
Majority of US Healthcare Costs Are Caused by Bad Eating Habits - jyu
http://www.nytimes.com/2009/09/10/opinion/10pollan.html
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edw519
_There’s lots of money to be made selling fast food and then treating the
diseases that fast food causes._

All the more reason for each of us to take more personal responsibility for
our food and our health. I wouldn't count on anyone else helping me much with
either any time soon.

~~~
Retric
Most health care spending in the US is caused by aging. Most heath care
spending is paid for by the state, local, or federal government (50%+). Most
heath care spending is caused by people living longer. Most heath care
spending is caused by better and more expensive treatments that we did not
have 100 years ago. Smokers have shorter lives and spend less on heath care
over their lifetime. Smokers cause a huge short term spike in heath care
costs.

PS: There are plenty of ways of slicing it, but excluding sudden death we are
all going to spend a lot of money on heath care and we are all going to die.

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thesecret
I work in healthcare and this is my understanding from the responses of
patients that I encounter - fast food is cheap. One of the families I work
with, both parents are diabetic and the children are all overweight. I asked
them about their eating habit and the answer was : McDonalds for breakfast,
lunch, and dinner. Why? Because it's cheap to eat at McDonalds for a family of
4 than it is to buy vegetables at the market....for 3 bucks, you get a whole
meal for one person. $3 at Safeway, you only get..a cabbage and some tomatoes?

They didn't understand that their eating habit is going to cost them much more
in health expenses

~~~
lionhearted
I've heard this before, but it isn't true. I make one cup of Quaker oatmeal
most mornings - cost is around 11 cents. I buy tea and coffee in bulk -
another 11 to 25 cents or so. My entire breakfast costs less than 50 cents,
and all it requires is boiling water or 3 minutes in the microwave. It's
faster than a drivethrough.

Rice and beans are practically free they're so cheap. I buy turkey or chicken
cold cuts, again very cheap. I buy "turkey dogs" (hot dogs, but made of
turkey) when they're on sale for something like $2 per six. 3 of them is 210
calories, almost all protein, for about $1. I buy whatever fruit is on sale,
fruit isn't so expensive either. I don't like bread, but wheat bread is cheap.
My girlfriend sometimes cooks a huge pot of stew that sits on the stove for
3-4 days and serves 10+ meals for under $10.

I'm not sure how much eggs are per dozen - maybe a dollar or two?

It's possible to eat very quickly and inexpensively. The problem isn't cost,
it's a mix of education and being willing to forsake convenience/delay
gratification. Our culture is decent at the former, but quite bad at the
latter.

~~~
coderdude
I agree, I find that going to the grocery store and paying upfront for my
meals to come is more cost effective than constantly buying fast food. Fast
food is not very cheap at all actually. Unless you're buying from the dollar
menu, in which case it's $3... for your kids. It's hard to get full on 99c
fries and a mini burger.

~~~
nitrogen
To provide a single anecdote, I am able to get full on two dollar menu items.
You don't have to stick to what they define as a "meal" (i.e. burger, fries,
soda). If I'm short on time or cash, I can get two double cheeseburgers, or a
chicken sandwich plus a salad, for less than $3, drink a glass and a half of
water with it, and be full until the next meal. Whether just anyone can do
that is another question.

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hughprime
The headline "Majority US Healthcare Costs Are Caused by Bad Eating Habits" is
not the headline of the article, nor is this supposed fact stated anywhere in
the article.

I very much doubt it's true, and I don't think it's well-defined enough to
even be false.

~~~
anigbrowl
_(...) the fact that the United States spends twice as much per person as most
European countries on health care can be substantially explained, as a study
released last month says, by our being fatter. Even the most efficient health
care system that the administration could hope to devise would still confront
a rising tide of chronic disease linked to diet._

This is a key argument in the article and the headline seems like a reasonable
paraphrase of that.

~~~
joe_the_user
At the minimum, a lack of physical activity has to be included as a factor in
this along side diet.

~~~
anigbrowl
Haven't you heard? The new wisdom is that exercise makes you even fatter.
Well, I exaggerate, but I'm referring to a recent Time story saying 'exercise
won't make you thin' (the idea being that you still need to eat less or you'll
just get hungrier and never lose weight).

You are quite right, but 'pin the tail on the donkey' seems to sell better :-/

~~~
ars
It's not actually new wisdom.

We are just going back to what we knew 40 years ago.

Basically, between 1960 and 2009 we thought exercise will make you thinner.

Outside those times exercise was thought to increase appetite.

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ZeroGravitas
The somewhat confusing thing is that people focus so much on "losing weight".
Even if exercise makes you hungrier, it's been shown quite conclusively to
make you _healthier_.

If you really want to _lose weight_ without regard to any other factors then
take up smoking as it reduces your appetite. Or just cut off your legs.
Certainly don't build up any muscle mass as that will only make you heavier.

~~~
joe_the_user
Also, lack of exercise is correlated with weight gain in larger population and
consequent lack of health.

People confuse this the statement that later exercise make up for a person's
lack of exercise at a given period. This might or might not be true but it
doesn't follow from the first statement. Lack of exercise over longer periods
might screw people in ways that we have no idea how to fix.

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RyanMcGreal
Are American eating habits really that significantly different from Canadian
eating habits to explain the fact that the US spends twice as much per capita
as Canada spends - notwithstanding the 50 million Americans without coverage?

~~~
ankeshk
Comparing Canada vs USA obesity rates shows that YES indeed eating habits seem
to be very different:

[http://eaves.ca/2008/07/08/fatness-index-canada-vs-united-
st...](http://eaves.ca/2008/07/08/fatness-index-canada-vs-united-states/)

~~~
potatolicious
As a Canadian living in the USA I have to say, we don't eat that differently
in Canada, the big difference is we eat _less_.

Canada is just as full of greasy, nutrtionless, processed-to-hell food as
America is, but we simply do not consume as much of it, from my observations.

When I moved to the USA I immediately (over 4 months) gained a buttload of
weight (both figuratively and literally...). This is due to my bad habit of
finishing everything on my plate. I've since fixed this and my weight is
rapidly decreasing. Yay. Serving sizes in the USA are simply ludicrous and
completely out of step with reality.

Before talking about high-fiber, low-fat diets, Americans need to do one
simple (but difficult) thing: _eat less. Eat way less_.

A friend and I (both Canadian) paid a visit to the Cheesecake Factory this
last weekend - when our plates landed on our table our eyes bugged out. There
was enough food to feed 4 people in a standard Canadian restaurant. I'm not
even exaggerating :S The table next to ours polished their food single-
handedly and then ordered dessert. We were shocked. How any single person can
consume that much food in one sitting is unimaginable, and somewhat
disgusting.

~~~
hughprime
Well, the Cheesecake Factory is a bit of an outlying case -- those portions
are ridiculous even by American standards. But as an Australian living in the
US I agree with you -- I find it hard just to get a normally-sized meal for
breakfast or lunch.

In Australia, if you order a ham and cheese sandwich, you get ham and cheese.
In America if you order a ham and cheese sandwich you get a huge stack of ham,
a bit of cheese, lettuce, tomato, pickles (!?), maybe some sprouts, mayo and a
bright yellow mustard-like substance. If I tell them I just want ham and
cheese they look at me like I'm crazy (and I am, cuz I'll be paying about six
bucks for this sandwich anyway).

On the other hand, last I heard Australian rates of obesity have overtaken US
rates. On the _other other_ hand, Australia probably has more of the slightly-
fat people (ordinary folks with big beer guts) and fewer of the ridiculously-
fat people (acres of waddling flesh or too-fat-to-walk electric wheelchair
folks).

~~~
callmeed
_"Well, the Cheesecake Factory is a bit of an outlying case ..."_

I'm not sure about that. Cheesecake Factory, Claim Jumper, you name it.

Even the fast casual restaurants like Chipotle. They tout the "freshness" of
their ingredients–despite the fact their burritos weight as much as my laptop.

Of course, every restaurant now is on the "hamburger slider" craze ... even
though the slider is probably the size a normal hamburger _should_ be.

Don't even get me started on the Midwest. When I first started visiting
Oklahoma regularly, I was a little shocked. You'd almost think there was a
state law that every restaurant had to be a buffet.

~~~
kdw
Restaurant meals have grown so large that I only order an entree if I'm
planning to take home a doggie-bag.

If I want to actually eat all I order, I usually get two appetizers, or an
appetizer and a salad.

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awt
Doesn't everyone die? If so, isn't the question what diseases take the longest
time to cause death, and thus require the most medical expenditure? Wouldn't
medical expenses be lower if everyone died of a heart attack at 55? That would
certainly be cheaper than living till 70 and treating cancer, bone loss
issues, bladder issues, and cholesterol issues over a period of several years.

~~~
dasil003
_If so, isn't the question what diseases take the longest time to cause death,
and thus require the most medical expenditure_

Not exactly. You're missing two variables. The rate of infection in the
population as a whole, and the rate of expenditure to treat the disease.

~~~
hughprime
How so? The argument is that eventually everybody dies of something, so
avoiding one fatal disease only shifts your death to another disease at some
point in the future.

I really think it's quite likely that fat people, on average, cost less in
health care over their lives than thin people. I don't have any numbers to
back this up, but every person who dies suddenly of a heart attack saves an
awful lot of money by not dying of cancer, or worse still some degenerative
disease.

~~~
dasil003
Nothing wrong with the basic gist, but read closely the statement I quoted.
Just because something takes a long time to kill you doesn't mean its
treatment is expensive. Similarly, just because something is expensive to
treat doesn't mean enough people have it to make it worth targetting from an
overall cost perspective. That's all I was saying.

~~~
eru
And if you get less deaths per person-years, you might also save money (per
person-year).

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bokonist
* and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. *

Cancer and heart disease are fundamentally diseases of age. Everyone will die
of one or the other eventually. The links to certain dietary elements are
almost all a result of a data mining.

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nradov
We are digging our graves with our teeth.

Caring for diabetes and related conditions consumes about 1/7 of all US
healthcare spending (could be a little more or less depending on how you
count). [http://www.diabetes.org/diabetes-statistics/cost-of-
diabetes...](http://www.diabetes.org/diabetes-statistics/cost-of-diabetes-in-
us.jsp) The vast majority of type-2 diabetes cases could be prevented with
better eating habits. If the incidence of preventable chronic diseases was
greatly reduced, healthcare costs would be so low that we wouldn't be arguing
over how to pay for it.

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nova
Yes, but before advocating any diet please read Gary Taubes' "Good Calories,
Bad Calories".

Please. The government already amplified a terrible mistake to colossal
dimensions and could do it again.

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asciilifeform
Why is there no mention of the artificially restricted supply of doctors? This
fact plainly accounts for a large portion (if not the majority) of US health
care costs.

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wallflower
A retired gastroenterologist once told me his personal theory: Every human can
consume a finite amount of sugar in his/her lifetime - once you exceed that
limit, you die. The theory is a bit flimsy but it makes you think about
cumulative nutritional choices.

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vijayr
Isn't it the same everywhere (assuming there is no war or natural calamity etc
like situation)?

~~~
anigbrowl
Not necessarily. For example: <http://library.thinkquest.org/16665/causes.htm>
<\- leading causes of mortality in ~20 countries. Look at how big the
variations between different countries can be even for coarsely-grained
statistics.

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peregrine
This is a poor headline. I'd say a better one would be. "Majority of US
Healthcare Costs are Cause by Not Exercising enough to burn calories from Bad
Eating Habits"

~~~
xsmasher
Well, there is something slightly perverse about eating more food than you
need, and then doing useless physical work to balance out the equation.

