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@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?