30 April 2011

Unhealthful News 120 - Banning use of food stamps for soda - can all of the arguments on both sides be wrong?

The New York Times ran an exclusive article about the New York mayor's proposal to forbid the use of food stamps for purchasing sugar sweetened beverages (soda and such).  The story read like a trial balloon to test out the arguments for and against (i.e., it looks like it was planted with a pet reporter or newspaper by a politico – presumably Bloomberg's office – to see how people would react before moving forward).  The funny thing is that pretty much none of the arguments presented in that article on either side of the issue seems valid.
 “This initiative will give New York families more money to spend on foods and drinks that provide real nourishment,” Mr. Bloomberg said in seeking federal approval.
Um, no.  It is not possible for a rule that only prevents someone from doing something to "give" them something.  If Bloomberg wants to make the argument that it forces people to spend more money on other products (or, more diplomatically, leaves them no choice but to spend more money on those products), then fine.  But if he has to claim that it gives people something he is (a) dishonest and (b) not very confident that the truth will win the day.
Food stamp benefits are paid for entirely by the federal government, and the city is seeking permission from the Agriculture Department to test its proposal in a two-year project. Because the proposal would define “food” more narrowly than federal law and regulations, food industry groups have unleashed a barrage against it.
Again, no.  Whatever happens, it will not change anyone's definition of food.  Opponents do not like the law because it would directly cut into sales of their products a bit and would probably set precedents for other actions that would cut a lot more.
President Obama, whose position on the New York plan is unclear, is in an awkward situation. The Agriculture Department, historically averse to restricting the use of food stamps, has said, “There are no bad foods, only bad diets.” ….  But Mr. Obama has set a goal “to solve the problem of childhood obesity within a generation,” and his wife, Michelle, is waging a high-profile campaign to promote healthy eating. The Web site of Mrs. Obama’s childhood obesity initiative even urges Americans to “drink less soda or sugar-sweetened drinks.”
Really?  Obama is going to personally intervene in this matter?  He does not have time to fight for a stimulus plan to help tens of millions of suffering Americans, or to figure out how to have a more enlightened way to deal with innocent (they have not been proven guilty) prisoners at Guantanamo, or even to provide a decent health financing plan, but he is going to get so involved in this that he cannot distance himself from it.  Just great.

And what about this list of facts makes it awkward?  It is common knowledge that the USDA says "there are no bad foods" because their primary constituents include the meat and corn industries, makers of bad foods, and not consumers.  There is no reason the President needs to yield to this conflict of interest if he does not want to.  As for the website recommendation, there are a lot of things that are recommended for health that are in no way enforced by government action.  Where is the awkwardness in leaving this one of them?
Opponents say that many factors, besides soft drinks, contribute to obesity.
You would think that the opponents of this could muster some good arguments.  But if this article is to be believed then this is their lead argument.  The logic is equivalent to saying, "many factors besides sleeping air traffic controllers contribute to plane crashes, so let's not do anything about it."
Moreover, they say, imposing restrictions on food stamps would require retailers to reprogram computers and embarrass some customers at the checkout counter.
I suspect there is not a food-stamp-accepting store in existence that does not sell some items that are not eligible for food stamps, so they are already asking for some cash from food stamp customers.  Even if customers feel bad about using food stamps or somehow feel bad about being asked for cash, these do not change, so where is the new embarrassment?  As for reprogramming, if anyone is using a cash register computer system that cannot be changed to handle this using one data upload that presumably the government could provide (the SKUs or other identifying series information of all the products included in the change), then I would guess that they are already committing food stamp fraud (at least unintentionally), so probably would not care too much. 

I cannot fathom how these pass for the arguments against the policy.  My only theory is that these are the fake arguments cooked up by the policy proponents to make the opponents look like they have no valid arguments.  As I said, the article does read like a planted trial balloon, and so is probably testing arguments Bloomberg is worried about, not the best arguments that could be made.  One more source of disinformation for serious readers of the health news to beware of.
Eighteen members of the Congressional Black Caucus recently urged the Obama administration to reject New York’s proposal. The plan is unfair to food stamp recipients because it treats them differently from other customers, they said in a letter to Agriculture Secretary Tom Vilsack.
Still not even making a close pass near reality.  This rule would actually treat food stamp recipients slightly more similarly to other customers, requiring them to pay cash for something that everyone else is already paying for.  Is the Black Caucus's reasoning that if food stamps can buy anything then it is unfair for them to not buy everything?  If so, why are they not protesting the fact that they cannot be used to buy prepared deli foods, beer, or greeting cards?

The article goes on to offer and answer:
While Coca-Cola and PepsiCo are among the largest contributors to the nonpartisan Congressional Black Caucus Foundation, a research and education institute, caucus members say their positions are not influenced by such contributions.

Not much face validity in that claim.  On the other hand, the fact that it showed up in the article again reads like a plant, with the planters trying to preemptively discredit what could be phrased as a legitimate concern.  The legitimate version appears below, which the previous version might have been intentionally made to sound dumb.

One public health professor type was quoted as saying,
the government spends hundreds of millions of dollars a year buying beverages that have been linked to risks for obesity and diabetes. These conditions cost the government and taxpayers billions of dollars a year in costs paid by Medicaid and Medicare.
The article still lacks a legitimate argument for a policy change.  Even if the "costing taxpayers" claims that are made so casually turn out to be completely true (as opposed to the claims about the health effects of smoking causing a net cost for the government which are false), this still does not justify the policy.  Show of hands out there – who wants to live in a country where "it saves the government money" is considered a sufficient justification for a restrictive policy decision?

Also interesting is that the San Francisco Chronicle runs a "ask Marion Nestle" column, which just happened to address the question of food stamps and soda on the same day as the NYT trial balloon story.  Coincidence?  It seems unlikely.  But then again, why would the people planting the NYT story set it up so that someone else's brief column could present the issue and the best real arguments on both sides better than their story (please read it if you are interested in the topic).  I can only guess there was a leak about the story and she took the opportunity to preempt it.

Nestle is an academic and probably the most well-known critic of U.S. food business and nutrition policies (or at least the most well known honest, intelligent and respectable critic – there are a few just science aficionados who are better self-promoters than she is, although she is pretty good).  She happens to be one of the authors I referred to in yesterday's UN who wrote the call for papers for article about how to change the behavior of the food industry.  But do not mistake her for the typical "health promotion" or anti-tobacco academic; she has worldly political views, but she is honest and does good analysis, not junk science.  Nestle manages to make a better case than the Black Caucus did (or at least were reported to have done), explicitly noting that the restriction could be seen as condescending to the poor.  In light of that she admits ambivalence about the Bloomberg proposal, but has come to support it.

Unfortunately, her articulate and though-out arguments strike me as dangerously close to invoking the "denormalization" concept from anti-tobacco.  That was the campaign that started out as "let's get people to stop thinking that smoking is an inevitable part of social interaction and getting through the day" and morphed into "let's convince everyone that smokers are evil and that seeing smoking should be as socially unacceptable as seeing someone get raped".  Nestle makes a good case, but a good policy that flirts with a proven-dangerous process is seldom a good idea.  This might be what some of the opponents are trying to say, but not doing a very good job of getting it into the papers.

The best part of the whole story, though, was the reader question that Nestle was answering in her column.  It read:
Q: When I see people in grocery stores using food stamp benefits to buy sodas, I get upset. Why does the government allow this?
It is just so sad that she did not answer the question as asked with:  "Because the government has no magic power to keep people like you from getting upset when your urge to force others to live how you want them to creates emotional turmoil.  Perhaps you should see a counsellor about that."

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