Bingaman tries to target obesity epidemic in health care reform

Photo by bandita/Flickr

ALBUQUERQUE — Despite growing evidence that obesity has reached epidemic proportions in the United States, an ambitious bill targeting the crisis introduced this spring by U.S. Sen. Jeff Bingaman appears dead in committee, a casualty of the larger battle being waged over health care reform.

According to a report released this month by the Trust for America’s Health, obesity rates among adults rose in 23 states in the past year but did not drop in a single state. More than 25 percent of America’s health care costs are directly related to obesity, a proportion that has been ballooning along with our waistlines. Over the past 30 years, adult obesity rates have doubled and childhood obesity rates have tripled, rates that are responsible for 20-30 percent of the increase in the cost of health care

Bingaman’s bill, the Obesity Prevention, Treatment and Research Act of 2009, would have established a 20-member Council on Overweight and Obesity Prevention; created grant programs to fund obesity prevention and treatment programs in schools and community health centers; and expanded Medicare, Medicaid and SCHIP coverage for nutritional counseling, physical education and other prevention services.

In a recent interview, Bingaman, a New Mexico Democrat, said he hoped to incorporate many of the elements of his bill into a larger health care reform bill, but as negotiations over various bills broke down last week, the state’s senior senator said nothing was for sure.

“The truth is we have thousands of bills introduced … and there’s no real opportunity for most of them to be brought up and passed on their own,” Bingaman said.

“What we wind up doing is looking for other related [legislation] that’s moving ahead and combine things. If we’re able to pass significant health care reform, hopefully we can have in there quite a few provisions … that will discourage folks from becoming obese.”

For Bingaman, the best way to combat obesity is to change the poor eating habits and lack of physical activity that have helped cause the epidemic.

“The most important [thing] is to ensure that people have early health care, nutrition care and health education, both through school system and public health delivery system. We need to emphasize the changes in behavior that will help prevent obesity. Those changes in behavior have gotten too little attention,” Bingaman said.

But what about the problem of access to fresh fruits and vegetables? In many rural areas of New Mexico, folks have to drive 50 or even 100 miles to reach a store that stocks fresh produce. And some who live in urban areas have a hard time getting to grocery stores using public transportation. Some blame these so-called “food deserts,” in part, for the obesity epidemic.

Bingaman acknowledged that lack of access to healthy foods, as well as behavior, is part of the problem, saying, “It’s a bit of a chicken-and-egg problem, to the extent that as people begin to demand more healthy foods, businesses will change and evolve to meet that demand.”

But according to a report USDA delivered to Congress this summer, improving access to healthy foods may not be enough. “A few studies have examined food intake before and after healthy food options become available (either within existing stores or because new stores opened). The findings are mixed — some show a small but positive increase in consumption of fruits and vegetables, while others show no effect,” the report found.

Demand may or may not be the problem for adults, but kids can’t demand things they don’t know about, and many children in low-income families simply don’t get very much fresh produce at home. Bingaman’s bill also would have increased funding for the Fresh Fruit and Vegetable Program, which provides fresh produce — some of it locally grown — to low-income kids who may not see very many cantaloupes at home. It’s a popular program in New Mexico, where the state buys tons of locally grown apples, among other fruits and veggies, for distribution in schools.

Bingaman said he was optimistic that funding for that program could be increased as part of the appropriation for the Department of Agriculture later in the year.

Asked if he thought the agriculture industry, specifically subsidies for corn and soybeans, which are turned into sweeteners and fats, is partially responsible for the nation’s bulging waistline, Bingaman demurred.

“I don’t doubt that there are some folks out there, some businesses, some industries that have interests that are contrary to the best diets for Americans, but I don’t think that the main problem we’ve got with obesity is a result of subsidies in the agriculture sector,” he said.

“I think that the problem comes down to individual behavior and knowledge about what is nutritious and what they ought to try to eat and the importance of exercise as well.”

As negotiations over healthcare reform broke down in Washington last week, it appeared that nothing was certain to be included in the bill, including the popular “public option.” But Bingaman was not giving up on trying to target obesity through the bill, adding, “It’s all still on the table.”