National food service

The issue of obesity has been rearing its ever fatter head again in the medical community this week. Firstly we had the worrying cohort study findings published by researchers from the Hebrew University-Hadassah in Israel and the University of Washington in the US. The Researchers found that higher maternal BMI before pregnancy was associated with increased BMI in children, as well as larger waistlines, raised blood pressure and increased blood levels of insulin and fat. Greater maternal weight gain during pregnancy was also associated with increased BMI, waist size and levels of fat in the blood.

Secondly, we have had experts from the University of Oxford’s Public Health department calling on the UK government to impose a “fat tax” of at least 20% on the costs of unhealthy food and soft drinks. This was based on research looking at theoretical models, which priced in the negative externalities to the cost of unhealthy foods, and suggested the most vulnerable groups in society are more likely to change their own behaviours if food prices more accurately reflected the negative impact on their own health.

For those of passionate about strengthening society, the role of the state in guiding people what to eat and drink is always seen as a bit of tricky area. Often the state can be seen as ‘nannying’ rather than trusting society to make their own choices – “nobody should tell me what to eat and drink: if I want to eat crap then that is my right regardless of how that affects my health or impacts on my wellbeing”. I think that principle is right – the state has no right in telling people how to live their lives. For sure it should be able to inform and signal choices that are in a citizen’s own long-term interests, but it should not dictate those choices …unless it undermines society as a whole.

And that is point about obesity – the costs of unhealthy eating and drinking are absorbed not by the individual but by society. Effectively society is subsiding the profits of fast food and soda producers such as McDonalds and Pepsi as their high fat and high sugar products do not price in the crippling costs of future healthcare to society which is caused by high fat and high sugar products (i.e. Diabetes, heart conditions, pregnancy complications, etc). So there is a market failure here with potentially catastrophic effects to the future viability of society’s health services. This means there is a legitimate argument for the state to intervene ensure a stronger, not weaker, society for current and future generations (regardless of how much you like that cheap daily big mac!)

How should the UK state intervene? Well, the UK has its own huge National Health Service (NHS) which spends billions of taxpayers money on treating health conditions, many of which could have been prevented through better diets and healthy lifestyles. Recently it was estimated that 40% of cancers treated in the UK are preventable with changes to lifestyle. So, why doesn’t the NHS in the UK spin-out some of it’s vast resource and budget to set up a National Food Service? An ‘NFS’ could oversee the current food market in the UK to ensure people can get the right food at the right prices? The NFS role would probably be a regulator and subsidiser of food provision in the UK (rather than provider as market provision is already established).

The NSF shouldn’t be a state body either. While the state could give it regulatory powers and guarantee an increasing percentage of the total NHS budget (relative to national obesity rates), the actual day-to-day work could be contracted out to an enterprise that sees fit to bid to run the service. A citizens jury of 100 people could be randomly selected from the NHS database to serve a two-year term to review the bids and appoint the service contract to the bidder it thinks will best represent the interests of society. That jury will also have powers to hold the service provider to account for the regulation it carries out and the subsidies it gives throughout its two-year term.

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