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D. Brad Wright Headshot

What Fat America Can Teach Us About Health Reform

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We are a nation that has grown unbelievably accustomed to the idea of getting whatever we want, whenever we want it, and paying for it later. Tech bubble? Check. Housing bubble? Check. Health care bubble? Check. Fat ass bubble? Double check. And super-size that.

So, here we are, waddling around the aisles of Barnes & Noble, looking for the latest miracle diet to make us fit in something other than our sweatpants, rather than working to make a change. We have the Atkins Diet, the South Beach Diet, the Ab Diet, the "Skinny" Diet, and even Dr. Phil's Ultimate Weight-Loss Solution. And this is just the beginning. People think it matters what specific foods you eat, how frequently you eat throughout the day, whether or not you eat late at night, skip or eat breakfast, and on and on.

Here's the secret: Yes, your metabolism may be slightly affected by some of the above things, but when it really comes down to it, weight hinges on one thing: Calories In and Calories Out. If you take in more than you expend, you gain weight. If you expend more than you take in, you lose weight. It's that simple.

Now, the expending part comes through your body keeping itself alive, and can be supplemented through exercise. The intake of calories, of course, comes from food. So, for the extremely lazy among us who hate to exercise, we'd at least be doing well to limit our caloric intake. But, when we eat on the go so often, it's hard to know just how many calories we're shoveling in, because restaurants don't make that information available.

The solution? Make the nutritional information--or even just the caloric content--readily available to consumers and they'll make healthier decisions about what to eat. This is exactly what they did in some New York City fast food restaurants, and guess what? People kept buying and eating the same old junk, as reported in the New York Times. The lesson? We don't really want to be healthier. We might say we want to lose weight, but armed with the information to help make that happen, we choose to ignore it and go for the cheeseburger over the salad because--surprise--it tastes better.

Many fiscal conservatives make a similar argument when it comes to health reform. Empower the people with information--on the costs and quality of their insurance coverage and the care they seek--and they will become more prudent consumers of health care. As I've written on one or two previous occasions, there are other reasons why such a strategy is unlikely to work that have to do with the less than ideal nature of health care in a market setting. Ignoring that, though, I'm still very skeptical about the feasibility of such an approach. After all, if well-informed consumers are unwilling to change their behavior when it comes to making choices about their lunch, do you really think that they will be more likely to change their behavior when it comes to making choices about their health?
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