GOPideas... ideas done right

Instead of lamenting death panels and socialism, Republicans should focus on the most important (and ignored) aspect of the health care debate: curbing behaviors that lead to preventable disease. Estimates range from 60-80% of health care costs are incurred by chronic, preventable disease and around 50% of health care spending is already paid for with public funds --- thus, 30-40% of all health care costs are borne by taxpayers for diseases that can be prevented.  Although both sides claim to want to address preventable disease and focus on personal responsibility, no tangible proposals provide concrete policies (or even attempts) at fixing the long-term behavioral drivers of health costs (unhealthy eating, lack of exercise, smoking and drinking).

Once such attempt was/is occurring in New York City: the city requirement forcing fast food restaurants to disclose the calorie content of their foods. Without wading into the big brother aspect of such rulemaking, the question is whether the new regulation facilitated the desired effect of decreasing the caloric intake of diners, thus reducing obesity. The answer: No.

In fact, the number of calories consumed by diners in New York increased from the time the regulation took effect last year --- by an average of over 20 calories. But, policymakers in New York can rave about the success of the program: 28% of people said that knowing the calorie count affected their choices and 90% stated that they made healthier choices as a result of knowing the calorie counts. Thus, 90% of people feel they made healthier choices, when, in fact, the majority of people made less healthy choices than before the labeling initiative.

This is the best example of my rationale for being a conservative: feeling good does not equal doing good. As you look though the articles discussing the program, wonder: where are the policymakers discussing how the added cost on businesses yielded a negative return? What are they proposing now? Are they going to rescind the regulation since it led to worse choices? This is not to say that policymakers should not be focused on reducing obesity: they should. However, they should be honest about what works and what does not --- and then stop doing what doesn’t work and start doing things that could.

So, let’s dump the labeling program (or keep it, as it does little harm) and place the onus on the consumer. Develop a system mandating that everyone buying a meal with a fat/calorie content above a certain level sign a receipt stating:

“I acknowledge that eating foods with high fat and caloric contents may lead to obesity and other diseases. The meal I have ordered contains X grams of fat and Y calories, which contain Z% of the recommended individual daily caloric intake.”

The benefit of such an approach is explained in Dan Ariely’s work concerning honor codes and other moral cues showing that when people are forced to publicly agree to do good (or not do bad), they will behave in the socially acceptable manner. Without such cues, a good percentage will choose the morally unacceptable option. Thus, we can expect to people to have second thoughts about fast food if they a.) have the cognition that it is bad and b.) are presented with the need to opt-in to that bad choice. If Ariely’s results are any indication, a good percentage of people may opt-out of their food choice, which would be a small step in the fight against obesity. (Note: one aspect that will need to be tested is the timing of the receipt signing. Ariely asks people to sign before making their decision, whereas a receipt would require signing after ordering.)