Michael Pollan on Big Food and Big Insurance

Last week, the New York Times published an opinion piece by Michael Pollan that connects the dots between health policy and food policy:

According to the Centers for Disease Control and Prevention, three-quarters of health care spending now goes to treat “preventable chronic diseases.” Not all of these diseases are linked to diet — there’s smoking, for instance — but many, if not most, of them are.
We’re spending $147 billion to treat obesity, $116 billion to treat diabetes, 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. One recent study estimated that 30 percent of the increase in health care spending over the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly a tenth of all spending on health care.

But health care reform could change the way insurance companies respond to chronic diseases.

As for the insurers, you would think preventing chronic diseases would be good business, but, at least under the current rules, it’s much better business simply to keep patients at risk for chronic disease out of your pool of customers, whether through lifetime caps on coverage or rules against pre-existing conditions or by figuring out ways to toss patients overboard when they become ill.
But these rules may well be about to change — and, when it comes to reforming the American diet and food system, that step alone could be a game changer. Even under the weaker versions of health care reform now on offer, health insurers would be required to take everyone at the same rates, provide a standard level of coverage and keep people on their rolls regardless of their health. Terms like “pre-existing conditions” and “underwriting” would vanish from the health insurance rulebook — and, when they do, the relationship between the health insurance industry and the food industry will undergo a sea change.

The costs of chronic diseases like renal failure and diabetes are some of the largest environmental externalities ever visited upon the public. These costs don't show up in the subsidized, low cost ingredients that make up most of the food products in our supermarkets, but are born by the unfortunate consumers who are making seemingly rational decisions by eating cheap, though ultimately unhealthy food.
If the health insurance industry is forced to take on the growing costs of chronic disease, then these externalities will be shifted from families with little political or market power to large corporations with enormous political and market power. The insurance companies' assumption of the costs of chronic diseases could help shift the balance of political power away from the food industry.