'I'd like a myocardial infarction with extra pickles, a side of diabetes and a super-sized colon tumor, to go."
That may not be what Americans are ordering when they pull up to the drive-in window at the local fast-food joint, but it's what an alarming number are getting. Obesity, and the serious health conditions that result, are rising sharply in the U.S., in part because portion sizes and fat content at restaurants are growing as fast as our waistlines.
Food choices are a matter of individual preference and not something the government can or should oversee. On the other hand, society is facing a large and growing burden because of the bad choices made by some, and as Congress looks to increase that burden on taxpayers by reforming the nation's healthcare system, it's also looking to play a bigger role in controlling health costs. The upshot: The food police may soon be coming to an Arby's near you.
Among the many provisions of the sweeping healthcare reform bill being considered by the Senate is a requirement that chains with more than 20 restaurants operating under the same name must post the calorie counts of all their dishes on their menus. A similar law is already on the books in California, where chains must comply by 2011; New York City also has one, and other states and cities will probably follow suit in the absence of federal action.
Though the calorie-count rule is only a tiny part of the healthcare reform proposal, it brings up surprisingly controversial and complex issues -- illustrated by the fact that it has provoked a food fight in the restaurant industry, with the National Restaurant Assn. supporting the provision, while a splinter group of 21 big restaurant chains wants it amended.
What's beyond dispute is that obesity is expensive, and not just for the obese. Last month, the journal Health Affairs published a study showing that the medical costs of obesity have nearly doubled since 1998, to $147 billion last year, about half of which was financed through Medicare and Medicaid. Obesity accounts for 9.1% of national healthcare spending, according to the study, up from 6.5% a decade ago. The costs are rising because Americans are getting fatter. The average citizen is now 23 pounds overweight, according to the Centers for Disease Control and Prevention, and obesity rose by 37% between 1998 and 2006.
