIREmenow]

Yeah, healthy choices are on the menu, but what do their commercials show? A burger with cheese and sauce oozing out of the bun. Food porn.

People are conditioned to place high value on certain foods -- sometimes through generations of culture. On the Ken Burns Vietnam series, there was a Japanese-American veteran who recalled how a family cooking rice in a village caused him to stop and ask for some, he missed rice so much while in the Army.

I don't buy this. It's still a DECISION. They are not strapped to a chair and forced to eat it.

Sure, it's the EASY decision, but choosing to be personally responsible is never the easy choice. Regardless of how enticing, one is still deciding and making choices. I'd love to sit on the couch all day and drink beer, but I know that's a bad choice.

Everybody's a victim, right? Evil corporations are responsible.

Education (not indoctrination) first, and personal responsibility immediately following.

 

[Midpack]

Yeah, healthy choices are on the menu, but what do their commercials show? A burger with cheese and sauce oozing out of the bun. Food porn.

People are conditioned to place high value on certain foods -- sometimes through generations of culture. On the Ken Burns Vietnam series, there was a Japanese-American veteran who recalled how a family cooking rice in a village caused him to stop and ask for some, he missed rice so much while in the Army.

Burgers are an American tradition, no doubt about it. But again, some of the burger creations the big franchises offer up to capture market share have -- again -- a vaguely pornographic quality. Are sales flat? Add bacon to that double cheeseburger. Want to sell more? Throw some onion rings on top. Some of the deluxe burgers have well over 1000 calories per sandwich.

McD's, BK and others are not just in business to feed people -- their goal is to bring in more diners than the restaurant down the street. So they'll keep on rolling out that bigger, fattier, piled-higher creations in a kind of fast-food arms race. I think I've noticed Mickey backing away from this, but then you have Carl's and others raising the ante.

One of the primary themes of the ad world is, "go ahead -- indulge. You're worth it." It attaches consumption to personal worth. Ad agencies are skilled at wielding the power of suggestion, and they use it to promote indulgence, in food as well as other consumer products. If you're watching commercial TV for any length of time, you'll get that cue to indulge over and over. It can be hard to resist even (especially?) if you're barely aware of it.

We’re just going to agree to disagree. You’re sold on the ‘if I make bad choices it’s someone else’s fault’ idea - if I make unhealthy choices it’s restaurants, advertising, culture, profits - not me.

What is the customers responsibility in all this to you?

Restaurants will provide and promote whatever we actually buy, they have no choice if they want to stay in business. Calories are right on the menu, nutritional info is readily available, doctors and journalists have warned us a thousand times and a thousand ways about diet, obesity, eat healthy, exercise more - anyone who doesn’t know better by now is willfully ignorant.

Again, if there was a tidal wave of people buying healthy salads or some other healthy choice at fast food restaurants and skipping double bacon cheeseburgers, they would transform their menus as quickly as possible. Their ad campaigns would follow suit, and the demand would make salads more profitable instead of cheeseburgers.

 

[FIREmenow]

We’re just going to agree to disagree. You’re sold on the ‘if I make bad choices it’s someone else’s fault’ idea - if I make unhealthy choices it’s restaurants, advertising, culture, profits - not me.

What is the customers responsibility in all this to you?

Restaurants will provide and promote whatever we actually buy, they have no choice if they want to stay in business. Calories are right on the menu, nutritional info is readily available, doctors and journalists have warned us a thousand times and a thousand ways about diet, obesity, eat healthy, exercise more - anyone who doesn’t know better by now is willfully ignorant.

Again, if there was a tidal wave of people buying healthy salads or some other healthy choice at fast food restaurants and skipping double bacon cheeseburgers, they would transform their menus as quickly as possible. Their ad campaigns would follow suit, and the demand would make salads more profitable instead of cheeseburgers.

+1000

 

[flintnational]

Part of the health problem this country has is the economy's tendency to promote unhealthy, nutritionally unbalanced products. When was the last time you saw a television commercial for kale or broccoli? McDonalds and Burger King, conversely, have a huge ad budget.

Then there's the tendency for makers of processed food to add high levels of sugar or salt to make their product more appealing. Check the sodium content in a can of soup.

People who want or need cheap, convenient dietary options may have little choice but to consume foods that, in the long run, are bad for them. And producers of those products spend big bucks to stimulate that market. It's easy to blame the consumer in this case, but some blame has to rely on the producers of unhealthy products as well.

It's worse than many think. The attached list of farm subsidies does not include any green vegetables (unless you include tobacco, number 14). The only subsidized fruit on the list is apples at number 20. The majority of the list is grains and seed oil crops. So we subsidize your fruit loops and margarine but not your broccoli and kale.

Edit to add: Finished the thread and agree with those that believe grocers and restaurants will provide what consumers want.

 

[flintnational]

If we allow a political framework to set lifestyle choices for health insurance, we have examples of the outcomes we will get. And, it may not be what you might think.

- See my post above about farm subsidies. Heck we still subsidize tobacco

- Someone mentioned school lunches. How hard can it be to feed our children healthy food? But we don't.

- Finally, WIC (the old food stamp program) may be the worst. We allow some of the most vulnerable in our society to use their precious resources to buy soda, candy and fruit loops. WIC only excludes the purchase of hot food, liquor and tobacco. Soda is just fine.

So, now imagine a "lifestyle" program from the same system that brought you the above. Soda and fruit loops might be the required "healthy" diet.

Sorry for the rant and long post.

 

[LOL!]

Who wouldn't want the Affordable Gym Act?

The gyms would be government sponsored with all the Personal Trainers paid by your taxes. Folks who had waist measurements less than half their height (example 6 ft tall, waist 32 in) would get a tax credit, too, as long as they could show they spent at least 3 hours in the gym every week.

Bronze Plans would cost more than Gold Plans, too.

 

[Mr._Graybeard]

Hey, I'm not saying people don't have the option to avoid unhealthy food. What I am saying is that the food industry works hard to convince people to eat the stuff -- and some people are vulnerable to that. It's just funny to read calls to penalize people for their behavior while a major sector in our economy spends big bucks to encourage that same behavior. Maybe a broader approach to the problem would be in order.

 

[athena53]

Finally, WIC (the old food stamp program) may be the worst. We allow some of the most vulnerable in our society to use their precious resources to buy soda, candy and fruit loops. WIC only excludes the purchase of hot food, liquor and tobacco. Soda is just fine.

I know- I see this at the grocery store near me. (The monitor, which is easily visible, shows when it's paid by an EBT card, and the other dead giveaway is when they pay cash separately for non-food items.) I think WIC (Women, Infants and Children) is a little stricter - the Food Stamp program was renamed SNAP (Supplemental Nutrition Assistance Program) and it does allow pop, candy and chips. Prohibiting those would be a good place to start.

But some well-thought-out nudges need to be tried in various places in order to find out what might work. Suppose, for instance, that public schools were incentivized to provide a plant-based (beans, rice, salads, veggies, fruits) to students and no meat, what would happen? Would kids grow up used to such a diet? Or would they refuse to eat anything at school?

If they refuse to eat it they're not hungry enough. I know that's harsh but I was raised in a family where Mom cooked good food and if you didn't eat the main dish you didn't get dessert (and Mom made great cookies). No one got served special dishes if they didn't like the main offering. My four siblings and I are now in our late 50s/early 60s, healthy, normal weight and active.

Or, if Johhny/Susie is such a special snowflake that they need to eat meat, let the parents send them to school with a lunch that fits their needs. Radical, huh? For the record, I think it would be a challenge to feed growing bodies on a strictly vegetarian diet, especially those in athletics, but there's a lot we could do to cut out empty calories.

And one more thought (yes, I'm passionate about healthy eating habits even though I OD'd on cookies last month): there ARE more healthy options in fast food than there used to be. Chipotle has been mentioned and I'm a big fan of Subway on my road trips. (It was a favorite of my parents, too.) Some convenience stores have salads and containers of fresh veggies. I can't remember when I was last in McDonald's. So, the fast food people know people like me are out there.

 

[audreyh1]

Hey, I'm not saying people don't have the option to avoid unhealthy food. What I am saying is that the food industry works hard to convince people to eat the stuff -- and some people are vulnerable to that. It's just funny to read calls to penalize people for their behavior while a major sector in our economy spends big bucks to encourage that same behavior. Maybe a broader approach to the problem would be in order.

Exactly - a huge amount of the economy is marketing unhealthy food to the US population, and companies have spend millions, probably billions, engineering food that is very strongly appealing, as well as pushing the messages about “treating yourself or loved ones”, “you deserve it”, etc.

I was suspicious of advertising from a young age and avoid it, but most people are bombarded by it and obviously it works otherwise companies wouldn’t spend nearly so much advertising to the consumer.

What kind of cereal did you eat growing up? Did you have a parent who kept the sugary cereals away? Or did you consume a bunch of that stuff as a growing child? What impact did it have on your health? And did you simply stop eating it as an adult?

 

[Mr._Graybeard]

I know- I see this at the grocery store near me. (The monitor, which is easily visible, shows when it's paid by an EBT card, and the other dead giveaway is when they pay cash separately for non-food items.) I think WIC (Women, Infants and Children) is a little stricter - the Food Stamp program was renamed SNAP (Supplemental Nutrition Assistance Program) and it does allow pop, candy and chips. Prohibiting those would be a good place to start.

Sure, I'd be all for limits on what SNAP benefits can buy. But Coca-Cola isn't so crazy about the idea.And they have an army of lobbyists.

Remember when New York City tried to limit the size of soft drinks people could buy at convenience stores? You'd have thought the city was infringing on the right to vote. And Coke's attorneys were right in the middle of the uproar, fighting it tooth and nail.

 

[FIREmenow]

Exactly - a huge amount of the economy is marketing unhealthy food to the US population, and companies have spend millions, probably billions, engineering food that is very strongly appealing, as well as pushing the messages about “treating yourself or loved ones”, “you deserve it”, etc.

I am sorry, I still don't see any of this as an argument for why people are not being personally responsible (maybe you didn't mean it that way). Peoples' decisions are what is driving those millions....

This is analogous to the current group of people raging against Apple to make their devices protect kids from "damage".

Why is it Apple's responsibility to parent their kids? Just because they can't get a spine, have some parental-responsibility and tell your kids "no", or limit screen time? Yes, it's certainly a very pressing problem with kids, but it should not be Apple's problem.

Never mind the fact that whatever Apple changed would necessarily make it less convenient for everyone else.

This just bugs me (sorry, and sorry for the tangent).....

 

[athena53]

What kind of cereal did you eat growing up? Did you have a parent who kept the sugary cereals away? Or did you consume a bunch of that stuff as a growing child? What impact did it have on your health? And did you simply stop eating it as an adult?

I know your question wasn't directed at me but Mom refused to buy "pre-sweetened" cereals (that was what they called them then) because they were more expensive. My youngest brother once secretly tucked a box of Rice Honeys into the cart and when she found out she made him pay for it. Now it's almost impossible to find cereals that don't have sugar, high-fructose corn syrup, or sugar substitutes such as aspartame and sucralose.

 

[audreyh1]

I am sorry, I still don't see any of this as an argument for why people are not being personally responsible (maybe you didn't mean it that way). Peoples' decisions are what is driving those millions....

No, it’s not about arguing against personal responsibility. It’s pointing out the big picture when folks start talking about penalizing folks by increasing health care costs when you’ve got a big industry working hard to get them to make poor choices.

People are suddenly far less responsible than they were 40 and 50 years ago? I’m sure some people think so. I think one can argue that plenty of things have happened to act on the US population and created an significantly unhealthier population.

 

[easysurfer]

I believe that about 90-95% of one's lot in life comes to personal choices. Yet at the same time, there are events which happen out of the blue that aren't dependent on a person's choice.

When comes to healthcare, I think the US has an identity crisis. That is, is healthcare a right or a privilege? Are all people created equal or some or more equal than others?

 

[athena53]

I actually don’t believe it would work because health is a lifelong project and when many folks are young they think they have good enough health and don’t even need health insurance - so why are they going to make sacrifices, just like so few save for retirement. I really don’t think a potential penalty way down the road is going to motivate them.

Yeah, I think part of the problem is that more activity and healthier eating have more long-term than short-term benefits for the younger people in the population. It's usually when you hit your 50s that you see the price of decades of poor choices: Type 2 diabetes, heart problems, high BP, knee and back issues (frequently made worse by overweight), etc. I'm not sure how much we'd save in healthcare costs if the under-40 population all got their weight within normal ranges, ate healthier and got regular exercise. The big payoff is a few years down the road.

 

[Midpack]

Hey, I'm not saying people don't have the option to avoid unhealthy food. What I am saying is that the food industry works hard to convince people to eat the stuff -- and some people are vulnerable to that. It's just funny to read calls to penalize people for their behavior while a major sector in our economy spends big bucks to encourage that same behavior. Maybe a broader approach to the problem would be in order.

The food industry works hard to convince people to eat what they've demonstrated they want by what they actually buy/choose. Food photography is an industry, they use lighting, gloss, artfully arranged ingredients, angles, etc. to maximize appeal - and throw in a baby, puppy, kitten and/or gorgeous twenty something to seal the deal. Yet it works generation after generation.

Name me one single food/dish that doesn't look FAR better on the package or menu than the actual. Doesn't matter if it's a healthy salad, some moderately healthy item or a double bacon cheeseburger. Seriously, name just one.

Restaurants sell food, that's their business, and they can't do it by trying to get you to buy anything you don't want. Advertisers are going to artfully promote whatever products bring in customers, all that language, photography and staging is not going to make people buy salads. People have tried and failed over and over.

We're having a chicken and the egg argument, and though somewhat related to the OP, if you want to keep at it we should probably start another thread. Be my guest.

 

[Rianne]

DH is a Phd food scientist, retired but keeps his foot in the field with at home LLC consulting with processed food companies and food science departments at universities. He considers this fun and keeps mind active.

I have argued and argued over our 33 yrs. of marriage how awful the processed food industry behaves and creates the worst possible definition of food. His career supported us very well and gave us FIRE, but what the processed food industry creates with fake colors, additives, flavors and texture is frightening. And don't get me started on the corporate farming industries. Monsanto...I will not get political or offend stock holders here. Even the healthy protein bars with 20 g of protein are pretty bad. Full of sugar and high protein diets are not that healthy. A friend of ours, also a food scientist worked at a large flavor company. She told me 1 cup of a blueberry flavor would kill a horse. Granted, they only use a fraction of cup for flavoring muffins or cereal or whatever. We get dozens of food science company magazines and I cringe when I read the articles. My suggestion is get one of these magazines, read the articles about food additives and how food is made from chemicals.

 

[mpeirce]

It don't really care if other people eat or act in a certain way.

All I ask is that that respect my choice to eat or act in the way I choose.

Seriously, I don't care if you eat a plant based diet or one based on cheese three times a day, make your own choices and live (or die) with those choices.

 

[Midpack]

It don't really care if other people eat or act in a certain way.

All I ask is that that respect my choice to eat or act in the way I choose.

Seriously, I don't care if you eat a plant based diet or one based on cheese three times a day, make your own choices and live (or die) with those choices.

I'd agree completely if we didn't have to largely pay for each others health care - back to the OP.

 

[Bir48die]

+1000

Even on this board with so many "well to do" members, there are many discussions about managing income to avoid going over ACA limits. Imagine if the entire country had to "pay" for their care or insurance. All of a sudden lifestyle choices would have a cost associated with them, and in general people would try and figure out a way to lower those costs.

I would like to comment on this but can't. Last discussion cause me to get a "demerit"

 

[Chuckanut]

It's worse than many think. The attached list of farm subsidies does not include any green vegetables (unless you include tobacco, number 14). The only subsidized fruit on the list is apples at number 20. The majority of the list is grains and seed oil crops. So we subsidize your fruit loops and margarine but not your broccoli and kale.

That is a huge danger, IMHO. Note this comment by the person who lead the group of scientists charged with developing the first food pyramid. As you will see this list of 'healthy' foods was heavily influenced by those with a financial interest in certain foods.

IMHO, it is highly probable that they will try to influence the list of 'healthy' behaviors to protect their financial interests. This was done with the first food pyramid:

Who Invented the Food Pyramid?

Emphasis added..

When our version of the Food Guide came back to us revised, we were shocked to find that it was vastly different from the one we had developed. As I later discovered, the wholesale changes made to the guide by the Office of the Secretary of Agriculture were calculated to win the acceptance of the food industry. For instance, the Ag Secretary’s office altered wording to emphasize processed foods over fresh and whole foods, to downplay lean meats and low-fat dairy choices because the meat and milk lobbies believed it’d hurt sales of full-fat products; it also hugely increased the servings of wheat and other grains to make the wheat growers happy. The meat lobby got the final word on the color of the saturated fat/cholesterol guideline which was changed from red to purple because meat producers worried that using red to signify “bad” fat would be linked to red meat in consumers’ minds.


Where we, the USDA nutritionists, called for a base of 5-9 servings of fresh fruits and vegetables a day, it was replaced with a paltry 2-3 servings (changed to 5-7 servings a couple of years later because an anti-cancer campaign by another government agency, the National Cancer Institute, forced the USDA to adopt the higher standard).


Our recommendation of 3-4 daily servings of whole-grain breads and cereals was changed to a whopping 6-11 servings forming the base of the Food Pyramid as a concession to the processed wheat and corn industries. Moreover, my nutritionist group had placed baked goods made with white flour — including crackers, sweets and other low-nutrient foods laden with sugars and fats — at the peak of the pyramid, recommending that they be eaten sparingly. To our alarm, in the “revised” Food Guide, they were now made part of the Pyramid’s base. And, in yet one more assault on dietary logic, changes were made to the wording of the dietary guidelines from “eat less” to “avoid too much,” giving a nod to the processed-food industry interests by not limiting highly profitable “fun foods” (junk foods by any other name) that might affect the bottom line of food companies.
​

 

[GTFan]

It never ceases to amaze me that we have this debate in our country. Frankly, it doesn’t make us look very smart because, it’s pretty clear what the major fixes are; they’re being practiced by multiple countries around the globe. Unfortunately, this seems like just another “problem” for which there is clearly a technical solution which is not implemented because of partisan politics.

Yeah that's what kills me, it's not like we don't have a bunch of working (and superior) examples to use. Almost anything would be better than what we have at this point, at least for the folks that don't get that gravy train subsidized HC from their employer.

Speaking of which, I've said that before in other threads - these responsibility, skin in the game, etc. commentaries are all well and good but nothing will change as long as the (relatively) cheap employer-provided insurance gives all those employees no incentive to want change.

 

[2HOTinPHX]

DH is a Phd food scientist, retired but keeps his foot in the field with at home LLC consulting with processed food companies and food science departments at universities. He considers this fun and keeps mind active.

I have argued and argued over our 33 yrs. of marriage how awful the processed food industry behaves and creates the worst possible definition of food. His career supported us very well and gave us FIRE, but what the processed food industry creates with fake colors, additives, flavors and texture is frightening. And don't get me started on the corporate farming industries. Monsanto...I will not get political or offend stock holders here. Even the healthy protein bars with 20 g of protein are pretty bad. Full of sugar and high protein diets are not that healthy. A friend of ours, also a food scientist worked at a large flavor company. She told me 1 cup of a blueberry flavor would kill a horse. Granted, they only use a fraction of cup for flavoring muffins or cereal or whatever. We get dozens of food science company magazines and I cringe when I read the articles. My suggestion is get one of these magazines, read the articles about food additives and how food is made from chemicals.

This is so true....so much goes into making junk food taste so good dispite how bad it for us....we are truly doing ourselves in all for $$$$.

 

[Midpack]

It never ceases to amaze me that we have this debate in our country. Frankly, it doesn’t make us look very smart because, it’s pretty clear what the major fixes are; they’re being practiced by multiple countries around the globe. Unfortunately, this seems like just another “problem” for which there is clearly a technical solution which is not implemented because of partisan politics.

Yeah that's what kills me, it's not like we don't have a bunch of working (and superior) examples to use. Almost anything would be better than what we have at this point, at least for the folks that don't get that gravy train subsidized HC from their employer.

Speaking of which, I've said that before in other threads - these responsibility, skin in the game, etc. commentaries are all well and good but nothing will change as long as the (relatively) cheap employer-provided insurance gives all those employees no incentive to want change.

+1. Nothing wrong with repeating it, there are always new members, but we’ve had this discussion for many years. We’re the only developed country in the world that can’t figure it out despite almost 60 examples all over the world, and we actually pay way more (indirectly so many don’t realize it) than every other country in the world with poorer outcomes than most. All goes back to campaign finance (more than partisan politics IMO)...

Unfortunately what Churchill observed is still true -’You can always count on Americans to do the right thing – after they’ve tried everything else.’

 

[GTFan]

This is so true....so much goes into making junk food taste so good dispite how bad it for us....we are truly doing ourselves in all for $$$$.

Corporations are driven by shareholder and exec pay responsibilities, not social ones. And that is even more true for the food industry from what I've seen. Fortunately there are some good, socially-conscious corporations in this business but the 'give them more sugar and fats' players far outnumber them.

And yeah I know, supply and demand. Doesn't change the fact that responsibility should be biased way more on the supply chain than demand IMO. Even more so when you consider that most of the consumers wanting all that cheap junk food can't afford or don't know better because that's all they can easily find.