Recently on 2/11/21 Supposedly preoccupied with costs and how to reduce them, the various committees involved in producing health care legislation have all but ignored the, well, husky animal in the room: fat people.
With an epidemic of obesity enlarging the country, Congress — like many Americans blithely ignoring the gradual tightening of their waistbands — is in denial.
The answer, by some accounts, is astoundingly simple: No one wants to tell Americans the bad news.
“The inability we have to address this issue head-on is because we’re uncomfortable with the reason people are overweight,” said Christine Ferguson, professor of health policy at The George Washington University School of Public Health and Health Services. “We haven’t come to grips with whether it is their own fault or a combination of factors.”
Just this week, a study in the journal Health Affairs reported that medical spending averages $1,400 more a year for someone who’s obese than for someone who’s not. The Centers for Disease Control and Prevention convened its inaugural conference on obesity in Washington within a healthy walk of the Capitol and produced a barrage of graphs, studies and scary statistics all showing that Americas are getting fatter faster and are causing diseases that cost an estimated $147 billion last year, nearly 10 percent of all medical spending in the country.
Still, drafts of House and Senate bills include only a handful of programs specifically targeted at fighting obesity. And the Congressional Budget Office does not consider the programs a cost saving — though that’s what their ultimate goal is — a bit of accounting that further diminishes political will.
There is also, of course, the glass house factor — as in, people who have their own issues shouldn’t be lecturing others, especially if they’re constituents. And Congress is no model for healthful living.
Long hours and high stress only help already hefty members pack on more pounds. During heated negotiations over the climate and energy bill last month, House Speaker Nancy Pelosi wheeled carts of Dove ice-cream bars into meetings to win support through members’ stomachs. And late-night votes last week required clerks to bring piles of pizzas into the Senate cloakroom.
Members of the Senate Finance Committee like to snack on Doritos, potato chips and beef jerky — among other things — while considering the future of health care, and on Wednesday they thoughtfully arranged for at least six dozen doughnuts to feed reporters covering the deliberations.
At least some of the people actually working on health care reform are relatively good models — there’s Montana Democratic Sen. Max Baucus, a 67-year-old ultra-marathoner who completed his ninth marathon in under five hours last year, and fit Republicans like Iowa Sen. Chuck Grassley and Maine Sen. Olympia Snowe. On the House side, Pelosi saves the pizza and Dove bars for others and manages to make time for early-morning speed walking around the Mall.
But from there, it can get ugly. The 5-foot-4 New York Democratic Rep. Jerrold Nadler opted for gastric bypass surgery after weighing in at 338 pounds. Rep. Jesse Jackson Jr. has admitted that a laparoscopic duodenal switch procedure helped the 5-foot-9 Illinois Democrat drop almost 80 pounds from his 262-pound frame. And the pudgy, outspoken Massachusetts Democratic Rep. Barney Frank dropped 100 pounds on a crash diet while working as a special assistant for former Boston Mayor Kevin White in the late 1960s. Today, he frequently jokes about his struggle to lose weight.
“I wish I didn’t have the five-minute rule. And I wish we didn’t have so many members. And I wish I could lose weight without dieting,” Frank said during a slow bailout hearing last spring.
Not necessarily the best attitude, according to Ferguson.
“There are a lot of people who are in the Senate, both staff and members, who struggle with their weight on a daily basis, and they beat themselves up because they think it’s their fault,” she says. “This is a health care issue, not a personal willpower issue or cosmetic issue.”
But totally eliminating personal responsibility is a political loser, especially in many of the conservative districts that have the biggest weight problems. The most obese areas of the country — Mississippi, Alabama and West Virginia — are also places that are traditionally skeptical of government intervention, even if it’s only offering free diet advice.
“There also has to be an element of personal responsibility in health care reform,” said Rep. Ron Kind (D-Wis.), another runner who has made obesity something
of a personal issue. “Don’t just expect Washington to come up with all the answers to improve the health care system.”
Add those types of conflicting attitudes to data showing that obesity disproportionately affects poor and minority communities, and the political danger alarms start ringing.
One way to avoid the whole complicated personal responsibility thing would be to adapt a variation of the old pro-gun motto: People don’t make people fat; junk food does. But that runs into another problem: the food and beverage industry.
Some of the most radical proposals for combating obesity — like raising taxes on sugary drinks — have been all but dismissed as political impossibilities. No surprise why: The food and beverage lobby spent more than $20 million in Washington lobbying in 2008 and contributed more than $15 million to political campaigns in the 2008 cycle, according to the Center for Responsive Politics.
Earlier this month, a coalition of more than 100 industry associations and dozens of food companies launched an advertising campaign against the proposed beverage tax. “We all want to improve health care, but taxes don’t make anyone healthy,” said Susan Neely, president and CEO of the American Beverage Association, invoking a fear far greater than fat. “Education, exercise and balanced diets do that.”
For the most part, Congress followed the industry’s recommendation. Legislation passed by the Senate Committee on Health, Education, Labor and Pensions, chaired by Tom Harkin, includes up to $10 billion in annual funding for community wellness programs and a provision requiring chain restaurants to list calorie counts. House legislation goes further, with an amendment by Kind calling for a national strategy to combat obesity.
But the spry, pedometer-wearing Harkin — with Kind, one of the few in Congress talking about the country’s growing weight problem — thinks it’s a beginning.
“I just want a state that gives you enough information and sets up a structure where you can choose to be healthy.” and so that’s why fat lives matter