Health could be a consensus issue in a partisan country

Health and health care should close the partisan divide, not rip it open further. Politicizing health and health care is not new. Remember Senator John McCain’s famous thumbs down on repealing the ACA? It was a rare act of overcoming the partisan divide. Absent politics, many people agree that the American diet should be healthier, that a diet that kills so many people annually must change. Both the quality and quantity of food are problematic. Obesity and chronic disease are costly to our healthcare system, lead to premature death, and make it more difficult to enjoy life and many activities. On this, most people agree. The statistics are not political. The incidence of high blood pressure, obesity, heart disease, and cancer speak for themselves. Diet is estimated to contribute to 678,000 deaths per year.

The facts justify the following priorities set forth President Trump’s executive order:

(i)     identify and describe childhood chronic disease in America compared to other countries;

(ii)    assess the threat that potential over-utilization of medication, certain food ingredients, certain chemicals, and certain other exposures pose to children with respect to chronic inflammation or other established mechanisms of disease, using rigorous and transparent data, including international comparisons;

(iii)   assess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs;

(iv)    identify and report on best practices for preventing childhood health issues, including through proper nutrition and the promotion of healthy lifestyles;

I do not have naively high hopes that our federal government will suddenly make America healthy again. So far, it simply has not been tried at scale. Public policy is the best long-term approach to decreasing chronic disease. Regulations requiring eliminating many chemicals (preservatives, food dyes, and additives) and processing techniques from foods, eliminating subsidies for unhealthy foods, eliminating food deserts, creating incentives to grow and sell organic and natural foods, and taxing the least healthy foods and drinks as we do cigarettes would help. These are evidence-based solutions. Attention to eliminating household chemicals, a cleaner environment, decreasing pollution, and taxing or penalizing corporations raising animals in inhumane contained animal facilities (CAFOs) to become processed meat are important as well. The shared goals of an environmental movement and healthy eating can be achieved synergistically, since at this moment, environmental agencies may lose funding altogether. Of course, additional public policies would support better health: wages, green spaces, healthy hobbies and activities, the free time to do the activities, and gym memberships (some insurance companies cover these). Policies to address root causes should be paired with healthy habits that require some determination and will to change. The proximate cause of chronic disease is often food intake.

Tribalism should not lead Democrats to oppose beneficial policies out of a dislike for other Trump administration policies. When Barack Obama was elected, Mitch McConnell said he would oppose everything Obama tried to do. He used threats of government shutdown to stop members of his own party from supporting Obama’s legislative agenda. Democratic and anti-Trump voters (I include myself) must not be immature like McConnell was. Taking the potential good while challenging the bad – the policies many of us vehemently oppose – may be better than blocking, criticizing, and generally poo-pooing anything good to come from the administration. Rather than being objective, commentators are decidedly negative toward the entirety of the Make America Healthy Again. Some push the conversation away from diet and chemical exposures to universal healthcare coverage, for example, as Bernie Sanders did, or to vaccines. However, any program that may pose some risks but reduce others should be given due examination and compared only to possible alternatives. Challenging bits rather than the entirety is a method of compromise and a show of good faith.

If ending the scourge of chronic disease is possible, it should be all hands on deck with wide popularity and support. Now is as good a time as any. Diet is a nonpartisan consensus issue. There are important distinctions between planning and carrying out. I am not writing with confidence that policies concerning food ingredients and pricing, subsidies, taxes, household chemicals, and all of the contributors to chronic disease will miraculously improve. But this glimmer of an appropriate path should not be shouted down based on its ties to an unappealing political agenda or even to some unsupported science in areas unrelated to diet. As a registered Democrat, a lawyer, a former nutrition counselor, and a bioethicist, I think it is OK to swallow our pride and attend to a chronic disease load that neither political party has been able to contain through public policy.