There are several stakeholders in the legislative arena when considering obesity and health policy. Key stakeholders include the government, the food industry, health care providers, employers, and the middle class.
The government, the major payer of Medicare and Medicaid expenditures has a concentrated interest in holding down the rise in medical expenditures. Also, since obesity has become a visible public issue, both the administration and Congress realize the potential political advantages of addressing the issue. Congress may not care about the exact number of calories that people should consume, or the ubiquitous presence of "junk food" advertisement and vendor machines. But Congress does care about how much political capital may be achieved from legislation. By calculating which legislative positions provide the greatest amount of political support essential for reelection, legislators will propose and support laws most effective to achieve this goal.
The food industry recognized the threat of potential liability and successfully lobbied for a law to shield them from such action (Library of Congress, 2003). The industry’s approach to policy change is to alter but not diminish daily food consumption through changing the national dietary guidelines, and stressing and placing increased emphasis on physical activity. The recent publication of the Dietary Guidelines for Americans (United States Department of Agriculture, 2005) was preceded by heated debates on balancing recommendations for caloric restrictions and activity. Food makers have donated heavily to members of Congress. In 2004, food processing and sales companies gave $4,636,835; the dairy industry donated $1,398,911; and the sugar interests gave $1,379,484 (Mishra, 2004), far outweighing public health interest group contributions. While nutritionist, scientists, and other health advocates promote the need to "detoxify food environment," the food industry places stress on physical exercises, upon which higher levels of calories will be expended.
Health care providers have dual interests: prevention and treatment. Numerous professional organizations have issued position statements related to obesity. The International Council of Nurses (1999) position statement, "Reducing Environmental and Lifestyle-related Health Hazards," advocates that "nurses and national nursing associations should play a strategic role in helping reduce environmental and lifestyle-related health hazards by…promoting a positive lifestyle, including exercise, stress management, accident prevention, weight maintenance, and nutrition education that is sensitive to socio-economic status and cultural beliefs" (International Council of Nurses, paragraph 1). The National Association of School Nurses (2004), "Position Statement on Overweight Children and Adolescents," includes recommendations for screening, primary prevention, advocacy, legislation, funding, and research. The American Academy of Pediatrics issued a major policy statement urging the restriction of soft drinks in the nation’s schools (Markel, 2004). Meanwhile, successful efforts to obtain insurance coverage for obesity as a diagnosis may increase the demand for health care and lessen uncompensated care.
The role of employers and the middle class in the policy debate is linked to the willingness of these segments to accept a tax burden that may be seen as related to a behavioral and moral issue (Smith, 2004). As the health insurance costs of obesity continue to rise, employers need to choose between decreasing profit margins and passing back costs to consumers through higher premiums, thus decreasing take home wages.
There are two discordant sides in terms of the multiple legislative options on the table: one is that government has a limited role, and the other that it has a significant one. Supporters of the first view insist that overweight and obesity result from daily lifestyle choices. They believe adults should not only make positive choices for themselves, but also supervise their children in terms of nutrition and physical activity. They feel the government’s role is to provide health information and facilitate behavior changes through the support for education, research, and community-based interventions. Proponents of a more active government role argue that overweight and obesity result from a complex interplay of behavioral, environmental, and genetic factors, and that the government needs to undertake broad policy initiatives ranging from regulating the food environment and prescribing physical activity and nutrition for children, to supporting urban planning for increased physical activity through transportation and public safety provisions.
Is obesity a left-wing issue? (Query about Fox news)
- that Fox news was right wing but only recently caught a glimpse of it when channel hopping the other night.
Reply With Quote
Originally Posted by econ21
.jpg "Meneldil's Avatar")
Bookmarks