A Simple Preventive Measure: Provide Nutrition Facts

With all the hullabaloo surrounding the public option, it’s easy to overlook some of the other interesting features of potential health care reform. For instance, what exactly are these “preventive measures” that senators and pundits always talk about in the abstract, but about which we never seem to hear details?

This morning I haphazardly discovered one such measure, thanks mostly to Matt Lauer. This morning, as I ate my fiber-rich cereal topped with banana, blueberries, and skim milk (my personal preventive measure), I watched Matt do a feature on making smart choices in chain restaurants. He lined up five or six ungodly sandwiches from places like Chili’s and Ruby Tuesday, next to each of which was a slightly-less-ungodly alternative, invariably a pallid-looking grilled-chicken concoction. The placards displaying nutritional information (e.g., 1,900 calories for a burger topped with onion rings from Outback) were not even the most powerful reminder of the unhealthiness of much restaurant fare. That would be the mammoth bowls of French fries or plates of glazed donuts that were said to have equivalent amounts of sodium, or saturated fat, or cholesterol as their respective ungodly counterparts.

Watching this, I thought to myself, surely there are millions of people who would eat a huge gooey burger topped with blue cheese, knowing obliquely that it is “bad for you,” but who wouldn’t eat 17 orders of fast-food French fries if they knew that’s what they were effectively doing. And surely, if we got people to stop doing the former, we could cut down on obesity, diabetes, heart disease… and huge medical bills to treat those conditions.

But how to make people face these alimentary choices directly, with full (or, in econo-speak, “perfect”) information? Obviously one way is simply to require that restaurants disclose nutritional information in easy-to-read places, preferably right on their menus or big menu boards. “Texas Ranch Bacon Cheeseburger” (or whatever)  doesn’t sound quite so appetizing when you see “1,440 calories” and “1,800 mg sodium” next to it. New York City has the most famous such law, requiring eateries with more than 15 locations nationwide to post calorie counts on their menus. Philadelphia recently passed a stronger law, requiring disclosure of not just calorie counts but saturated fat, trans fat, sodium, and carbohydrates on printed menus (just calories on the big boards in fast-food restaurants). California is the only state with a nutrition-disclosure law.

Though perhaps not as controversial as a ban on trans fats like NYC’s, which impinges more obviously on Americans’ beloved freedom to make terrible, costly choices, a nationwide nutrition-disclosure requirement seems to me like one of those good ideas that might die a quick, quiet death in that graveyard of good ideas, the United States Senate. Various food-industry groups and fast-food company spokespeople will adopt the comfortable rhetoric of choice in order to defend denying people the information necessary to make choices. They may even evoke the “free market” in defense of information asymmetry, which, as economists know, always leads to a distortion of what consumers’ choices would look like in a real, pure market. These objections, of course, are and will be ridiculous. Nobody thinks the “free market” is harmed by my knowing that a serving of cereal contains 13 grams of sugar, or that a can of Dr. Pepper contains 40. Why it should be any different for food served in restaurants is beyond me.

In any case, the Senate HELP Committee health care reform proposal includes a calorie-disclosure requirement. It’s not perfect: I would like to see a national regulation modeled off Philadelphia’s, because calorie counts are only part of the nutritional picture. And I think that, in an ideal world, the regulation would apply to all restaurants, not just chain ones. I can see why the issue is tackled that way: for one thing, fast food and chain restaurants attract poorer clientele, who are more likely to be insufficiently educated about proper nutrition; for another, they are easier to demonize because everybody, even those who frequent such places, knows that they’re bad for you. But there’s no reason other than political calculation to exempt a 16-ounce Wagyu steak from a law covering a Texas Ranch Bacon Cheeseburger.

So, let’s hope that the HELP Committee’s proposal, which is a good start, does not die in the markup process, and that it is incorporated, if it’s not already, into other health care reform proposals. I’ll eat to that.