Obesity Law: Rushing into the Void

1
Obesity Law Rushing into the Void

• Edward P. Richards
• Director, Program in Law, Science, and Public
  Health
• Harvey A. Peltier Professor of Law
• LSU Law Center
• richards_at_lsu.edu
• http//biotech.law.lsu.edu

2
Key Policy Questions

• Why Obesity?
• Why Now?
• Why Pass Laws?
• What Can We Learn From The Past?

3
Why Obesity?

• Contributes to diabetes, cardio-vascular disease,
  and cancer
• Increasing at a dramatic rate over the past 2
  decades
• Increasing fastest in children
• Fatter earlier means sicker earlier, longer, and
  more expensively
• A serious health problem that disproportionately
  affects the poor, blacks, and American Indians

4
The Most Important Reason

• COSTS

5
Costs of Obesity

• Direct health care costs for the management of
  diabetes and other secondary diseases
• Cost of SSI disability payments
• Costs of disability to the economy
• Medicaid costs to the states

6
Why Now?

• Federal government wants to do something about
  health care costs
• Obesity is the do it yourself solution
• Put a little money into regulation and education
  and the rest is up to individuals
• Avoids the hard issues
• Access to care
• Drug pricing
• Etc.

7
Why do Motives Matter?

• Reducing obesity will take a very long term
• Preventing the next generation from being as fat
  is the important goal
• Costs will go up before they go down
• The complications of the already obese
• The cost of obesity treatment
• Governmental timeframe

8
Is Obesity an Unintended Consequence of Past Laws?
9
Farm Policy

• Make food more affordable
• Make a larger variety of food available
• Make meat affordable for everyone
• Make more fresh food available
• Unintended consequences
• Supersizing as marketing edge
• Larger portions at home
• The snack culture

10
Land Use

• Separate commercial and residential development
  to make neighborhoods more healthful
• Encourage greenspace development to reduce the
  cost of housing
• Low density housing requires automobiles, so
  there is no need to walk

11
Building Regulations

• Fire regulations keep stairs closed and at the
  edge of the building
• Security regulations often limit routine access
  to stairs
• ADA and other regulations require easy access for
  handicapped persons, but non-discrimination regs
  also prevent this access from being limited to
  disabled persons

12
Vending Machines in Schools

• Driven by budget cuts
• Generate important income for many schools
• Lead to the breakdown of rules against eating in
  schools, otherwise no income
• If you eliminate the vending machines, will you
  make up the income?
• If you put healthy snacks, are you missing the
  point that unlimited snacks are the problem?

13
School Lunches Why Fast Food?

• Many schools are overcrowded
• Lunches are served to many more students than the
  kitchens and cafeterias are designed for
• Fast food, especially when it is supplied by
  third parties, is the only way to serve the crowd
• Will banning fast food result in better lunches
  or just encourage schools to let students leave
  campus to eat?

14
Physical Activity of Students

• Many schools do not require students to have
  organized physical activity each day
• PE was cut as budgets were cut
• PE was cut to make more room for substantive
  courses
• School increased homework so students do not have
  time to play after school

15
What Should We Learn From Past Mistakes?

• Think before you legislate - the science does not
  support a lot of the common sense solutions
• Look hard at the underlying reasons for current
  behavior and address those causes directly
• Analyze the possible unintended consequences of
  new laws
• Develop a long term strategy, including money

16
What are Potential Unintended Consequences?