Roseanne the Riveter & the New Guilted Age

Looks like the new Media Village talking point has been distributed:  Americans don’t deserve a decent health care system because we are disgusting fat pigs

There’s a point (around 3:00) in the MSNBC  clip John posted earlier where Taibbi talks about America’s relatively high infant mortality rate and low life expectancy, and Maria Bartiromo interrupts  to snarl, “We’re OBESE!” with the same combination of loathing & denunciation that a televangelist would use for “We have sinned!”  Bartiromo, of course, is not obese — her television contract is based on her meeting certain standards of attractiveness, and I’m sure it includes clauses covering the personal trainers, gym memberships, nutritionists, and whatever other outside assistance is required to keep Bartiromo up to those standards.   But the rest of us, well, how can we expect our babies to stay alive if we insist on being willfully, knowingly “obese”?

Then, in the WSJ op-ed John linked later in the evening, anesthesiologist and anti-happiness crusader Dr. Ronald Dworkin complains that Obama’s threatened health reforms will drive skilled professionals like himself out of the medical business, because taxes are too high and Medicare compensation is too low and frankly, smart people don’t want to work that hard.  Also,  “Americans have grown very fat. This complicates anesthesia tremendously. Putting in IVs, spinals and epidurals is harder. Inserting breathing tubes is much more dangerous. “   True enough, but then,  he’s getting paid somewhere north of $300k a year to deal with those complicated fat people.  “Quality of care will inevitably decline. That decline will come first in obstetrics… “  Go away, fat people, or the laboring mothers and their babies will suffer!

Granted:  Being too fat is a genuine medical problem.  Obesity, or the yo-yo dieting too often connected with obesity, leads to higher rates of heart disease, diabetes, joint problems, yada yada yada.   But it’s also a very “resistant” Medical Issue, with roots in everything from genetics to modern suburban planning to the way industrial agriculture is subsidized by tax dollars but local farmers markets are not.    In modern America, for all these reasons and more, it often costs more to be thin than to be fat.  And it sure costs more to stay healthy, so — more and more often — poor Americans are fatter and less “fit” than wealthy Americans.  It does not seem coincidental that one of the memes leaking upwards from the anti-reform astroturf has become  “America’s medical system hasn’t failed American citizens — American citizens have failed its medical system.” 

Us fatties  are using up too much health care,  taking up too much room in the emergency rooms, just like we take up too much airline seat space and use too many resources to fill our swollen gullets and cover our bloated hides.  And women, of course, are particularly susceptible to this kind of guilt-tripping.  Feminist, post-feminist or anti-feminist, some very large percentage of  all American women, whatever their actual medical BMI, will always have to fight an inner voice suggesting that we could stand to lose a few (more) pounds.   There is nothing so unfeminine as taking up too much space, using up ‘more than one’s share’, attracting too much attention.

After World War II, American economists decided that in order to keep unemployment at an appropriate level, the women who’d been “enticed” into paid employment while “their men” were overseas needed to be sent back to the kitchen and the nursery.  A deliberate part of this campaign was the argument, repeated at every level of the media from the radio soap operas to the Harvard Business School research journals, that “bored housewives” and “novelty-seeking co-eds” who insisted on keeping their high-paying office or technical jobs, or demanded slots at the better universities, were “taking jobs away from the heads of households (men), who wouldn’t be able to feed their families”.   All the old reliable anti-womanist slogans were also revived (‘career girls’ were unattractive, sterile, neurotic spinsters who couldn’t ‘get a man’, probably because of their sexual abnormalities), but this new meme really sold.  Any woman who wanted a job more interesting or better-paid than retail clerk or primary-school teacher was a selfish, self-centered, unpatriotic monster who didn’t mind taking food out of the mouths of starving children.   This re-branding worked so well that by the mid-1960s, even women who “had no choice but to work” — women who were themselves heads-of-household — often felt compelled to wear their “excuses” like a badge, or a mark of shame.

Today, American economists are facing a new re-structuring of a nationwide industry, the health-care system, that uses almost one dollar out of every five available.   Our current system works very well for the top economic tier, less well and far more expensively for the middle (voting) tiers, and badly / catastrophically for the expanding bottom layer.   Suddenly, out of every media outlet, from the morning talk shows to the political blogs to the Wall Street Journal, comes a new slogan:  Americans get less health for more dollars than any other industrialized nation because we don’t deserve good health.  We haven’t earned it, and if we insist on using it anyway, we’ll be depriving other, more needy fellow citizens of their fair share.   And the mark of our selfish unworthiness is that we’re fat.   Any good citizen, especially any woman, who “knows” that she should be eating better and exercising more (if only there were more hours in a day, or she could afford a gym membership, or vegetables weren’t more expensive than mac’n’cheez) gets the subliminal message:  She can’t afford a mammogram, much less  treatment for breast cancer, not because the World’s Best Health Care System is broken, but because she’s selfish even to want such luxuries when she hasn’t earned them.






234 replies
  1. 1
    Lit3Bolt says:

    This is a great analysis. To simplify it, just say that anyone who scorns the seething rolls of the great unwashed that they’re being classist. It’s another form of “the peasants can’t read the Bible because they don’t know LATIN, the lazy pigs!”

  2. 2
    JK says:

    Anne,

    I concur with Lit3Bolt, great job. You’ve raised some important points. I’m glad that John Cole doesn’t have the obvious insecurity of Andrew Sullivan who makes it a point to choose only buffoons to post on his blog.

    Anyone interested in obesity, for personal reasons or just in general, should check out the book The End of Overeating: Taking Control of the Insatiable American Appetite by David Kessler, former Commissioner of the Food and Drug Administration. Here’s a talk he recently gave discussing his book. Thank God for BookTV.
    http://www.booktv.org/Program/.....etite.aspx

    Maria Bartiromo is a pure, unadulterated disgrace to journalism and an abomination as a human being. The only good thing about Bartiromo was that she provided the inspiration for this song by Joey Ramone http://www.youtube.com/watch?v=vbJxMd3Pls8

    RIP Joey. You left us too soon.

  3. 3
    Ailuridae says:

    I’m not going to disagree with the analysis but I will mention a couple of things.

    It was Mika who made the comment about obesity and it wasnt as much of a non-sequitir as you are making it out. Taibbi had begun to list a areas where US outcomes were poor and Mika threw obesity into the mix. Its a hobby horse of hers.

    I think its pretty untoward to comment on TV anchors weight but as someone who has seen Maria from within 20 feet pretty often in the last three years she has actually had a large weight gain herself since the late 90s.

  4. 4
    simonee says:

    It makes sense in Maria Bartiromo’s world for obese people (and their families) to go bankrupt after a catastrophic illness. Survival of the fittest, assholes!

    Seriously, awesome post.

  5. 5
    Riggsveda says:

    I’m so happy you wrote this. I’ve been bitching about this for days. Every time someone suggests our health delivery system is broken, some yutz pipes up with: “I see fat people!” Sweet fancy Moses.

  6. 6
    Ash Can says:

    Another great piece, Anne Laurie. Brava! (And I love that “vagina outrage” tag.)

    You can add yet another factor to the complicated roots of obesity — urban crime rates. A friend of mine who’s very active in the various Latino communities of Chicago has mentioned to me that obesity has become a problem with Latino children because very often the neighborhoods where they live aren’t exactly the city’s safest, and parents are afraid of letting their kids go run around outside. As a result, for the sake of keeping the kids safe, they don’t get enough exercise, and obesity rates go up.

  7. 7
    JK says:

    @Ailuridae:

    Mika and Maria are equally full of shit. They have no fucking clue and absolutely no idea what the hell they’re talking about. They belong behind cash registers and not in front of tv cameras.

    Morning Joe is one of the most worthless and useless programs on cable. For every intelligent person like Matt Taibbi who appears as a guest, Joe Doucheborough pollutes his program with thousands of obnoxious numbskulls like Maria Bartiromo.

  8. 8
    Lesley says:

    American food manufacturers would be very hurt, upset, and angry if Americans became educated and stopped eating the shit factory farms and junk food manufacturers spend billions marketing and urging Americans to shove in their pie holes non stop.

    The American food supply causes an overwhelming amount of entirely preventable diseases, including obesity, diabetes, heart disease, cancer, sleep apnea, to name a few. Many people suffer from at least one and usually more of all of these conditions as the body breaks down.

    The second beneficiary of an overwhelmingly diseased nation is the pharmaceutical industry which peddles drugs to treat (usually with a whole host of side effects) the symptoms of preventable disease. These companies have a stake in Americans never being well.

    It is possible to live well into old age without having to constantly go to the doctor, without having a cupboard full of prescription drugs, without having ANY prescription medications, and without feeling like shit physically your whole life because of what you eat day after day without thinking or questioning its content and what might be doing to your body.

    It doesn’t help that the average family doctor has no training in nutrition and the little they have (a week out of years of medical school) is based on an antiquated food guide drummed up by food manufacturers.

    Prevention should be a huge part of any country’s health care policy, but it’s a subversive proposition; probably even more threatening than the idea of public health insurance.

  9. 9
    crayz says:

    This post seems like an excessively long and imprecise rant about a topic that seems a pretty marginal issue even for the people raising it

    If you’re going to bother with the debate at all, why not provide readers some facts or studies, like this estimate that obesity costs us $147 billion/year in health care costs. You could then point out that while high, it’s still only 9% of total costs, and so couldn’t account for our care costing 2x as much per capita than an average western european country with better outcomes. You could also point out that other western countries such as England have obesity rates close to ours

    Instead we get these vague analogies and obvious anger – but how does this leave anyone more informed?

  10. 10
    HeartlandLiberal says:

    This is an outstanding analysis of how the corporate right wing is now trying to steer the “discussion”, and I use that term very loosely.

    It immediately occurred to me that that sounded exactly like the attitudes of the extreme right wing fundamentalist Christians.

    Not that this is not typical in our cultures. I learned last night from someone doing therapy to try and help overcome alcohol and drug addiction that in China, there is virtually no treatment for such problems. This was learned from their therapist, who although a U.S. citizen, is Chinese by birth, and visits China every year. Over there, such diseases are seen as moral failings, not deserving of treatment, just deserving shunning and rejection.

  11. 11
    geg6 says:

    Personally, I can’t wait for some of the teabaggers I’ve seen start running around with signs declaring obesity is facism. And if you’ve seen them, too, you’ll know that cognitive dissonance will never trouble their little heads.

  12. 12
    shortstop says:

    I’d like to see a little national attention paid to the serious challenge of obtaining healthy food in poor urban neighborhoods — a problem that many otherwise well-informed people are completely unaware of. There is a devastating lack of fresh fruits and vegetables, and a near dearth of whole grains and low-fat protein sources, in the grocery stores low-income city dwellers are forced to shop at. Very often people without wheels who can’t carry large amounts of food on the bus are relegated to buying overpriced, crappy, overprocessed foods at mom-and-pops or bodegas.

  13. 13
    shortstop says:

    I’d like to see a little national attention paid to the serious challenge of obtaining healthy food in poor urban neighborhoods — a problem that many otherwise well-informed people are completely unaware of. There is a devastating lack of fresh fruits and vegetables, and a near dearth of whole grains and low-fat protein sources, in the grocery stores low-income city dwellers are forced to shop at. Very often people without wheels who can’t carry large amounts of food on the bus are relegated to buying overpriced, crappy, overprocessed foods at mom-and-pops or bodegas.

  14. 14
    harlana pepper says:

    After World War II . . . A deliberate part of this campaign was the argument, repeated at every level of the media from the radio soap operas to the Harvard Business School research journals, that “bored housewives” and “novelty-seeking co-eds” who insisted on keeping their high-paying office or technical jobs, or demanded slots at the better universities, were “taking jobs away from the heads of households (men), who wouldn’t be able to feed their families” . . .‘career girls’ were unattractive, sterile, neurotic spinsters who couldn’t ‘get a man’, probably because of their sexual abnormalities), but this new meme really sold.

    Wow, I’m just thinking of the “working girl” movies of the 50’s and early 60’s where in each woman’s secret dream is the husband, kids and picket fence, she’s working because she’s either trying to prove something or she has no choice. Interesting to put it all into perspective in this way.

    And I’ll never forget Paula Prentiss, in “Where the Boys Are” — “I’m going to be a walking, talking baby factory!”

  15. 15
    harlana pepper says:

    @JK: Wow, she was awful, just watched the clip. Her pooh-poohing Taibbi’s accurate, if dark analysis, is like holding up a cartoon next to a Renoir.

  16. 16
    Brick Oven Bill says:

    Re: Feminist, post-feminist or anti-feminist, some very large percentage of all American women, whatever their actual medical BMI, will always have to fight an inner voice suggesting that we could stand to lose a few (more) pounds.

    Structural Feminists must mean the big ones then. This is something which continues to fascinate me. Google has precious little on Structural Feminism. Structural Feminism, should my theory be correct, is really is not an accurate description though as lipid accumulation is not structure as much as it is loading on a structure.

    Perhaps Barack would be more accurate to describe white people he was willing to talk to as Marxist professors and Feminists of Proud and Expanding Girth (FPEGs). This still seems kind of snotty to me. You should not judge a woman based on her weight, or lack thereof.

    In my experience, men do not like the whispy bodies of these self-starving aerobics-infatuated ninety pounders. This does not mean that you should not talk to them if they are nice. Perhaps they have a medical condition. I think the perfect BMI for a woman is around 25.

  17. 17
    Johnny B says:

    Am I the only one who remembers the early days of the Democratic Presidential primary where Clinton and Obama were continually discussing American obesity, but refused to propose a national health care plan? I remember hearing both candidates in Iowa scolding their audience and listeners about their weight. Focusing on American obesity, rather than solving our health care mess, is not just something that is done in the OpEd pages of the Wall Street Journal or by conservative talking heads on cable news.

    That said, this is America. The country where obesity is a vice, but torturing innocents is a virtue.

  18. 18

    All you need to know about Bartiromo’s journalistic credibility:
    http://files.wallstreetfolly.c.....thain-bac/

    It’s worth watching that interview she did with Thain. First time I’ve seen a tongue bath on live national television.

    As for the obesity trope, it is pitiful that we can’t view the issue objectively. If someone submitted a cure for a disease that had a .5% effectiveness rate over 5 years to the FDA, they would be run out of the country. But with obesity, they get to write a book about it, appear on every major news program and nothing really changes, wash, rinse, repeat.

  19. 19
    Michael says:

    I made the mistake of listening to that asshole Medved yesterday, and nearly put my fist through the radio.

    In a fashion that would do Joe Goebbels proud (and wouldn’t it frost Mikey to realize it), Medved’s shifting message is now that fighting public option is being done for the benefit of the uninsured, because the uninsured don’t want any sort of coverage. He then had his call selectors parade several 20-something Paultards who are just fine with being without insurance.

    My favorite was the 23 year old that said he’s young, and then (with youthful hubris) that kid followed up with “I’ll get a good job with insurance”.

    I have to find a better country to emigrate to.

  20. 20
    GReynoldsCT00 says:

    I have to say that I am torn on the obesity issue. Your post makes very good points that I agree with. However, I’ve seen family members and co-workers (400 lbs) over the years who have the means to take care of themselves, eat better and exercise but they choose not to. In spite of bad knees, diabetes, etc. nothing changes, they line up the pills. I know it runs in my family and I pay very careful attention to my habits because I don’t want to wind up living like that.

    Thoughts?

  21. 21
    c u n d gulag says:

    The FAT in the HEADS of the pundit class is the obesity we need to worry about.

  22. 22
    Mudge says:

    Michael Moore is fat. So is Al Gore.

  23. 23
    T. O'Hara says:

    Japan has the highest life expectancy in the world. They’re skinny (except for some fat kids eating at McDonalds). If we want a longer life expectancy, we should get skinny.

    They’re also Japanese. That’s harder.

  24. 24

    And under which scenario would America be more likely to deal with its obesity problem – under its current fragmented non-system, or under single-payer?

    If the insurer paying the bills knew it would benefit from programs to combat obesity, then it would have a motive to institute such programs. Under single-payer, that would be the case for the single payer – our government. Under our current fragmented non-system, it isn’t the case for anyone.

  25. 25
    T. O'Hara says:

    Under single-payer, that would be the case for the single payer – our government.

    They could fix it. I know! Boot camp for everybody!

  26. 26
    MikeJ says:

    And under which scenario would America be more likely to deal with its obesity problem

    Health care policy won’t do it. Farm policy is where it’s at. Stop subsidizing corn, start subsidizing “specialty” crops like tomatoes, cukes, you know, veggies.

    This year for health policy, next year we can start the battle of “you want to destroy the family farm!”

  27. 27
    aimai says:

    Anne, You are one hundred percent correct. I know that because I was having the identical thoughts while watching the Taibbi clip and I had begun thinking about blogging the weirdness of the way the moral panic over obesity seemed to cloud people’s minds that people get…oh, I dont know…cancers, or break bones, or need health care for a gazillion reasons other than their weight. To my mind the obesity panic, which I see firsthand as the mother of a mildly pudgy ten year old, fits in the same space that mental health costs fit. The implication is not only that we are *doing it to ourselves* and therefore we don’t have the right to get coverage, but also tht the pit of our *wants* and *needs* is so great that asking for a little bit of coverage is asking too much. This comes up every time mental health counseling or medication or hospitalization comes up in the insurance debate. Suddenly we get warned that americans are “just plain lazy” and using mental health issues to “refuse to work” or that people want mental health counseling not because they have suicidal impulses but because they are faking it, and anyway there’s not enough money in the world for treatment and hospitalization so mental health stuff takes away from the “real” medical issues like new hips for old people.

    aimai

    PS. My husband and I are still laughing over your amazing line about “tying leonardo di caprio to the bowsprit of the titanic and trying to change its course that way.”

  28. 28
    WereBear says:

    @GReynoldsCT00: Good for you to notice.

    I’ve seen family members and co-workers (400 lbs) over the years who have the means to take care of themselves, eat better and exercise but they choose not to. In spite of bad knees, diabetes, etc. nothing changes, they line up the pills.

    I know, I’ve seen it, too. Two important things about cheap, crappy, carb sources is:

    They make you hungrier. The book Good Calories, Bad Calories is a 600 page indictment, using a hundred years of science, of how too much carbohydrates make us fat, tired, and sick. They goose the pancreas into blood sugar cycles that means the hungry never stops when it is fed mostly starches and sugars.

    They get you high. The whack of a blood sugar surge releases serotonin and endorphins, thus the lure of ice cream when we are depressed. Emotional Eaters are like drug addicts whose crack is available cheaply and at every turn. Other addicts can stay away from their drug. But Emotional Eaters have to eat; and they make the choices that keeps their addiction burning bright.

    Eating Real Food means a lot of shopping and cooking. But the Right Wing thinks we should all get second jobs to pay for our health insurance. Leaving less time to buy real food, which also costs more.

    I loathe these people.

  29. 29
    arguingwithsignposts says:

    @low-tech cyclist:

    If the insurer paying the bills knew it would benefit from programs to combat obesity, then it would have a motive to institute such programs. Under single-payer, that would be the case for the single payer – our government. Under our current fragmented non-system, it isn’t the case for anyone.

    As someone pointed out above, the insurers do have an incentive. It costs money to treat people who are obese. lowering obesity rates would mean fewer doctor’s visits, treatments, etc. for obesity-related illnesses, thus same insurance rates with less payout for treatments.

    The problem is they just don’t f-ing care.

    the free market hasn’t fixed health care yet. I don’t see why people expect it to do so in the future.

  30. 30
    arguingwithsignposts says:

    Jon Stewart introduced Betsy McCaughey as a “patient advocate.” I don’t think that word means what she thinks it means.

  31. 31
    Leelee for Obama says:

    OT-I haven’t read though all of this thread yet. However, one of the questions to Barney Frank came from an 89 yo woman whose concern was that 50million new patients would mean she wouldn’t be able to get an appointment with HER Doctor.

    I guess folks like me should just die and decrease the surplus population, huh?

    I’m wondering who I should consult on method-or should I just wait for nature to take its course?

    What is wrong with people? First the Doctor with his fucking taxes, Betsy McC with her death panels, and now little, very old ladies telling someone elses great grandchild they’re not worthy. BLARRGH!

  32. 32
    MikeJ says:

    Under our current fragmented non-system, it isn’t the case for anyone.

    Actually it’s fairly common to get gym discounts through HMOs. That’s not anti-obesity per se, but is pro good health and may have as a side effect weight loss.

  33. 33
    Napoleon says:

    @arguingwithsignposts:

    I am so surprised I have not seen more people making your first point. American’s being obese and that effecting health is an arguement for a universal program, not against it.

  34. 34
    arguingwithsignposts says:

    @Leelee for Obama:

    OT-I haven’t read though all of this thread yet. However, one of the questions to Barney Frank came from an 89 yo woman whose concern was that 50million new patients would mean she wouldn’t be able to get an appointment with HER Doctor.

    It’s classic IGMFU thinking. Of course, she’s also already on government health care.

  35. 35
    Napoleon says:

    @Leelee for Obama:

    On your first point that has been something I have seen raised in public discussions several times a week during the health care discussion. The pure immorality behind peoples comments like that are just mind boggling.

    Apply it to something like water. There is suddenly a shortage and you have to stand in line so some people complain that they never needed to before so some number of people should just be made to get out of line and die of dehydration so as not to inconvenience the others with a line.

  36. 36
    Leelee for Obama says:

    @arguingwithsignposts:Yup and yup, Signposts.

    I guess if being that old and on Medicare already, for decades-then the question “What will we tell the children?” has lost all meaning for her.

    BTW-How the hell are you doing?

  37. 37
    Jorge says:

    Lesley wrote
    “The second beneficiary of an overwhelmingly diseased nation is the pharmaceutical industry which peddles drugs to treat (usually with a whole host of side effects) the symptoms of preventable disease. These companies have a stake in Americans never being well.”

    I sell world’s #1 prescribed branded diabetes pill. And I can tell you that I spend almost as much time giving away free educational materials such as meal planners, exercise guides, calorie diaries, and working with diabetes educators as I do anything else. Yes, metabolic disorders are extremely profitable, but to think that the entire pharmaceutical industry is run and made up of mustache swirling villains is inaccurate.

    As far as obesity, I’m sorry to see that it is becoming an “us vs them” political football. The facts on the ground are that obesity is slowly killing the productivity, quality of life, and economy of this country. There is enough blame to go around: from subsidized high fructose corn syrup to individuals in rural and suburban areas who ride their personal golf carts to their mail box or to visit their neighbors (their parents walked.) The issue has to be dealt with both from the organizational and governmental side as well as making personal responsibility for one’s own health part of our societal belief system.

  38. 38
    arguingwithsignposts says:

    @Leelee for Obama:

    been getting better, thanks for asking. although I was injured in an accident earlier this week (not my fault), so I’m in serious pain at the moment, having just had some experience with our greatest healthcare system in teh world (not too serious, fortunately – bruised back). onward and upward, hopefully.

  39. 39
    Leelee for Obama says:

    @Napoleon: Again, the pure immorality is what boggles me.

    I used to think that the “Death Panel” BS was really disgusting to use to scare people. Now, I’m wondering if that’s what the older people expect. And with attitudes like this, there is a self-fulfilling prophecy quality to it all. Maybe their heirs have said shit like this to them?

    It’s similar to the gun-toters, Obama’s gunna take my guns. If they keep up the crap, someone IS gunna take their guns. QED

  40. 40
    debit says:

    @GReynoldsCT00: I get where you’re coming from, but I don’t know anyone who wakes up and thinks, “Yes! Another day of being morbidly obese!” My ex mother in law weighs in at 400 or so and is the most miserable person I know. She’s been dieting for 30 years but each passing year just sees her packing on more pounds. Unfortunately, she’s just one person of many I know in the same boat.

    I don’t believe any of them want to be where they are physically. I don’t know why they can’t seem to lose weight. But I would never think of them as willfully forgoing the option to lose weight and being content to merely treat the symptoms.

    During my second pregnancy I gained a lot of weight. I’d quit smoking, worked long hours at a desk job and was unhappily married. All of these conditions led me to make poor eating choices and far too many of them. Food is a comfort and one of the things that could make me feel good when everything else made me feel like crap. It took me ten years (and starting to smoke again) to lose sixty pounds. Within another ten (after quitting smoking again) forty came back.

    Last year I commuted to work by bike. The weight didn’t come off. This year I’m commuting by bike, walking and jogging and counting every freaking calorie I eat. The weight is coming off, but my grocery bill is three times what it used to be because I’m only eating fresh produce and lean cuts of meat. My personal conclusion: losing weight is a full time job that costs money to keep. No wonder no one wants to do it. Now if you’ll excuse me, I have an appointment with my treadmill.

  41. 41
  42. 42
    arguingwithsignposts says:

    McCaughey says “Americans have spent a declining percent of income on food and gas and a steady level in housing, and that has allowed them to spend an increasing share of their disposable income on health care.”

    I like how she uses that word “allowed.” Like we all *want* to spend buttloads of money on health care.

  43. 43
    Leelee for Obama says:

    @Leelee for Obama: Speaking of word press hell. I was glad to see you posting, so I could catch up. Hope you’re feeling fit again soon.

  44. 44
    Leelee for Obama says:

    @arguingwithsignposts: Betsy McC should just have a big steaming cup of STFU. What an absolute waste of skin and blonde hair.

  45. 45
    kay says:

    @Jorge:

    I would just suggest, though, Jorge, that is health care providers are going to complain about the health habits of their patients, they might take some responsibility for that.
    It is what they do, after all. They’re health care providers. Certainly spending time on nutrition is an important element of their job.
    Shouldn’t the first referral for a diabetic be to a nutritionist rather than to a pharmacy? Heart ailments, high blood pressure, etc.? It won’t make their patients happy, everyone wants a quick fix, but it might make them healthier.
    They can’t really call themselves health care providers and then throw up their hands when confronted with a patient population who aren’t getting any healthier. Isn’t there some intersect or connection between national health and our health care providers?

  46. 46
    Napoleon says:

    @arguingwithsignposts:

    when in reality every cent spent on health care (like national defense) is money that, in a sense, you are just throwing away. Sure, if your sick (or your nation faces outside threats) you spend the money because it beats the alternative, but its money spent under a form of duress.

  47. 47
    Ryan says:

    Modern Conservatism is a perverse mix of Calvinism and Social Darwinism.

  48. 48
    Leelee for Obama says:

    @Napoleon: Yes, there is a coercive element to both. Perhaps we should use an argument about National Security viv-a-vis health care. Someone mentioned this ‘tother day, but a repeat of Spanish Influenza this Fall could concentrate some minds. The fReichtards are already going there, accusing the Administration of ginning up the possible dangers of a Flu Pandemic to push the Bill through.

    I want to make it clear, I hope it doesn’t happen, I love my family too much to sacrifice them or anyone else to the cause-but it’s like living in FL-we HOPE the hurricanes don’t come, but sometimes they do.

  49. 49
    Ash Can says:

    @MikeJ:

    Farm policy is where it’s at.

    This. It’s not the silver bullet, but it’s huge. If this can be put in the queue of train wrecks for the Obama Administration to sort out, future generations will benefit substantially. Eating healthy should be affordable for everyone.

  50. 50
    Leelee for Obama says:

    @Ryan: WIN! Such a shame the Quakers weren’t more aggressive; oh yeah, that was the point wasn’t it.

  51. 51
    Sloth says:

    As someone pointed out above, the insurers do have an incentive. It costs money to treat people who are obese. lowering obesity rates would mean fewer doctor’s visits, treatments, etc. for obesity-related illnesses, thus same insurance rates with less payout for treatments.

    The problem is they just don’t f-ing care.

    It’s not that they do not care, it’s that the simplest path to profitability is to cherry pick healthy people to insure and to raise prices. The incentives are out of line. Getting people to change their habits, reforming the entire health delivery system to be more efficient, this is hard.

    Certainly the public option gets those incentives in line. Whether not having a public option will do so remains to be seen. With proper price controls in place, it might.

    Another way to think of the entire obesity issue is that maybe our shitty health care allocation system causes (or at least contributes to) obesity – not the other way around.

    Last year I commuted to work by bike. The weight didn’t come off.

    The recommendation of Good Calores Bad Calories is spot on. I also bike commute to work the same thing . I was riding 40 miles a day. Sure I lost weight, but I eventually hit a plateau. Eliminating empty, simple carbs made all the difference, even with much less exercise (15 miles a day.)

  52. 52
    arguingwithsignposts says:

    @Leelee for Obama:

    The fReichtards are already going there, accusing the Administration of ginning up the possible dangers of a Flu Pandemic to push the Bill through.

    Yes, like the Bush administration never manipulated, say, the terrorist threat level, to win elections (cough, tom ridge, cough).

    The hypocrisy, it burns.

  53. 53
    ericblair says:

    @arguingwithsignposts: If the insurer paying the bills knew it would benefit from programs to combat obesity, then it would have a motive to institute such programs. Under single-payer, that would be the case for the single payer – our government. Under our current fragmented non-system, it isn’t the case for anyone.

    This is because the insurance industry knows damn well that most of their subscribers change insurers every few years, mostly involuntarily. So there’s little benefit for them for spending money keeping a subscriber healthy when they probably won’t see the lower costs down the road (it will be some other insurer). So they don’t do it. Health insurance market fail again.

    And if we start hearing Rush Limbaugh ranting that we can’t get health insurance because America is too goddamn fat, our journey to the Dark Side will be complete.

  54. 54
    arguingwithsignposts says:

    @Sloth:

    It’s not that they do not care, it’s that the simplest path to profitability is to cherry pick healthy people to insure and to raise prices. The incentives are out of line. Getting people to change their habits, reforming the entire health delivery system to be more efficient, this is hard.

    You say “to-MAY-to” I say “to-MAH-to.”

    I’ll rephrase: they don’t care about long-term solutions to hard-to-deal-with problems because they only care about short-term profits.

    It’s a variation of IGMFU.

  55. 55
    Xanthippas says:

    Good post. I definitely agree; everytime we talk about expanding an entitlement of some kind, some right-wing jack-ass starts telling us about how those people’s problems are all their fault and we shouldn’t “subsidize” their bad behavior.

    As far as people being overweight…well, try to do something about (soda tax, etc.) and you’ll hear right-wing wackos/libertarians telling us about how it’s our “freedom” to eat as much red meat as we want.

  56. 56

    […] Juice writes about the new media talking point that Americans don’t deserve better health care because we’re a bunch of big fat slobs. America’s obesity epidemic even explains, to Maria Bartiromo, our high infant mortality rates: […]

  57. 57
    Leelee for Obama says:

    {{And if we start hearing Rush Limbaugh ranting that we can’t get health insurance because America is too goddamn fat, our journey to the Dark Side will be complete.}}

    This is what I’m waiting for! He’ll probably say he has a glandular condition, nes’t pas? How about Newt, not so svelte, either. We should make a list of not so fit Rethugs and post it on blogs that push the obesity meme.

  58. 58
    PeakVT says:

    @arguingwithsignposts: As someone pointed out above, the insurers do have an incentive.

    The problem is that insurers aren’t guaranteed to reap the benefits of good preventative care, of which reducing obesity is a subset. Because people move, change jobs, lose jobs, etc., they change insurance companies fairly often. If one insurer was to invest in good preventative care, and others didn’t, that one good actor would be less profitable in the short term than other companies. And by short term I mean the next 4 quarters, which is not long enough for good preventative care to reduce costs. So no insurance companies take that step, or the take only small steps.

    As the Deanic pointed out the other day on NPR, some companies are expanding preventative care. But those tend to be large companies that self-insure and only use the insurance companies to administer their plans.

  59. 59
    flukebucket says:

    McCaughey says “Americans have spent a declining percent of income on food and gas and a steady level in housing,

    No shit. Since when?

  60. 60
    Leelee for Obama says:

    @arguingwithsignposts: The saddest part of the Tom Ridge revelations is that I’m so not shocked, it’s anti-climactic.

    Have I mentioned that I try not to, but I despise these lying asshats.

  61. 61
    ironranger says:

    Bartiromo & the rest of her media herd should have to spend their weekends volunteering at Remote Access clinics in this country. If that isn’t enough to knock the cobwebs out of their heads, then they should get some tents & camp out at the homeless tent cities.

  62. 62
    Leelee for Obama says:

    @flukebucket: I meant to comments on that statement before and posted too fast. In what universe is anything she said remotely true? This is the problem, they lie, they back up nothing, because they can’t, and they get away with it.

  63. 63
    Cataphract says:

    Spot. Fucking. On.

    Love this post.

  64. 64
    Original Lee says:

    @debit: Exactly right on the time-consuming nature of weight loss. It can come off fairly easily when you’re young, the first time you need to lose weight, and then it takes more time and effort the older you get. Which is why these talking heads likely have gym time with personal trainers written into their contracts.

    One part of the obesity panic that I’ve seen only tangentally addressed is the fact that people tend toward two extremes as they get older, skinny or fat, and it’s harder for them to maintain healthy weights/go against these tendencies as time goes by. So I think part of the obesity panic is “Oh crap! I’m getting old!”,. because omewhere along the line, Americans as a culture have bought into a meme that being old is bad.

    Anne Laurie, this was a great post. You are totally right about the concentrated “get them back at home” effort from the media. I once worked in an archive where various locally important people donated their papers for posterity, and at one point, I had to go through a couple of boxes belonging to someone (IIRC, a dean at a state university) who had been on the Department of War mailing list for certain kinds of morale issues. I think I remember seeing a couple of letters from around early 1944, when they thought the war would go on for a very long time, where some bright light had pointed out that the longer the women were in the workforce, the harder it would be to get them out of it to make room for the returning soldiers. So I would not be surprised at all (especially given FDR’s use of Madison Avenue types in certain areas of his administration) if it turned out that this amazing push for the German KKK originated somewhere in the government.

  65. 65
    Leelee for Obama says:

    @ironranger: I think we’ll see Armageddon first. These people have no interest in THE truth, they’re only interested in THEIR truth. For that, they don’t need to see anything, or even leave their chairs.

  66. 66
    arguingwithsignposts says:

    @Original Lee:

    It can come off fairly easily when you’re young, the first time you need to lose weight, and then it takes more time and effort the older you get. Which is why these talking heads likely have gym time with personal trainers written into their contracts.

    I think there’s something that could be said here about the nature of personal finances as well. People don’t do well at saving (I know I don’t), and it is a very incremental process unless you don’t have a lot of bills/overhead. Not sure where I’m going with that, but it seems related.

  67. 67
    PeakVT says:

    Ah, ericblair already made my point, and with less typos.

    I’m going to pretend I posted this pets-gone-galt pic instead.

  68. 68
    arguingwithsignposts says:

    @ironranger: @Leelee for Obama:

    Someone proposed a reality show the other day, I’d like to propose another one: “I’m a celebrity, get me health care!” Take them out to a RAM setup and put them at the back of the line and see if they can use the “do you know who I am” to get close enough to get in to see a doctor.

  69. 69
    MikeJ says:

    In what universe is anything she said remotely true?

    Food and fuel getting cheaper in the post war era is undeniably true. I would have guessed housing prices going up rather than flat, but that is with no data, so I would certainly believe otherwise if someone had numbers.

    Note that the “cheaper” food is calories per dollar. Americans spend a much smaller percentage of their income on food than they did in years past, but they get crap for their money. If you ate the same quality food it would probably cost more, but collectively people spend less.

    Gas prices, expressed in constant dollars, are still stupid cheap.

  70. 70
    Napoleon says:

    @MikeJ:

    I think housing prices were relatively flat (compared to income) until around 2000.

  71. 71
    ironranger says:

    @Leelee for Obama:
    Nope, but I like to imagine these know it all, sitting’ pretty people actually having to experience real life america.

  72. 72
    Fern says:

    I’m been a little surprise lately about the level of invective and the amount of sheer disgust I’ve heard expressed against fat people in the last little while. Especially fat women. It seems like fat people, and to some extent old people, are the only remaining socially acceptable targets of verbal abuse.

    It’s very easy to put on weight, very difficult to take it off, and even more difficult to keep it off, as any dieter can tell you. In fact, once they stop dieting, the overwhelming majority of people regain more weight than they lost.

    Lets also not forget about one more industry that benefits from the overweight – the enormous diet industry, which largely sells solutions that don’t work.

    The body developed it’s prodigious ability to store excess energy at a time when that made it possible to survive through times of scarcity. We can still store energy efficiently, but we no longer have the seasonal food shortages. Our work has become more sedentary, and the diet of many people has become increasingly calorie-rich and nutrient-poor.

    I could go on and on, but I will spare you…

  73. 73
    Fulcanelli says:

    @WereBear:

    Eating Real Food means a lot of shopping and cooking. But the Right Wing thinks we should all get second jobs to pay for our health insurance. Leaving less time to buy real food, which also costs more.

    Good points, and hopefully that second job (jobs? where?) will enable us to afford better quality food which is a big part of the obesity equation. Europe and Japan spend a noticeably larger portion of their income on food than the US, get better quality and thus better health to show for it.

    And THEY HAVE MORE VACATION TIME MANDATED BY THEIR SOCK A LIST GOVERNMENTS SO THEY AREN’T SO CONSTANTLY STRESSED OUT AND EXHAUSTED, a condition of which gorging on junk food loaded with carbs and sugar provides immediate short term psychological relief. Lather, rinse, repeat as required.

    Even if you take shopping at Whole Paycheck Foods out of the picture, better quality equals non-factory or smaller, family-run farming which equals more expensive. Gee, maybe that’s why low income areas and States (hello Mississippi!) have stratospheric obesity rates.

    As Chris Rock hilariously has noted repeatedly, “Our poor people are fat!”. Lower income equals affording only cheaper, lower quality food, the carb and sugar laden junk that gives us a sugar rush to help abate our depressed attitudes and stokes that carb/blood sugar cycle which piles on the pounds and numerous health problems.

    But the thing about this that really boils my rabbit is how this combination of conditions gives rise to the ignorant attitudes and comments puked up by financially well off snobs and racially biased assholes towards the less affluent (and often darker skin colored) among us that claim the poor are fat because they’re lazy and worthless so they deserve what they get. Walk a mile in their income bracket, assholes.

    Eat the rich. I hear they taste like chickenhawk.

    /vagina outrage. the mind boggles… need more coffee.

  74. 74
    ironranger says:

    @arguingwithsignposts:
    I like that one.
    All legislators against a public option must join the media at RAM & tent cities, also.

  75. 75
    Leelee for Obama says:

    @MikeJ: I haven’t experienced any of the prices going down with wages going up situation-so perhaps I live in a different universe. Of course, I lived on Long Island, and now FL and have never made more than 30 grand a year before taxes so that may change the dynamic some. I still think , for most people, this is not true.

  76. 76
    Leelee for Obama says:

    @Leelee for Obama: Just to note, most of my life 20 grand a year or less was the norm, with two kids. Even when I was with spouse, there wasn’t much money around. The 30 figure was 18 months, and I had a daughter and a grand daughter to support. If my rent stayed flat, my transportation, and food and utilities, more than made up for it.

  77. 77
    Silver Owl says:

    There are a lot of ignorant, arrogant and obtuse adults in positions that they are too immature to handle responsibilty.

    I’m truly gobsmacked at the number of adults in these positions and in the public eye that do not even come close to acting like adults. They do not think. They do not get informed. They do not research. They act and behave like spoiled rotten royalty from the 14th century.

    The childishness is mind boggling.

  78. 78
  79. 79
    kay says:

    Isn’t some of this that we’re getting a lot of medicine, but maybe not a lot of health care?
    I had occasion to use a county clinic when I was younger and poorer, for a pregnancy, and I actually learned a lot about health.
    I got what I have since found out is called “wrap-around care” as opposed to what is called “the medical model”.
    It was twenty years ago, so it isn’t new or radical. I spent 5 minutes every month with a (very nice) doctor, and hours with assorted other people, like the diet person, and the mental health person, and the lady who hectored incessantly on exercise, and, it worked. I did all those healthy things.
    We did the general health consultation components in groups, and the doctor’s actual exam in private, and while I was glad there was a doctor in case something went terribly wrong, she wasn’t central to what I referred to at the time as “training”. I understood the goal there was not to need her.
    It seems like that approach might work for diabetes, or heart disease, or high blood pressure.

  80. 80
    different church-lady says:

    We’re obese because the American way of producing food has failed us.

    — you have to work really hard to eat healthy food in this country. They’re dumping high fructose into EVERYTHING.

    — If you try to start a healty diet initiative, you’re scorned by the wingnuts. Just like they’re proud of their guns and anger, they’re proud of their fat.

    — There’s food available 24/7. Food is being pushed at you from every nook and cranny. You don’t even have to suffer the indignity of getting out of your car to get something that’s mostly fat.

  81. 81
    MikeJ says:

    @MikeJ: On that graph, compare what percentage of American income was spent on food in 1970, v what percentage in 2005. ~14% in 1970. ~10% in 2005.

    I’ve seen other graphs that go back to the end of WWII where the percentage goes even higher. I’ll see if I can dig up a chart with more data.

  82. 82
    satby says:

    @Fulcanelli:
    Yes Fulcanelli!
    Besides the atrocious agriculture subsidies, the corporate culture in this country contributes enormously to the obesity epidemic. People who work desk jobs for 50-60 hours, then commute for another 2, have no real time to engage in the kind of intense exercise that’s needed to peel pounds when you get very overweight. The sedentary nature of the average job, combined with the stress that everyone has over potentially becoming jobless are key factors to contributing to ill health in this country; and then the people in this bind get blamed.

    Corporations cannot fail, only the people can fail the corporations. We don’t deserve jobs, either, probably.

  83. 83
    RSA says:

    Just because…

    The various food industries fight every measure to inform people about the nutrition value of their products,

    And your average small town seems much more likely to have a half-dozen fast food restaurants than a single farmers’ market,

    And America is set up so that driving, rather than walking or biking, is the most convenient way to get around in everyday activities,

    And the sedentary lifestyles of most of our population make it harder to fit exercise into the day in any case,

    And so forth…

    None of this prevents someone with moralistic tendencies from saying that preventing obesity is just a matter of will power. It’s that simple… Isn’t it?

  84. 84
    ironranger says:

    Rachel Maddow showed a clip from a Sen Grassley town hall last night. I loved the senior citizen woman who confronted him with using Lewin group factoids when it is funded by United Health. I’ve been looking for that clip to send to friends but haven’t found it so far.

  85. 85
    Hunter Gathers says:

    This is a class war. All of the people who argue against HCR all have one thing in common – protection of their own wealth. The debate really started heating up was when the plans to pay for HCR came out. Two of the plans involve taxing the rich. The other involves taxing ‘gold plated’ health insurance plans. The ‘gold plated’ insurance plans they refer to are mostly plans held by union workers. I’ve never met an upper class idividual who did not hate unions with every fiber in their body, family included. They see unions as giving the working class more power than they deserve. Because people who are not rich are automatically stupid and fat and deserve to die broke in an alley. The richest 5 percent of the country would rather watch the rest of the country burn to the ground than give up an extra 1 percent of their income.

    The teabaggers are prodded by astroturf organizations that take money from rich corporations and individuals. They gin up anger within the senior citizen community, because seniors are for the most part incredibly gullible, taking as gospel anything they see on TV. Add in the large amount of the population that is dumber than a bag of fucking hammers, and you have the clusterfuck that we have now.

    Majorities believe all of the health care lies for a reason. Because the MSM is more than willing to propogate lies about anything, even when they know it is bullshit. Because bullshitting the public is a money making enterprise. Remember the last big lie that worked? Wasn’t that long ago. And the MSM propogated that lie as well. They ever apologize for duping the public and getting us into a war based on lies? Of course not.

    Obama is not perfect. Anyone would have a problem fighting a battle over legislation when your adversaries outnumber you 4 to 1. I still think HCR is getting done.
    If it doesn’t, it proves that this country is structurally fucked, and deserves the utter chaos that a President Palin would bring.

  86. 86
    CalD says:

    I read somewhere a while back that when governments are the ones paying their nations’ health care bills they tend to discover a newfound level of concern about other policies that negatively affect the health of their citizenry. Environmental policy was the example cited but I’d guess that an agricultural policies that effectively encourage obesity would also be something that might start drawing more scrutiny than before.

    I wouldn’t be surprised if there were similar shifts in attitude among taxpayers to some extent, since we’re the ones ultimately paying the bills. I’m not sure that’s such a bad thing.

  87. 87
    Deborah says:

    I’m kind of lost on the reasoning, though I guess other commenters get it. I think I agree with the general point but the subpoints lose me. e.g.

    You don’t need a gym membership to exercise. Really. It is not a requirement. Whenever I walk past gyms on a beautiful day I see lines of people on the treadmills, watching me walk outside. Now, I will happily grant a serious issue for children and adults who are poor enough to live in unsafe neighborhoods not being able to exercise outside, there’s a limit to how much you can do inside if jumping is ruled out by downstairs neighbors, etc–but that wasn’t the point made here. 100 years ago, or 50 years ago, people were much thinner yet we had almost no gyms and were poorer. Fallows recently had a good post showing Hitchcock and Gleason, notorious fatties of their day who seem just slightly well-upholstered now.

    Obesity complicates anything surgical because it is harder to get to the parts. Bring in two people from a car accident, one in the normal range and one carrying an extra 100 pounds, and the latter will be at a serious disadvantage as surgeons attempt to get at the windpipe for a tracheotomy, etc. It is a medical fact, a biophysics fact, a simple “can you find it” fact. Ask someone who works in the emergency room. Picture doing a delicate, precise motor task with an extra liter of fat wrapping everything. I have no idea what the doctor’s “fat people are harder to anesthetize” thing is doing in his piece on the public option, but I have no idea what it’s doing here, either.

    Seats in public venues have been getting wider to support our expansion. And still, no one is pleased to go to the theater or on a plane and behold two immense people squeezing into the seats next to them. Short of a campaign to replace all seating everywhere with individual lazyboy recliners, this is going to continue. It was true 100 years ago–Oh no my seat is between two immense men!–and will be true in any future short of Wall-E’s, which did in fact include individual lazyboy recliners for everyone. It is in no way a conspiracy against fat people.

    I don’t hate fat people, I carry extra pounds, but the “oh noes he says we’re harder to operate on, oh noes people don’t want to be squeezed next to us” is not evidence of a grand conspiracy.

  88. 88
    Mike P says:

    But what does Megan Mcardle think of all your talk about obesity? She got into it with Ezra Klein over this a few weeks back.

  89. 89
    Brick Oven Bill says:

    There is a game I play at the grocery store. I look at a shopping cart in line and guess what its possessor looks like.

    Having played this game for years now, I have come to a conclusion. Shopping carts full of meats, cheeses, frozen entrees, and sugar soda are possessed by fat people.

    Shopping carts full of fruits and vegetables, along with grains, are possessed by physically fit people.

    These factors, and not cost or time of preparation of the items in the shopping cart, are the best predictors of physical fitness. A head of lettuce costs exactly as much as a McDouble, $0.99. You can just peel and eat leaves of lettuce. You need to go through the drive-through to get a McDouble.

  90. 90
    debit says:

    @Deborah: I think the point you’re missing is that fat people are being told they are lazy and therefore deserve to be fat and despised and should shut the hell up and just go lie down in a corner and die somewhere. Preferably out of sight.

    Okay, there was a lot of hyperbole in there. Sorry.

  91. 91
    Shinobi says:

    As americans we spend over 40 billion dollars on dieting related products every year.

    I wonder how much health care that could buy.

  92. 92
    Napoleon says:

    @Hunter Gathers:

    HG said: “I’ve never met an upper class idividual who did not hate unions with every fiber in their body, family included. They see unions as giving the working class more power than they deserve. Because people who are not rich are automatically stupid and fat and deserve to die broke in an alley.”

    This is exactly right and cannot be emphisised enough. They have run class warfare on the working and middle class for decades now.

  93. 93
    Shinobi says:

    @Deborah:
    I am sorry that people don’t like sitting between me and another fat person, or hell, even next to me.

    But I don’t particularly like shoving my ass into a seat designed for someone half my size.

    If I can’t find pants in a store, is it my fault because I’m too fat, or is it the stores fault for not carrying pants that fit me?

    If a short person can’t reach something on the top shelf? Shouldn’t they just get taller? And if a tall person keeps hitting their head, shouldn’t they just get shorter?

    If I can’t get good ccare at a hospital, is it my fault for being fat? Or is it the hospitals fault and the medical industry’s fault for not training people to work on fat bodies and buying medical equipment suited for people of all sizes? (like gurneys beds etc)

  94. 94
    cmorenc says:

    The health care system is structurally, financially broken for reasons aside and beyond obesity. Nonetheless, obesity is ONE (among several) of the most important factors helping to strain it to the breaking point.

    My wife & I ate out last night at Chili’s, a guilty very-occasional pleasure (most often we grill/cook healthier fare at home). There was another family eating at a booth across from us, and the only way to describe the dad of this family was a hugely obese heart-attack waiting to happen, and his wife was well beyond merely being “Rubenesque”. Their two kids weren’t as far along (yet) as their parents, but clearly headed that way by early adulthood if not sooner. Of course, their table was crowded with some of the higest-calorie count items from the entire menu, bring on the chili fries please.

    We all WILL be paying immensely for this family’s irresponsibly indulgent dietary habits under just about any health care “reform” scenario in one way or another, including failure of any reform to pass and including public-option advocates full wish-list. So don’t try to indignantly pass the buck about the obesity thing, all you fat slobs out there. Put down that cheeseburger, and get ye to the gym forthwith!

  95. 95
    T. O'Hara says:

    Nonetheless, obesity is ONE (among several) of the most important factors helping to strain it to the breaking point.

    Yes. The other side of this is: longevity is not a very good measure of how much we need health care reform. Health care reform will not make us skinnier, and until we get skinnier, we will not live as long as the Japanese. If living longer is the goal, fitness programs and diet have a bigger impact than health care reform.

  96. 96
    satby says:

    “So don’t try to indignantly pass the buck about the obesity thing, all you fat slobs out there. Put down that cheeseburger, and get ye to the gym forthwith!”

    Because it was OK for you to cheat at Chili’s but not for them. Got it.

    Totally gave up on the blockquote thing.

  97. 97
    GReynoldsCT00 says:

    @Shinobi:

    I think part of the issue here is that the fact that we are getting bigger as a society is the change – if that makes sense. We’re bigger than we were, and while many people have health or hereditary reasons for not being able to lose weight, many simply CHOOSE to have a 1/2 lb of cream cheese on their bagel. I worked with someone like that. My uncle and his wife do that. How much more accommodating is society going to be by enlarging seats, etc.? And if we keep doing that, when will it end?

  98. 98
    A Mom Anon says:

    One of the saddest things I’ve seen in this whole mess was a woman holding a sign that said”Healthcare is Not a Right”.

    This wasn’t a wealthy woman,in fact she looked to be pretty much like any woman I’ve known. Pretty average,someone we all see each day and barely notice. Working class,blue collar,like any mom you’d run into in any middle class neighborhood. There’s no way this person had loads of money stashed for a rainy day. I’d bet,just like most people,she’s one illness or accident away from debt she’d never be able to get out from under. I honestly don’t think most people have an even remote clue exactly how expensive ER and hospital care really is. It’s STUNNING and frightening to look at itemized bills,astounding.

    I don’t understand this need to punish everyone all the time for everything. That’s their answer to all of our ills,suffering and punishment. They expect to be able to shit all over the world and everything in it and no one else has a say. Their rights stop where the rights of others begin. If they don’t want single payer health care,fine then,let them gamble with the insurance companies. Good for them. They don’t have the right to tell the rest of us what we need and don’t need.

    Can we get the Civics education back in the schools please? Jesus,I cannot believe I’m one of the only adult people in this country that had education that stressed the need for citizenship(Not Nationalism,big difference),a need for A Commons,that kind of thing. It DOES matter,it has a place in our lives,and I wish it wasn’t seen as trivial by so many people.

  99. 99
    Max says:

    What a great post. Discrimination against the chubby is strong in our society. The medical field is no exception.

    My friend spent 8 years trying to get diagnosed for what was wrong with her. She has all kinds of symptoms, but doctors, lots of doctors, just told her “you’re fat, lose weight”. Finally, she got obsessed with proving them wrong, so she lost the weight and guess what… she’s got MS. That’s what all her symptoms led to, but the bastard doctors didn’t see her as a person, they saw her as a fattie, so they didn’t even try to heal her.

    That happens over and over again in our medical system.

    Fat people know they are fat, and we know it is unhealthy. But, there are a variety of reasons why someone may be heavy and being “lazy” isn’t even in the top ten.

  100. 100
    Shinobi says:

    @cmorenc: How do you know those people don’t eat like you every other day and were just having a big old binge for a change?

    How do you know they weren’t celebrating something? Because they were fat? Therefore they must eat like that all the time.

    What if you’d seen a thin family doing this? Would you just have assumed that they ate healthy most of the time? Totally ignoring that some people have a metabolism that allows them to eat whatever they want without gaining any weight. I have a coworker who eats Mac Donalds EVERY DAY and she is still quite thin. Is she healthier than me? The “death fat” girl who eats salads for lunch most days? (because I like them)

    You can’t make assumptions about people’s health or eating habits based on watching them eat one meal. That’s prejudice. Socially sanctioned and accepted prejudice, but that’s what it is.

  101. 101
    Shinobi says:

    @GReynoldsCT00: You should know that a lot of the statistics arguing that we are getting “bigger” are based on a change in BMI standards in the 1990s. It has levelled off in the last few years.

  102. 102
    FormerSwingVoter says:

    Wait… I thought we were supposed to be the elitists?

  103. 103
  104. 104
    Shinobi says:

    Uhh I think I broke it

  105. 105
    GReynoldsCT00 says:

    @Shinobi:

    I know, the BMI is crazy… if I lost what the BMI said I should, I’d look like a scarecrow… they need to change that… that makes people go too far in the other direction

  106. 106
    YellowJournalism says:

    “Can we get the Civics education back in the schools please?”

    No. Unfortunately, there’s no time for that because we need to have kindergarten children doing fractions and writing short papers.

  107. 107
    Deborah says:

    @Debit: I think the point you’re missing is that fat people are being told they are lazy and therefore deserve to be fat and despised and should shut the hell up and just go lie down in a corner and die somewhere. Preferably out of sight.

    Okay, but how does that go in with the switch from Rosie the Riveter to housewives shouldn’t take jobs–both real, I grant? I would understand this more as pure rant without the odd sidelines into What Women Should Be and If The Whole Medical Profession Finds It Harder To Operate on the Obese It’s Not Because The Fat Gets In the Way, It’s Because THEY ARE MEAN. I’ve seen plenty of chubby nurses; I don’t think they claim that it’s really easy to operate on the obese.

    @Shinobi: I am sorry that people don’t like sitting between me and another fat person, or hell, even next to me.
    I don’t expect you to be sorry, I just don’t expect you to be surprised or view it as a conspiracy based on size prejudice rather than “this will be uncomfortable.” People hand out the same looks crammed into an overstuffed subway car full of thin people.
    But I don’t particularly like shoving my ass into a seat designed for someone half my size.
    You seriously want the all-public-seating-to-be-individual-lazyboys option?
    If I can’t find pants in a store, is it my fault because I’m too fat, or is it the stores fault for not carrying pants that fit me?
    It’s a sign there isn’t much market for people your size. You know, capitalism. My husband has to shop online because he’s 6’3″ but thin, and the Big and Tall stores do not cater to the Tall Only.
    If a short person can’t reach something on the top shelf? Shouldn’t they just get taller? And if a tall person keeps hitting their head, shouldn’t they just get shorter?
    I stand on a stool, and the tall people duck. We do not normally assume a vast conspiracy to make us feel inadequate, just that the world is designed for more average sized people. Tall people can write perfectly good rants about the itty seats with no leg room, but it’s usually not prefaced with “the airlines are prejudiced against me and wish I would just go die.”
    If I can’t get good ccare at a hospital, is it my fault for being fat? Or is it the hospitals fault and the medical industry’s fault for not training people to work on fat bodies and buying medical equipment suited for people of all sizes? (like gurneys beds etc)
    Assuming it’s size-related it is your fault or bad luck for being fat, because the issue is not one of artistry–tragically training everyone to do impressionism rather than cubism–but biophysics. It is harder to find and get at and manipulate the relevant parts of the skeletal, circulatory, respiratory systems. This is like complaining that if a doctor finds it more difficult to parallel park a Suburban than an Accord, it’s all the doctor’s fault for not getting enough training–the issue, given a constant size of parking spot, is that the Suburban is bigger and harder to fit and harder to maneuver. Don’t claim that the difficulty of doing an operation on you and on someone who weighs 140 pounds should be exactly the same to be, you know, fair.

  108. 108
    Shinobi says:

    @GReynoldsCT00: Plus people categorized as “Obese” by the bmi actually have better chances of surviving most health issues, like cancer and cardiac arrest.

    They call this the Obesity Paradox, even though it is shown repeatedly in studies. OBVIOUSLY fat is bad, so why are these fat people living longer than thin people with the same problem. It must be some kind of paradox. Way to question your assumptions medical community.

  109. 109
    Billy K says:

    Anne Laurie is a great writer who has yet to master the art of blogging.

  110. 110
    satby says:

    Yeah, I need to talk about the healthy eating makes us all thin myth. I scored the highest score possible on the nutrition NLN board in nursing school, and know more about the subject than most people. I eat very healthy: grassfed beef and other lean meat, whole grain foods, fresh fruits and veggies, many from my organic garden. I can make tofu into anything, including cheesecake.

    And I am an IT professional who monitors systems live for 9-12 hours every workday; that’s a lot of ass-in-the-chair time. So after 10 years in this biz, I’m 50 lbs overweight, though due to my great diet I have no other health problems even though I’m 54. None. But I work with 20-somethings who have high BP and cholesterol already, and will barely make it to my age. Poor food choices is a part, but so is a culture where people are kept prisoners of the cubicle, afraid to walk away early enough for a healty walk or some life balance to reduce stress.
    Just putting down a cheeseburger is not the solution to what ails this country.

  111. 111
    WMass says:

    @Shinobi: “If a short person can’t reach something on the top shelf? Shouldn’t they just get taller? And if a tall person keeps hitting their head, shouldn’t they just get shorter?”

    Sorry, but this is a very dumb analogy. People cannot change their height, but they can change their weight.

    “If I can’t get good ccare at a hospital, is it my fault for being fat? Or is it the hospitals fault and the medical industry’s fault for not training people to work on fat bodies and buying medical equipment suited for people of all sizes? (like gurneys beds etc)”

    Sorry to disagree with you again, but yes, it is your fault. The problem is not that doctors dont know how to treat overweight people, it is that it is fundamentally more difficult to treat them. Training is not going to change that.

  112. 112

    As someone who’s trying to “drop a few”, this issue is important to me. I’m GLAD people are discussing the obesity epidemic. I’d love it if this conversation got people moving again and got people thinking about the food they put into their bodies. However, I’m scared this could quickly slippery slope into “fat people are the cause of all our problems.” This would break my heart. The last thing overweight folks need is more stress and pressure. I don’t think stress and pressure and low self-esteem ever made anyone get fit. What gets people fit is a pro-active desire to take control and get HEALTHY (NOT skinny).

    Of course, this issue always gets my blood pressure rising. As a woman who’s always been lauded for her looks, I think back to my fitness peak in my early 20’s, when I achieved a size 2/4 waist. At one point, I actually squeezed into a size 0 a-line skirt. And STILL I wanted to “drop a few more.” It’s scary and sad…the things we women put ourselves through.

  113. 113
    Shinobi says:

    @Deborah:
    It’s a sign there isn’t much market for people your size. You know, capitalism. Uhm, weren’t we just talking about how obesity is such a huge problem in this country? And weren’t you just complaining about all the fatties that come into your hospital? Where exactly do they get their clothes? mars?

    “everyone knows” fat is a “problem” in this country, so lots of companies should be selling stuff for fat people. But they aren’t. And we’re just supposed to assume this is because actually there aren’t any fat people? The average woman in this country wears a 14, and most stores only go up to a 12. It has nothing to do with economics and everything to do with appearances.

    Also, I’m not saying I want all public seating to cater to me. What I am saying is that I want a little CONSIDERATION from ASSHOLES who think that I don’t have a right to sit somewhere because the seats are too small.

    I’m tall too, I’m 6′ tall which for a girl is pretty tall. I don’t blame the airlines for having seats that I just point blank don’t fit in. I’m not mad at them for that, it’s economics.

    I AM mad at them for saying they will bump me from a flight if someone else whines enough, because THEIR seats are too small to accomidate me. And I AM mad at the people who sit in front of me and get my knee in the middle of their back for turning around and glaring, because you inow what, there is no where else for it to go.

    I don’t, as you put it, want to go die. I want people who hate fat people, like yourself, to FUCK OFF and quit judging us.

    I don’t hate myself because I’m fat. I hate people who hate me because I’m fat.

  114. 114
    Shinobi says:

    @WMass: Sorry, but this is a very dumb analogy. People cannot change their height, but they can change their weight.
    Orly? Please show me the magical diet study that shows most people losing substantial amounts of weight over a longer than 5 year period? See Also, gastric bypass patients who regain within 5 years.

    Sorry to disagree with you again, but yes, it is your fault. The problem is not that doctors dont know how to treat overweight people, it is that it is fundamentally more difficult to treat them. Training is not going to change that.

    And whining about it will? OH OBVISOULY. It is clearly way more effective to deny care and give lower quality care to fat people than it would be to say…figure out how to give them better care. This is Haaaaard waaaah we can’t doooo iiiiit.

    Give me a break. The medical community does things that are difficult every single day. To say that if they really tried they couldn’t figure otu some better methods for treating/operating on/dealing with fat people is really to say that they just don’t want to. They aren’t motivated to help fat people, because it is fat people’s own fault they are fat right?

    Despite evidence that indicates that over 70% of body weight is related to genetics.

  115. 115
    Z says:

    You know who actually haven’t earned their sweet healthcare benefits? How about those Medicare recipients who are blocking healtcare reform. They, on average, have put in $64,000 in taxes toward the benefits … they, on average, consume more than $165,000 in benefits.

  116. 116
    WMass says:

    @Shinobi: You are right, having a large supply of fuel for emergencies like a serious illness is helpful. But muscle is a better, more energy-dense source of fuel. If your concern is surviving a serious medical problem you are better off putting on muscle than fat.

  117. 117
    GregB says:

    But, but, we’re still the greatesest country evah! Right?

  118. 118
    Marci Kiser says:

    “Americans have grown very fat. This complicates anesthesia tremendously. Putting in IVs, spinals and epidurals is harder. Inserting breathing tubes is much more dangerous. “ True enough, but then, he’s getting paid somewhere north of $300k a year to deal with those complicated fat people.

    Actually, doctors do not receive extra money for dealing with these complicated fat people. Pedantic, maybe, but the idea that the dozens of medical professionals whose jobs are made four times as hard by the obscenely obese are in some way ‘pre-compensated’ for their efforts is insulting.

  119. 119
    WereBear says:

    @cmorenc: I must note:

    We all WILL be paying immensely for this family’s irresponsibly indulgent dietary habits under just about any health care “reform” scenario in one way or another

    We pay for everybody, one way or another. We pay for the miserable teen girl who turns to food as the only drug that helps the pain. We pay for the reckless teen boy who thinks drinking is a game and wraps his pickup truck around a tree.

    We pay for the angry loner who shoots up a gym. We pay when we throw away half our young people’s minds because we won’t give them education and safety.

    We always pay and pay and pay. It’s all about what we pay for.

    And what we get.

  120. 120
    Shinobi says:

    @WMass: Those studies are based on BMI, so it doesn’t differentiate between muscle or fat. (Because, y’know, the BMI is BS.)

  121. 121
    Leelee for Obama says:

    Remember my post about seeing the apocolypse before the celebrities going to RAM sites? Well, whaddyaknow, I saw it.

    Per CNN: for the first time evah, it’s casual Friday on NYSE! I could care less if they work at home in the buff-the Apocolypse part is that IT’S FUCKING NEWS!

  122. 122
    JenJen says:

    @Ailuridae: Agreed… Mika made the obesity comment. Childhood Obesity has become her raison d’etre.

    Doesn’t change the point at all. Mika absolutely snarled-out that “obesity” word.

  123. 123
    WMass says:

    @Shinobi: BMI gets a really bad rap, and it is totally undeserved. It is a tool for measuring a large population, not, under any circumstances, an individual. BMI is absolutely meaningless when applied to an individual. If anyone wants to know how much fat they are carrying around, just spend $15 on skinfold calipers and you can easily measure your percentage of body fat. It is amazing how many people misuse BMI and then go on angry rants about it.

  124. 124
    Fern says:

    @Shinobi:

    Heavier women are also less prone to osteoporosis.

  125. 125
    GReynoldsCT00 says:

    @WMass:

    Somebody ought to tell the CDC about that… and other medical institutions…

  126. 126
    Dude in Jersey says:

    @crayz:
    +1

  127. 127
    Chad N Freude says:

    @ironranger:

    All legislators against a public option must join the media at RAM & tent cities, also.

    Wouldn’t work. It would be proof that charity, not government, is the solution.

  128. 128
    Mnemosyne says:

    There is nothing so unfeminine as taking up too much space, using up ‘more than one’s share’, attracting too much attention.

    It’s interesting — when I lost 32 pounds, I ended up in this weird psychological space where I felt too small. Diminished. Like having that extra weight had given me more power, and now it was gone because I was physically taking up less space.

    I solved the problem by starting to lift weights rather than gaining the weight back, but I can’t help but wonder if that’s a component for some of our obesity. We’re already diminished by the corporate culture we live in — our only hope of being noticed is to be big enough that we can’t be overlooked.

    I dunno, just a random thought.

  129. 129
    Jason says:

    Excellent post. Brilliant read.

  130. 130
    Mr Furious says:

    @Brick Oven Bill: Do you ever stick around to see the total bill for those carts, jackass?

    Fresh produce costs more. Period. It takes more time and effort to prepare. It also goes bad if you don’t use it promptly. Which is not always easy if you work two jobs and can only shop once a week.

    Prepared foods are not always a better deal, and are most certainly not as good for you, but this is not as simple as you paint it.

    What else is fucking new…

  131. 131
    Mr Furious says:

    Anne, this post is phenomenal.

  132. 132
    Chad N Freude says:

    Brick Oven Bill:

    You’ve mentioned your fascination with supermarket shoppers in the past @
    http://www.balloon-juice.com/?.....nt-1333548

    … it is fun to tailgate her around and around the store with an empty shopping cart.

  133. 133
    rs says:

    Aside from the valid political and economic reasons cited above that result in an oversized American population, medical procedures are more difficult in obese people. While I disagree with most everything else in the WSJ editorial, the doctor is absolutely correct about the increased degree of difficulty when attempting to intubate, establish IVs, or perform LPs on fat people. Also, inasmuch as some drugs are fat soluble, people with higher body fat content do become more difficult to sedate, to answer someone above who seemed to question that contention. Not mentioned are the effect on the health of the provider. Back and shoulder injuries are endemic among health care providers, particularly in nursing, many of them arising from moving the 300/400/500+ pound people who have become more prevalent in the years I’ve been practicing.
    While serious health care reform (which this country obviously isn’t prepared to address) would require a multi-pronged attack including, but not only, universal single payer, addressing the obesity problem and it’s effect on health (start with diabetes, hypertension, and lower extremity orthopedic problems) would also be part of that attack. While it’s not the bulk of the problem (9% of total cost, as someone pointed out), it does contribute and needs to be addressed.

  134. 134
    Will says:

    The men in my family have always lived about 20-30 lbs above their recommended weight. No skinnies in this crowd.

    Over the past year, I got my fat ass up from my usual 20 lb overage to about 50 lbs overweight. Through 4 months of diet and exercise, I have been able to lose 30 of those extra lbs. However, that extra 20 is sticking to me like white on rice, no matter how little I eat, or how fanatically I exercise.

    I think there are weight/health struggles that go beyond simple lifestyle choices.

  135. 135
    R-Jud says:

    When I was 16, I went for a checkup. I got on the scale. “5’11”, 165,” said the doctor, “As a female, you should only weigh 150. Lose 15 pounds.”

    So I went on a crash diet. Lived on diluted juice, tea, and a half-portion of whatever Mom served at dinner. Two weeks after beginning this regime, I had lost 10 pounds. I was getting compliments about how skinny I looked. Then I passed out at swim practice.

    “What are you doing to yourself?” asked my coach, after I’d been treated. I explained about the doctor’s appointment, being overweight, etc. He rolled his eyes, and called his female assistant who turned up with some calipers. She did some skinfold pinches and came up with an estimated body fat percentage of 13.5%. The bare minimum most women need to have a fully-functioning reproductive system is around 10-12%.

    The doctor had taken two numbers and drawn a conclusion. What he didn’t take into account was the fact that I was a state-ranked sprinter who swam 20-30 hours a week and undertook heavy weight training. I was wearing a size 4/6 when this guy told me I was too heavy. It is a testimony to the stupidity of most doctors’ height-weight charts and our warped image of female beauty that I, a reasonably smart kid, took him seriously.

  136. 136
    someguy says:

    Americans don’t deserve a decent health care system because we are disgusting fat pigs.

    You watched Wall-E, right? Americans in general eat too much, consume too much energy and natural resources, and do too little. We consume 80% of the world’s resources, while producing maybe 10% of the world’s goods. The only flaw in the argument is the conclusion. Drive through Red State America or look at how many resources we consume and you realize the premise – that as a nation we a bunch of fat pigs – is spot on. Well, except there’s a lot fewer teeth in much of RedState America than there are in a typical pig’s jaw, probably due to the abundance of Mountain Dew. When our consumption is more in line with India’s or China’s or Africa’s, then you can contest the premise. Until then… Oink oink oink oink. And if the pig moniker bothers you, then just say “we’re obese greedy assholes” and leave it at that.

    If you think we ought to incentivize that kind of behavior by providing all sorts of medicines, surgeries, joint replacements, and the inevitable 10 year maelstrom of treatments that most diabetics wind up needing after eating themselves into diabetes… well, basically, you’re going to love a lot of people to death. All of us who don’t shovel in chips and ice cream and who bust our asses exercising 6 times a week, are going to pay shitloads for covering diseases that, for many if not most people, are self-inflicted results of their bad choices.

    It’s like TARP but for fat people’s health insurance.

  137. 137
    gex says:

    @someguy: Way to miss much of the discussion about how our suburban development policies, agricultural subsidies, and various other public policy issues have fed in to the weight gain problem in America.

    You are absolutely right – 2/3 of Americans are just fat lazy slobs while only you and the few other people who aren’t overweight are the only ones with any discipline and morals.

  138. 138
    Beej says:

    @Leelee for Obama: There’s a commercial running here right now with the same message. If we institute a program that insures all the currently uninsured there simply aren’t enough doctors and the elderly, in particular, won’t be able to get in to see their doctors expeditiously. Disgusting commercial.

  139. 139
    Chad N Freude says:

    @A Mom Anon:

    I cannot believe I’m one of the only adult people in this country that had education that stressed the need for citizenship (Not Nationalism,big difference),a need for A Commons,that kind of thing.

    You’re not. I worry about the disappearance of the concept of common interests and shared responsibilities from the public discourse, and apparently the public mind, in this country, and I fear that the United part of United States is going to be irretrievably lost (if it hasn’t been already).

  140. 140
    Deborah says:

    @Shinobi: Sigh.

    And weren’t you just complaining about all the fatties that come into your hospital? Where exactly do they get their clothes? mars?
    No. First, I do not have a hospital, I have a habit of reading widely in science, relevant to both my job and interests. And thus I noticed when the physical problems of doing a tracheotomy on the obese started to be noted. At no point in my post do I complain that fatties come into hospitals; I disagreed with your assertion that an obese person should be as easy to treat as a thin person, and if they weren’t it was all the fault of the doctor’s inadequate training. It is the same basic reason that an experienced driver faced with a small parking space will have a harder time parking a suburban.

    As for where the fat people get their clothes: They appear to be dressed. Ergo they are finding clothes. My visits to Jo Ann’s suggest the entire nation has not taken up sewing. I don’t understand how you can simultaneously say “There are no clothes for people my size!” and “Oh yeah honey, well people my size wear clothes! Do you think we get them on Mars?” You’ve covered both sides of the argument in two posts. I’ve noticed a preponderance of large size departments when I venture into department stores, and I get a lot of petite stuff online–again, I’m just not seeing a conspiracy to deny you clothing. The only clothing data I know of is that sizes have expanded, and thus the size 6 I wore as a teen is a size 2 or 0 today.

    Also, I’m not saying I want all public seating to cater to me. What I am saying is that I want a little CONSIDERATION from ASSHOLES who think that I don’t have a right to sit somewhere because the seats are too small.
    Like what? Are people actually standing up and informing you that you are not allowed to sit there? If so, feel free to tell them off; I’ll back you up. Or are you mindreading them? If so, please consider that “oh no we’re going to be squeezed” is a universal sentiment. People don’t want to be squeezed. A deep appreciation for the art of Rubens wouldn’t make them welcome it.

    I want people who hate fat people, like yourself, to FUCK OFF and quit judging us.
    I don’t hate myself because I’m fat. I hate people who hate me because I’m fat.

    The only judgment I would seem to have made is that your argument for simultaneously finding and not finding clothes doesn’t hold up, and that your argument that surgery is more difficult for the obese because of dire prejudice rather than straightforward physics is also lacking. Those aren’t based on how you look–I really have no idea how you look–but on what you write.

  141. 141
    serge says:

    I’m horrified by real violence, especially man-on-woman and adult-on-child. There was a moment, though, (forgive me Father, for I have…) when I wanted Matt Taibbi to jump up and just bitch-slap Maria Bartiromo.

    That would have been so wrong, though.

    I settled for, and was happy at, him simply making her look like an idiot. This is how things should be done.

  142. 142
    Joshua says:

    @Beej: My girlfriend used to throw out that argument in our health care arguments. I realize the simple solution would’ve been to dump her, but I informed her that it was simply barbaric to think the only way we could get decent care on time is to keep the hordes out. She understood it. Problem is, we live in a “fuck you, I got mine” society now (see @someguy‘s post) so quite frankly, it is a message that more people take to than should.

  143. 143
    Riggsveda says:

    Nothing brings out the hate in one’s inner 5th grader like the lure of obesity. Lots of unresolved issues here amongst that crowd. Why don’t we, instead of giving them insurance, set up community dodgeball tournaments where the local shitheels can burn balls at the fat kids? The ones who manage to avoid getting hit can have health insurance, and the rest can slink off to nurse their bruises and wait to die of some well-deserved physiological complication. Would that satisfy your mean-hearted, misplaced frustration, all you self-righteous paradigms of health?

  144. 144
    kay says:

    @Beej:

    If there’s a shortage of physicians, and I don’t know that there is, it seems like we could address that, by expanding opportunities for people who might want to become physicians. Like, adding medical school slots.
    I recognize that it’s a difficult job, but there are lots and lots of difficult professions that don’t lack practitioners, because they allow more applicants into the licensing process.
    Alternately, physicians could allow non-physician medical professionals to provide basic medical care, which is what they’re doing now anyway, and we could just acknowledge that, and charge accordingly.

  145. 145
    Deborah says:

    @rs:
    Applause. Good sense.

    I strongly agree with the people upstream about changing the incentives in our farm subsidies, but I don’t see that happening soon.

    Fewer people with type 2 diabetes (my parents and mother-in-law, all moderately overweight, all have it) would be a huge public health plus, and that is related just to straight excess fat carried. (Whereas the tubby but active are protected from stroke and heart attack to a degree.) This is true whatever health insurance system we come up with–I support single payer, but if Type 2 diabetes starts to become the norm for people above a certain age it will not be good for any health insurance system.

  146. 146
    Interrobang says:

    Another major factor that nobody has really mentioned so far is lack of sleep. Want to pack on pounds fast no matter what you eat? Try being seriously sleep-deprived for a few weeks. Most North Americans are chronically sleep-deprived anyway…

    For a long time, the medical profession thought that being obese caused sleep apnea, because sleep apnea and obesity were correlated in many patients. Turns out, sleep apnea causes obesity, not the other way around. In a lot of cases, fixing the sleep apnea fixes the obesity almost immediately.

    North Americans work more, vacation less, and sleep less than just about every other culture on the planet. Four weeks’ paid vacation plus sensible labour laws restricting the legal limit of hours people can work in a week, plus living-wage laws would go a long way toward reducing obesity, without even getting into issues of diet and/or exercise.

  147. 147
    DonkeyKong says:

    Bipartisan answer to this problem would be death panel’s for fat old people. David Broder just got a thrill up his leg.

  148. 148
    Joel says:

    @rs: Obesity is a public health issue, but one largely irrelevant to the question of whether the nation should provide universal access to health care.

  149. 149

    @someguy

    If you think we ought to incentivize that kind of behavior by providing all sorts of medicines, surgeries, joint replacements, and the inevitable 10 year maelstrom of treatments that most diabetics wind up needing after eating themselves into diabetes… well, basically, you’re going to love a lot of people to death. All of us who don’t shovel in chips and ice cream and who bust our asses exercising 6 times a week, are going to pay shitloads for covering diseases that, for many if not most people, are self-inflicted results of their bad choices.

    Am I a bad person because I hope you have a massive stroke while you’re on the elliptical trainer? One of those ones that completely wipes out your motor functions and leaves you unable to do anything other than move your eyes. Either that or that you end up getting hit by a car, a car driven by some huge fat person, while riding your bicycle. Am I a bad person for thinking that either one of those outcomes would be perfect justice for your smarmy, self-righteous, holier-than-thou ass?

    Yeah, we’re “incentivizing” obesity by providing medicines, surgeries, joint replacements, etc. What a fucking load of nonsense (are you sure you haven’t had a stroke already, one that wiped out your higher brain centers?). I’m sure that fat people are sitting there saying “Yep, I’m going to go down to Chili’s, have some chicken fried bacon, come home and take my lipitor and then schedule some bitching joint replacement surgery. Whoo hoo! Obesity 4-evah! Incentivizing? We stigmatize obesity more than we stigmatize smoking in this country and only slightly less than we stigmatize drug addiction.

    The fat issue is just one more goddamned thing that the reichtards are tossing out there to muddy this debate. As someone pointed out above obesity only accounts for 9 percent of our medical expenses, so why is it that we’re still paying twice as much as the rest of the world for substandard outcomes?

  150. 150
    Andrew says:

    This.

  151. 151
    Andrew says:

    Well, that didn’t work.

    I meant:

    Obesity is a public health issue, but one largely irrelevant to the question of whether the nation should provide universal access to health care.

    This.

  152. 152

    What gets people fit is a pro-active desire to take control and get HEALTHY (NOT skinny).

    Gotdamn! Took this place long enough to say it. Eat your veggies, indulge your cheeseburger or ice cream fix 1 to 2 times a week, exercise 30 mins a day and throw the motherfuckin’ scale out into the damn trash. You know who lives longest? Happy people.

    Shinobi, obviously, this is a very personal issue for you, so the only point I want to make is from the medical treatment standpoint. I’m not a doctor. I’m in the Army as a Combat Medic. If need be I can intubate. If, I were to have trouble intubating a bigger person, my next option is to perform a crich. But at the point, with a bigger person, it will be harder for me to find the right landmarks and I have to consider whether or not they have BP issues, etc., etc., etc. And I consider myself pretty damn good at my job. And by bigger, I mean obese, or muscular, etc. Bigger people are harder to work on, period. I’d have the same problem with big-necked Ben Roethlisberger. If I had to do a needle decompression on a body-builder, I’m partially winging it.

  153. 153
    kay says:

    Americans aren’t just getting heavier (and I would distinguish between fat unhealthy people and fat healthy people, if we’re talking about….health) we’re getting SHORTER too, and I think that goes to poor nutrition, for both thinner AND fatter.

    Americans used to be the tallest people in the world. We have elaborate records. We’re rivaling brutal regimes (North Korea v. South Korea) for commensurate loss of HEIGHT.

    Our food system is all screwed up.

  154. 154
    The Raven says:

    Chalk it up to another failure of “free” markets. Basically, we’re fat because agribusiness is fattening us up. There’s a huge financial incentive for them to sell more food, and they do it by creating products which are good-tasting, caloric, and unsatisfying. One can, for instance, drink incredibly more sugared soda pop (a major factor in childhood obesity) than one needs for energy. A sensible public policy in this area would be, indeed, to devise better agricultural policy. But that is much more likely to happen if a national health-care system raises the issue in Congress than as a result of denying fat people health care.

  155. 155
    Comrade Darkness says:

    @satby: When we eat out, we split one main course and a side salad with no dressing and that’s it. As a calorie counter I can assure you that the average restaurant main meal is 1500 calories. You have to split meals or you have to take half home. If not, you are asking to gain weight. Period. End of story.

    Eating at chilis isn’t the problem. Eating too much at restaurants is the problem, because their food is rife with hidden calories. A law requiring calorie counts, directly on the menu next to each item would be a HUGE start. Ehem.

    Eat out ignorant. Get fat. Period.

  156. 156
    Deborah says:

    @Interrobang:

    I agree about sleep apnea, and that we sleep less now, but not with the problem being work or paid vacation. We used to work more hours and have fewer vacation weeks and we were thinner.

    Heck, a lot of it is stuff to do–one can watch tv, hang on the internets, all these things that weren’t possible back in the days of “well, it’s dark. Guess I’ll go to bed.” Limiting how long people can work won’t change that.

  157. 157
    Joshua says:

    @Interrobang:

    North Americans work more, vacation less, and sleep less than just about every other culture on the planet. Four weeks’ paid vacation plus sensible labour laws restricting the legal limit of hours people can work in a week, plus living-wage laws would go a long way toward reducing obesity, without even getting into issues of diet and/or exercise.

    You bring up a good point. There are many, many, MANY solutions on the table to deal with obesity. Problem is… the GOP, the libtards, the agriculture lobbies, and the corporatists are having none of it.

    Paid vacation time mandated by law, limits on hour worked, higher minimum wage, calorie counts in restaurants, zoning laws that discourage more fast food joints being built in inner cities, better food labeling, agricultural subsidies, the list goes on. All this stuff is either off the table or is facing serious resistance.

    The problem isn’t just that not enough people have a gym membership. The problem isn’t that being obese in this society is “cool” and subsidized with surgeries and joint replacements. The problem is that our food system is fucked up and people have no time to pursue a healthy lifestyle because they’re too busy putting that fucked up food on the table so they can do it again tomorrow. How can you enact reforms if you can’t enact reforms?

  158. 158
    Max says:

    @Wile E. Quixote: NO, you are not a bad person and as a Type II diabetic, I share your wish for someguy.

    Dear Mr. Someguy – I am single with no kids, a renter, who makes pretty good money, and lives in CA (where state taxes are high). I pay a HUGE amount of taxes proportionate to my overall income (standard deduction). Trust me, I’m paying my share and more than enough to cover my meds.

    While we are at it, let’s not cover mental illness, because after all, those people can just shake it off and man up. Or, because the world is overpopulated, maybe we don’t cover childbirth past the 1st kid.

  159. 159
    WereBear says:

    @Interrobang: Bravo! Too true.

    I mean, being overworked and stressed and short of time has nothing to do with our state of health?

    Not to mention the vast flood of confusing information that gets throw up like chaff from every TV channel, every magazine at the grocery checkout line, even from doctors who don’t know squat about nutrition.

    Ever notice that some women’s magazines have some kind of luscious treat on the front, with a headline about a new diet cutting right across it?

    The mixed messages are incredible.

  160. 160
    Comrade Darkness says:

    @Will: I ran into this too. 35 pounds off, held it off 3 years (by basically continuing to attempt to lose the last 20 with no luck). Discovered soluble fiber. That’s working finally, albeit slowly. I eat lots of salads with only lemon juice and massive piles of cooked greens with all meals. Slows calorie absorption in the gut, basically, and keeps the insulin level nice and low.

  161. 161
    b-psycho says:

    @Xanthippas: It depends on what you do about it…

    The reason that crappy food-like substances are cheaper than actual food is the use of corn products as filler.
    The reason corn products are popular as filler is we produce a ridiculous amount of corn that has to go somewhere.
    The reason we produce a ridiculous amount of corn is we subsidize it, heavily.

    Solution: stop subsidizing it. Why bother with junk food taxes when you can just end junk food ingredient spending?

  162. 162
    Deborah says:

    @Cassidy in Iraq:

    Gotdamn indeed.

    It’s worth distinguishing between the very poor and obese (two jobs and barely affording rent make McD’s three times a day a logical choice) and the country at large (a grocery cart full of pre-processed snacks isn’t noticeably cheaper than one with veggies, in my experience). For the group “diners at Chili’s” I think extreme poverty needs to be ruled out for explaining body size.

  163. 163
    rs says:

    @Joel: I didn’t mean to imply it was- health insurance reform is only one aspect of health care reform.

  164. 164
    tavella says:

    @debit: My personal conclusion: losing weight is a full time job that costs money to keep. No wonder no one wants to do it.

    That’s pretty much it. I’ve dieted seriously a few times in my life, and yes, I could lose weight — but only if I obsessively thought about it all the time, and most especially if I was *hungry* all the time. The moment I stopped, the weight came right back. It was pure misery.

  165. 165
    Geoff Wittig says:

    I’m a doctor, and let me tell you, Dr. Dworkin is an asshole.

    Does obesity make the technical/procedural side of medicine more difficult? Of course it does. But apparently what really frosts Dr. Dworkin is that this might delay his 3 pm tee-time at the country club. Oh, and all those dreaded socialist taxes might take away his “incentive” to practice high quality medicine.

    In my poverty-stricken rural town, the anesthesiologists drive BMW’s and have private planes. The primary care doctors? Not so much. I drive a dented Subaru, and work twice as many hours for about one fourth the pay.

    Arrogant jerk.

  166. 166
    Xenos says:

    My kids have been nagging me lately about soda pop. How their friends always have, but we never get it for them, and so on. I went got an artisanal root beer and served it to them in 3 ounce glasses, lightly chilled. They realized it was so sweet they could not even finish it – it reminded them of cough medicine. Which is exactly what it was.

    If I had served them the 20 oz bottle ice cold from the vending machines they would have polished that baby off. And never known the difference between that and the occasional glass of orange juice we let them have. But if they drank the soda in the quantities the marketers want them to drink it, it would take 30 years of their lives. You have to have the same cynicism and caution dealing with big food that you need dealing with credit card companies.

  167. 167
    R-Jud says:

    @Xenos:

    I went got an artisanal root beer and served it to them in 3 ounce glasses, lightly chilled. They realized it was so sweet they could not even finish it – it reminded them of cough medicine. Which is exactly what it was.

    Nice. Here’s another trick: My Dad sat my brother and I down when we were in grade school and had us measure 14 teaspoons of sugar into a glass.

    “Would you eat that?”
    “No.”
    “You do every time you have a can of soda.”

    Problem solved. He repeats this every year with the freshmen he coaches (except now he has them measure out 24, for the big bottles).

    That said, proper root beer is a lovely treat. And I can’t get it where I live, so boo.

  168. 168
    WereBear says:

    @tavella: I hear ya, tavella. That was always my experience too; until six years ago when I went low carb and haven’t looked back.

    I take walks a couple of times a week, and get to eat real salad dressing, bacon and eggs for breakfast, and low carb cheesecake, so I’m satisfied. And I mean that.

    Even since I’ve started eating this way, I haven’t been hungry. Ever.

    AND my blood pressure is now “perfect’ according to my doctor’s office, with good blood panels and all.

    I think it’s not only the healthy way to eat; I think it’s the way our hunter/gatherer ancestors ate, before there was agriculture.

  169. 169

    These are the same know-nothings that mock the so-called “nanny-state” mentality of not wanting to push carbonated suger water and other high fat/high sugar content “treats” in schools (that the corporations provide lavish incentives to have the schools partner in this early establishment of addiction to non-nutricious foods).

    In Morgan Spurlock’s documentary “Supersize Me”, he showed a school system for “problem students” that put together a healthy school lunch menu and the behavioral problems were significantly reduced, grades went up, and it was actually cheaper for the schools to provide healthy alternatives, while at the same time the students learned more about nutrition that they could make use of throughout their lives.

    F*cking godd*mned hypocrites!

  170. 170
    satby says:

    The entire problem with discussing policy changes in this country has so far been clearly demonstrated by the answers to this post. The correlary to “I’ve got mine” must be “my experience is the only true measure”.

    No matter how many reasonable arguments can be made that the ratio of weight to willpower is not 1:1, there’s always the dedicated few who just know that it is. Because they do everything exactly right and THEY aren’t fat. So anyone who is, as Anne Laurie says is a “disgusting fat pig”.

    Thanks to all who so amply proved her point.

  171. 171
    Brachiator says:

    @Lesley:

    The American food supply causes an overwhelming amount of entirely preventable diseases, including obesity, diabetes, heart disease, cancer, sleep apnea, to name a few. Many people suffer from at least one and usually more of all of these conditions as the body breaks down.

    What? This is incredibly wrong, wrong-headed, near wingnuttery. American food supply causing disease? Even though life expectancy is up?

    And issues related to sleep apnea are complicated by obesity, but not simply related to the food supply.

  172. 172

    @arguingwithsignposts:

    As someone pointed out above, the insurers do have an incentive. It costs money to treat people who are obese. lowering obesity rates would mean fewer doctor’s visits, treatments, etc. for obesity-related illnesses, thus same insurance rates with less payout for treatments.

    Suppose the insurer pays for someone to lose weight. Who reaps the benefit of those payments? That person’s future insurers.

    This is the fundamental advantage of single-payer: the same insurer, rather than a different one, reaps the reward of paying for the ounce of prevention upfront. Whether it’s vaccinations, smoking cessation programs, weight management programs, or whatever, the cost is in the present, the benefit is down the road, and (in the current non-system) probably in some other insurer’s pocket.

    The government as single payer has some other unique advantages: it can pass laws nudging Americans towards healthy behavior. For example, it can pass laws mandating that restaurants provide the calorie counts of their menu items, for instance, which (a) enables people to see just how many calories they’re really eating, and (b) gives the restaurant an incentive to do something other than add as much butter to a dish as it’ll take to make it taste great.

    Or it can note that it’s paying twice for its current ag subsidies – once in the actual payouts, and a second time in their effect on health outcomes – and feel more impetus to change the status quo.

    Or it can say, “why don’t we just buy up the entire domestic tobacco industry – wouldn’t we be coming out ahead on the deal, once health outcomes are factored in, if we kept on running it exactly as is, other than cutting out all of its advertising and promotional budgets?”

    Government as single payer has some great advantages that even a private insurance company wouldn’t have in the same situation.

  173. 173
    Legalize says:

    “What? This is incredibly wrong, wrong-headed, near wingnuttery. American food supply causing disease? Even though life expectancy is up?”

    I think that’s the point: even though we live longer, we don’t live any healthier. The same people who feed us swill that makes us sick are the same people keeping us alive by feeding us medication so that we can stay alive longer, thereby ensuring our ability to eat more swill and consume more medicine to keep us alive longer, thereby ….

  174. 174
    Erin Burnette says:

    Bartiromo may not be obese, but televison lies:

    http://timothysykes.com/2008/0.....bartiromo/

  175. 175
    Brachiator says:

    @low-tech cyclist:

    The government as single payer has some other unique advantages: it can pass laws nudging Americans towards healthy behavior.

    Then I guess this is the problem with the government as single payer (and to be fair, it’s a problem with private insurance as well).

    It ain’t the gummint’s freaking business!!

    It’s one thing to give information about what somebody thinks is healthy behavior, something else again to “nudge” someone towards that behavior. And another thing entirely to be punitive.

    The obesity thing is getting to the point of stupid intrusion. Some people are fat, but perfectly healthy.

    For example, it can pass laws mandating that restaurants provide the calorie counts of their menu items, for instance, which (a) enables people to see just how many calories they’re really eating, and (b) gives the restaurant an incentive to do something other than add as much butter to a dish as it’ll take to make it taste great.

    No. No. No! I hate this crap. I see that these laws are foisted onto fast food eateries. I see that most people don’t care. And do we really want warnings pasted onto Super Bowl commercials for pizza places (“warning: each slice of our super pepperoni contains 15 kazillion calories”).

    And I have not yet heard of a trendy upscale restaurant providing calorie information about its meals.

    I also didn’t notice any calorie warnings concerning recipes used in the end credits of the film Julie and Julia.

  176. 176
    ** Atanarjuat ** says:

    Brachiator said:

    No. No. No! I hate this crap. I see that these laws are foisted onto fast food eateries. I see that most people don’t care.

    I guess I’m not part of that “most people” group, then.

    I like having as much information as possible so as to make an informed choice. I don’t see how being informed is a terrible thing, but perhaps someone would like to take a crack at it.

    By the way, the menus at Olive Garden (at least the ones in the NYC area) now feature nutritional information next to each food item. It’s awesome.

    -A

  177. 177
    The Main Gauche of Mild Reason says:

    @Shinobi:

    They call this the Obesity Paradox, even though it is shown repeatedly in studies. OBVIOUSLY fat is bad, so why are these fat people living longer than thin people with the same problem. It must be some kind of paradox. Way to question your assumptions medical community.

    I don’t think this is all that perplexing, if you consider selection bias, although I’ve only seen it discussed with respect to heart attacks. Obesity in general puts you at a higher risk of heart attack, whereas the risk for a person of roughly normal weight is considerably lower. So you can think of it as “easier” to generate a heart attack in an obese person vs an average person. So obese people with heart attacks are probably people with much milder ailments overall (e.g. mild atherosclerosis) but average weight people (because it’s “harder” to get them to have heart attacks) are much more likely to have serious ailments (serious artery blockage, heart defects, etc).

    Generally, whenever you see this sort of situation where group A is more likely to suffer from a disease than group B, but group A is statistically more likely to survive, you should suspect it’s because there is something qualitatively different about the spectrum/seriousness of the disease in both groups and some selection bias is occurring.

  178. 178
    Will says:

    @Comrade Darkness:

    Thanks a lot. That’s really it–I am keeping the 30 lbs off by trying to lose the remaining 20. I am going to look into soluble fiber…

  179. 179
    The Main Gauche of Mild Reason says:

    And it’s also important to know that your “obesity paradox” example is a classic example of Simpson’s paradox. “Normal” weight people are still less likely to die from a heart attack, because they get heart attacks at lower rates. But of the “normal” weight people who get heart attacks, they’re less likely to survive. So it really doesn’t say anything about the “healthiness” of being overweight.

  180. 180
    Shinobi says:

    @Deborah:
    I see where our disconnect is. The argument that I was trying to make was not that all stores are required to cater to me due to my size. Rather, that there are two ways to look at this issue. 1. It sucks to be me I can’t find clothes because i’m fat. And the alternative 2. It sucks that these companies don’t make clothes for fat people.

    Worldview 1 is what is pretty much generally encouraged in our society. Which is why so many people spend so much time trying to change their body shape to fit what society deems acceptable. Which as Anne Laurie notes may actually lead to many of the health problems commonly associated with obesity.

    Like what? Are people actually standing up and informing you that you are not allowed to sit there?
    Actually, yes, many airlines now have policies allowing them to force Fat people to buy additional seats and to have them removed from flights. So far it is just the airlines, though they did try to pass a bill last year to keep fat people from eating in restaurants in Mississippi (for their own good).

    Look, I am not saying you hate me personally, but your language choices are, shall we say, dripping with fat hatred. I don’t think there is some secret conspiracy against fat people in this country. I don’t think it is secret, or a conspiracy.

    This country just doesn’t like fat people, period. The word fat is associated with SO many negative things in our culture, life is like a never ending fat joke. (see also any story Tyra has done where she dressed up in a fat suit and learned about how she got treated as a fatty.) You can’t watch the news for a whole day without some kind of story about how fat people are going to cost us gazillions of dollars. Fat workers make less money than thin workers, and if, as a fat person, you ask to be accommodated you are told you should just lose weight.

  181. 181
    Common Sense says:

    Anna Laurie;

    With regards to your posting habits, what you lack in quantity you more than make up for in quality. I appreciate your insights on this blog.

  182. 182
    cmorenc says:

    @Shinobi

    @cmorenc: How do you know those people don’t eat like you every other day and were just having a big old binge for a change?

    Well, there were a few clues apparent to anyone with a firm grasp of the obvious:
    1) The enormous degree of obesity by both parents – the dad’s belly area was beyond the “I swallowed a keg of beer, barrel and all” look – the wife’s torso was shaped like a giant egg.
    2) There may indeed be a some people plagued by a combination of both severe metabolic problems and significant physical handicaps limiting their ability to physically exercise. However, MOST people who get obese to a pathological degree DON’T get there by following even moderately reasonable dietary habits on a day-to-day basis. They get there by far too often indulging the chili cheese fries as an appetizer and fudge n’ice cream volcano for desert.
    3) When you’re that severely obese, and your kids are obviously already well on the path toward getting there themselves YOU DON’T ORDER THE CHILI CHEESE FRIES AS AN APPETIZER, AS THESE FOLKS DID. Along with the fried blooming onion as the other appetizer, in addition to their mucho-cal main courses. We didn’t stay around long enough to see what they might have ordered for dessert, whether to celebrate some occasion, or for whatever reason.

    I can understand how past a certain age in adulthood for that extra ten or twenty pounds to slip on there somehow as our work and family life sometimes wear folks out too much or preempt their good intentions to exercise on many days following a sedentary workplace environment. But in general, the great majority of truly obese people get there by reason of bad lifestyle habits (including most predominately eating habits) NOT “metabolism”. Unless there’s an epidemic of inherited metabolic diseases in the United States that’s somehow not shared in most European countries, the “metabolic” excuse is pure bullshit for the majority of significant obesity we see so prevalent around this country every day in shopping malls, restaurants, and elsewhere.

  183. 183
    Shinobi says:

    @The Main Gauche of Mild Reason:

    I have also seen it discussed with regards to cancer and kidney dialisys. (Which makes sense as these can both cause weight loss and if you have less weight to lose, you have a bigger problem.)

    I don’t think the argument is necessarily that people should run out and gain weight so they don’t die. I think it is just that targeting weight as the issue overlooks the whole idea of health. Weight is not a proxy for health. Some people lead very healthy lifestyles and remain morbidly obese. Some people lead very healthy lifestyles and still get and die from heart disease. Some people lead incredibly unhealthy lifestyles, remain thin, and live to be 110.

    In a way I think our fixation on weight loss is based in a desire to control our own mortality.

    @Cassidy in Iraq:
    I think you are 100% right about being healthy and happy being the goal.

    I think there is a point to be made somewhere about everyone’s body being a little different. Some may be easy for some things and harder for others. I Just think making it all about fat, not fat, is an issue. If it really is hard to do certain things for fat people, shouldn’t we try to find a way to make it easier? Rather than just blame the fatties. That’s all I’m saying.

  184. 184
    Brachiator says:

    @** Atanarjuat **:

    I like having as much information as possible so as to make an informed choice. I don’t see how being informed is a terrible thing, but perhaps someone would like to take a crack at it.

    But it’s not an informed choice. While information about vitamins and minerals is informative, information about calories and fat is trivial without the context of your personal life, and even here it may not say much. As I noted, just because a person is fat does not mean that they are not healthy. The calorie and and even fat and sodium count of a meal doesn’t say anything definitively meaningful about its nutritional or health value.

    By the way, the menus at Olive Garden (at least the ones in the NYC area) now feature nutritional information next to each food item. It’s awesome.

    Olive Garden is not an upscale restaurant. Here’s a bit of a NYT review of 4 star (extraordinary) restaraunt, Eleven Madison Park:

    Mr. Humm’s French-grounded cooking, which bridges the classically saucy decadence of the past and the progressive derring-do of a new generation, drew notice from the get-go. He hadn’t been in place long before the city’s gluttons were atwitter (in the old-fashioned sense) about his way with suckling pig. He served it as a dense, tender brick of confit below the most crisply fatty sheet of crackling imaginable.

    http://events.nytimes.com/2009.....038;st=cse

    Not a calorie count in sight. And the fat here is a good thing.

    Legalize — I think that’s the point: even though we live longer, we don’t live any healthier.

    Nonsense.

    The same people who feed us swill that makes us sick are the same people keeping us alive by feeding us medication so that we can stay alive longer, thereby ensuring our ability to eat more swill and consume more medicine to keep us alive longer, thereby ….

    You mean doctors also control agri-business? Wow. Interesting conspiracy.

    I guess we should feel some nostalgia for the good old days, when people died in large numbers of yellow fever, smallpox, cholera, polio, when vitamin and mineral deficiencies resulted in weakened bodies, lost teeth.

    But for some reason, I just can’t work up a sense of outrage about this.

  185. 185
    Shinobi says:

    @cmorenc:
    You seem to have an awful lot of opinions about what these total strangers are doing with their own money. But it’s okay right? Because they are fat, and therefore deserving of your ridicule.

  186. 186
    Comrade Darkness says:

    @Will: No problem. Your cholesterol level will thank you too. Easing into it is recommended, tho, to let your intestinal flora adjust.

    Breakfast took some effort to work out. The American breakfast is not conducive since I find the breakfast cereal route too carb loaded. Now I either have cabbage fried in a little pork fat (what would breakfast be without pork fat??) or homemade baked beans seasoned with cinnamon and clove to make them taste sweet, because the canned ones are loaded with sugar. (love my crock pot…)

  187. 187
    Alan in SF says:

    I still remember that day back in 1957 when Americans voted to have big supermarket chains buy out local produce merchants and butchers, substitute packaged processed preservative-laced food trucked in from thousands of miles away, and replace healthy ingredients with cheap poisons. I suppose if we knew then what we know now, we might have voted differently. But hindsight is 20/20, right?

  188. 188
    Darkrose says:

    I started having blood pressure problems–like, 169/120 problems–back when I weighed about 130. I worked out on a regular basis. I was also in a job I loathed and dealing with the stress by self-injury and the occasional suicide attempt.

    After my nervous breakdown, I went on Zoloft. Over the course of three months, I gained 60 pounds. I was actually binge eating less, but like all SSRI’s, Zoloft screws with your metabolism. I changed drugs later, and the weight gain leveled off, but it’s never gone away entirely. Short of gastric bypass surgery, it never will. Given that one of the people I know who had the surgery is now dead from liver failure; another replaced her food addiction with an addiction to painkillers, and everyone I know gained the weight back within less than 5 years, I’d rather be fat, thanks.

    Imagine, thinking that it’s healthier to be fat than being stressed enough to literally bang my head into walls, or give serious thought to jumping in front of the T! How selfish, to prefer being alive and not depressed to being fat!

    And by the way, my blood pressure is good these days, because I’m not spending every waking moment thinking about how much I loathe my job and hate living in Boston. I’m healthier now that I can sleep, although living in the Central Valley hasn’t done anything good for my asthma. And I’ll never be able to eliminate one of the big risk factors for hypertension, since I’m pretty confident that I’m going to be black for the rest of my life. My blood sugar and cholesterol levels are fine. I suspect I’ll outlive everyone on my father’s side of the family–the thin side–most of whom didn’t make it past 62.

  189. 189
    Xenos says:

    @Erin Burnette:’ When your reach 40, you can keep your ass or your face’ ~ attributed to Catherine Deneuve.

    OK, we know which choice Bartiromo made. Probably the right choice. Erin gets to make her own choice in ten years or so.

  190. 190
    EthylEster says:

    Several random points:

    10 years ago LLBean did not offer “plus” sizes on every item sold to women. Now they do.

    Remember when the public schools got the idea that having soda pop machines was a good way to raise funds for education? Obviously a very bad idea but we had to do the fucking experiment anyway. Those vending machines are now mostly out of public schools (at least where I live in the PacNW).

    Nina Planck (Real Food author) says to shop at the edges of the supermarket. That is, stay far away from the processed food. It’s amazing how much crap is for sale in the grocery store. Most of it is not good for you but it’s cheap and attractively packaged and you’re already seen 100 commercials saying you MUST try it so….

    I’ve been drinking raw milk for about a year now and have noticed a decrease in my appetite. I just don’t get hungry as quickly. This change has allowed me to get the 10 pounds off that I have been working at for at least 5 years. I didn’t diet; I just paid close attention to what went in my mouth and continued to exercise regularly. Perhaps it’s the CLA, which is high in grass fed ruminants. One hundred years ago most people/everybody drank milk from grass fed cows; now not so much. Of course it costs a fortune compared to industrial milk.

    All those labor saving devices we are surrounded by decrease calorie expenditure quite a bit. Think of how people had to expend calories just to saddle the horse or hook up the carriage. Now, just put the key in the ignition. Plus refrigerators permit us to shop one a week, instead of every day. Get a step counter and quantify your activity; then increase that number steadily.

    And then there’s TV. A drug in itself. It makes us passive and promotes over-eating and twists our brain with its demand-creating commercials.

    Most people I know (fat or skinny) do not want to live without TV, multiple cars, or frequent dining out. They would consider this a big step backwards. They want to have it all. Voila, the explosion of “fitness” as an industry. Three very silly modern ideas: gyms, tanning salons, and nail salons. Obsessed with appearance much?

    Some people have weight problems, others do not. I don’t hate people who are fatter than me. I just don’t necessarily want to be “squeezed” by them as someone up thread said.

    You know the people I hate: smokers. They choose to do something unequivocally bad to themselves and those around them. I look at a smoker and think “Loser”. But that’s just my personal prejudice, I guess.

  191. 191
    cmorenc says:

    @Shinobi

    @cmorenc:
    You seem to have an awful lot of opinions about what these total strangers are doing with their own money. But it’s okay right? Because they are fat, and therefore deserving of your ridicule.

    If this was indeed just a couple simply doing what they wanted to do, living as they liked, using their own money, impacting no one else other than themselves, there would be nothing worth anyone’s concern, discussion, or even mention here (move along, nothing to see here folks).

    However, the far higher incidence of serious (read: expensive to cover insurance-wise) health complications that accompany obesity DOES have enormous implications for any proposal to extend universal health coverage, including preexisting conditions. Here in eastern North Carolina at Brody School of Medicine in Greenville, there’s an expensive brand-new cardiac unit that’s largely (though not exclusively) filled with folks suffering the effects of years of obesity and poor dietary habits, rather than simply having unfortunate luck in the genetic draw of vulnerability to cardiovascular disease after they pass age 40. Pregnant women who are obese are at vastly higher risk of serious complications for themselves and their baby – this is not just a statistical abstraction, but my wife (who’s an Obstetrician) regularly comes home with stories about the arduous difficulties she experienced while on call trying to safely deliver the child of some obese patient, particularly if a C-section is required. There’s so very much that can so very much easier and more likely go wrong than with a healthier patient. We could go on and on about specific examples…but…

    The point is that OBESE PEOPLE ARE GOING TO COST THE REST OF US SIGNIFICANTLY MORE MONEY FOR THEIR HEALTH COVERAGE, ONE WAY OR ANOTHER, either through taxes or insurance premiums (especially if we go to universal coverage, with no-preexisting conditions exclusions). Unless somehow you can think of a way (including a way to make it legislatively and administratively stick) to force obese people to pick up the entire extra share of costs they will statistically, as a group, otherwise impose on the rest of us.

    And we haven’t even gotten around to discussing that these folks are well on their way to inflicting the same sort of problems on their children that will in turn burden taxpayers and insurance ratepayers of their children’s generation.

  192. 192
    Nutella says:

    We’re always talking about people with unhealthy traits like smoking or obesity being expensive for the general public but that’s not necessarily true. If smoking and obesity cause earlier death then they may be saving money spent by the taxpayer on medicare, social security, and other expenses related to age.

    The healthy, skinny, active, non-smokers who live to 100 probably cost us more.

  193. 193
    Anne Laurie says:

    @Original Lee:

    So I would not be surprised at all (especially given FDR’s use of Madison Avenue types in certain areas of his administration) if it turned out that this amazing push for the German KKK originated somewhere in the government.

    I didn’t want to make a long post longer, but I first learned about the post-war “Kinder, Kuchen, Kirche” push from J.K. Galbraith’s essays. Glad to hear JKG’s claims reinforced via first-hand historiography!

  194. 194
    EthylEster says:

    @Nutella: Just to be clear. I wasn’t talking about enmity based on health care costs.

    And I want to disagree with this often repeated idea about healthy people costing the system more. Because I think a 60 yo smoker who gets a lung transplant and then dies a couple of years later probably runs up a bigger bill than many healthy long-lived individuals.

    Now if you want to argue that the smoker doesn’t get the transplant, that’s another matter. But that is not my position. The way massive amounts of health-care dollars get expended is two-fold: admin costs and big ticket items like bypass surgery, transplants, intensive care units, dialysis for decades.

    I’d like to see some hard data on this meme.

  195. 195
    Xecky Gilchrist says:

    @EthylEster: I’d like to see some hard data on this meme.

    Likewise. As a scientist, I’m annoying that way.

  196. 196
    Zak44 says:

    From “Money Honey” to “Dough Ho.”

  197. 197
    Nutella says:

    EthylEster, you said you weren’t talking about enmity but there does seem to be a lot of hostility in this thread.

    You said

    You know the people I hate: smokers.

    cmorenc said we need to

    force obese people to pick up the entire extra share of costs they will statistically, as a group, otherwise impose on the rest of us.

    Unfortunately the only person who has studied the issue of overall costs of people with unhealthy habits seems to be Vanderbilt University economist Kip Viscusi. His research was largely supported by the tobacco companies so we really need more work done on the issue. Until we do, the contention that obesity or smoking or whatever else we consider irresponsible is more expensive than behavior we consider responsible is completely speculative. Anyone who claims to KNOW that smokers or obese people cost the public more or less than others is really just guessing.

  198. 198
    Lesley says:

    Hilarity from Raw Story (more evidence the rich people are completely out of touch with anything but their own reality):

    Bloomberg: Drug CEOs don’t make much money

    Yeah, those poor oafs pocketing only $17-25-million a year in base salary. Brother, can you spare them your criticism?

  199. 199
    someguy says:

    Yeah, we’re “incentivizing” obesity by providing medicines, surgeries, joint replacements, etc. What a fucking load of nonsense (are you sure you haven’t had a stroke already, one that wiped out your higher brain centers?).

    Yeah, I’m an ass. But I think it’s moronic to bitch about how ag policy has subsidized terrible eating habits, and then not promoting insurance coverage policy that doesn’t say a thing about the other half of the equation, about making it tougher on people who choose to be fat by making a half dozen or twenty bad decisions every single day. There are exceptions – darkrose above mentions his. But most fat people aren’t similarly plagued – unless there’s some medical condition that compels them to get the huge box of bags of chips at Sam’s Club.

    I have a sis-in-law who is fat as two pigs. She ate herself that way, living basically on welfare benefits since she turned 18, on a diet of three squares which are paid for nicely by benefits, plus a bag of chips, couple chocolate bars, couple sodas and a couple beers every day. She’s now 45, 5’1″, 300, and 160/120. You do the math on which one of those numbers is which. She’s also diabetic, and her doctor is reasonably certain she induced it herself with shitty eating habits.

    About six months ago she fell and blew out her hip. It needs replacement. Her insurer told her to go pound sand, they weren’t paying for a new hip because she was obese so the hip wouldn’t last, and that her diabetes was self-inflicted and probably could be controlled by losing weight. So if she wants a new hip, she has to lose a hundred pounds or so and get her diabetes under control, or they aren’t going to drop the money on her. She’s also angling for some eye surgery because her skyrocketing blood pressure has warped her eyes, and she’s half blind now. She’s getting the same answer on that.

    Sounds terrible, right? That rotten insurance company.

    Thing is, she lives near Manchester, England. The National Health Service told her she gets jack other than routine checkups, emergency care and stuff like antibiotics for infections. No elective surgery. But they’ll give her a Morgan Spurlock Supersized wheelchair, if she wants it. Funny enough, she’s started Weight Watchers and is trying to lose some weight for once in her mostly wasted life.

    I’d rather be living under a tough-love health care system like that, which at least encourages people to try to control themselves and take responsibility for their health, than a private or public system that provides Cadillac care, even for utterly self-destructive people. What you’re talking about here with single payer is a single risk pool for everybody, no matter what kind of insane behavior they want to undertake. Am I a bastard for not wanting to subsidize my in-law’s totally self-destructive, grotesque behavior? Maybe so. But at what point would I get to stop underwriting her potato chips and candy bars and beers and cokes – both at the consumer end, and the consequences end (never mind the ag subsidies that favor the production of shit food)? Liver transplants are routinely denied on similar rationale, I don’t see why treatments for various obesity-related complications shouldn’t be treated the same way.

    If you have a medical problem that makes you fat, fine, you should get care. But if you don’t have some other disorder – if it’s just a failure on your part to do your daily pushaways – I don’t see why all the rest of us should pay for it. That’s fucked up, it’s like being permanently stuck with some drunk guy’s bar tab, and every time the guy takes a drink you say “okay, cool, I’ll pay for that. And the DWI fines.” I don’t give a shit about about how the majority of Americans are obese if we’re talking private insurance, because people like that get stuck in a risk pool, or their group rate reflects it, or there are other disincentives to acting like that. But once the taxpayer is on the hook to treat them, as a constitutionally protected right (you won’t be able to deny it without legal due process) then we’re all paying for it. Sorry, but I think the U.K. is completely on the right path, and if we don’t have something like that, it’s going to be a disaster.

    And yeah, I think for the most part obesity is a similar problem (my God, just try to find a thin Redstater), except it ain’t a disease, unless getting seconds on desert is communicable.

  200. 200
    shortstop says:

    I think it is just that targeting weight as the issue overlooks the whole idea of health. Weight is not a proxy for health. Some people lead very healthy lifestyles and remain morbidly obese. Some people lead very healthy lifestyles and still get and die from heart disease. Some people lead incredibly unhealthy lifestyles, remain thin, and live to be 110.

    Certainly weight is not the sole indicator of health, but your examples remind me of people smoking two packs a day and assuring everyone around them that their granddaddies smoked even more and lived to be 110. Yeah, it happens, but it’s nowhere near the norm.

    I’ve got no problem with asking people to lay off the gratuitous derision of overweight people, but you lose credibility when you imply that obesity has not been sufficiently correlated with all sorts of significant health problems. Some seriously overweight people are lucky enough to avoid those problems. That doesn’t make the data worthless or the goal of paring significant extra pounds unnecessary.

  201. 201
    someguy says:

    similar problem to alcoholism…

    Whoops, really need the edit button back. I hate to truncate my holier-than-though dickheadedness.

  202. 202
    Diagoras says:

    Makes me want to punch whomever came up with this meme right in the face. Really.

  203. 203
    Lesley says:

    Haven’t read through all the comments so apologize in advance if this has already been shared (which it probably has…but since I’m so frothed can’t help posting anyway).

    Originator of the death panel fiction resigns her position as “director of Cantel Medical Corp., which bills itself as a “leading provider of infection prevention and control products in the healthcare market.”

    Jon Stewart confronted the beeotch.

  204. 204
    Lesley says:

    Some people lead very healthy lifestyles and remain morbidly obese.

    Back away from the koolaid and board a plane back to Earth, TODAY, before Planet Stupid destroys takes the little that’s left of your brain.

  205. 205
    Jackie says:

    Gee I don’t want to pay for fat people, or smokers, or drinkers or people who don’t wear their seat belts, or drive fast or erratically, or have unprotected sex, or ride a bike on roads or rock climb or hang glide or drive taxi’s for a living. They made a high risk decision and why should I pay for it? Please why can’t everyone be perfect like me ,who ,like totally deserves health care.

    While we’re at it let’s repeal the silly law that says the ER must treat all comers. That wallet biopsy at the triage desk will lower my insurance cost and decrease waiting times. for those of us who deserve to be treated.

    Get a grip.

  206. 206
    Makewi says:

    The nice thing about having the government run health care will be that we won’t have to make all those nasty decisions for ourselves anymore. For example, if you can’t get people to quit smoking voluntarily, and the cost of caring for smokers is too high, you can either deny health care for the smokers or ban tobacco. Fortunately the federal government has the power to ban tobacco, so win.

  207. 207
    Anne Laurie says:

    @Mnemosyne:

    It’s interesting—when I lost 32 pounds, I ended up in this weird psychological space where I felt too small. Diminished. Like having that extra weight had given me more power, and now it was gone because I was physically taking up less space.
    I solved the problem by starting to lift weights rather than gaining the weight back, but I can’t help but wonder if that’s a component for some of our obesity. We’re already diminished by the corporate culture we live in—our only hope of being noticed is to be big enough that we can’t be overlooked.

    That’s an excellent point. Going back to the 1970s, politicians like Bella Abzug, Barbara Jordan, and Janet Reno said that one reason they felt free to throw their weight around was that, as women outside the cultural ‘attractiveness’ norms, they had nothing left to lose. Even Molly Ivins, who wasn’t by any standards ‘obese’ but was tall and strongly built, said that going to a mid-60s Texas high school where only tiny blonde cheerleaders were allowed to be ‘winners’ convinced her that she might as well say what she thought because she was already ‘invisible’ to the Powers That Were. I have to dig out my copy of FAT IS A FEMINIST ISSUE and re-read it again…

    P.S. Congratulations for making smart choices for yourself!

  208. 208
    kay says:

    @Makewi:

    Except. The government already bankrolls huge portions of health care, and they haven’t banned cigarettes or soda yet.

    Now have they? Through 40 years of Republicans and Democrats, your oft-threatened prediction has not, in fact, occurred.

    But just keep saying it.

  209. 209
    Anne Laurie says:

    @Interrobang:

    For a long time, the medical profession thought that being obese caused sleep apnea, because sleep apnea and obesity were correlated in many patients. Turns out, sleep apnea causes obesity, not the other way around. In a lot of cases, fixing the sleep apnea fixes the obesity almost immediately.

    Not entirely true, but yes. I have a dear friend who found that treating her sleep apnea (using a C-PAP) improved her health (as measured by blood pressure, blood sugar & cortisol levels) more in six weeks than stomach-stapling did in a year. But it was only after she drove her car off the road during a micro-nap that she was tested for sleep apnea, because “of course” fat people snore, and if she would just lose weight she’d fix that! Back when PCs were first being introduced to every workplace, this same woman went to her doctor complaining of persistent headaches, and was assured they were weight-related (i.e., her own fault) — turned out she was far-sighted, which had never been an issue until she had to read monitor screens 8 hours a day. Obesity is a real health issue, but it doesn’t affect the ocular muscles that cause far-sightedness.

  210. 210
    kay says:

    @Lesley:

    I can forgive people for Iraq. They screwed with the terror colors, they lied about the WMD, IMO people were just pissed off and wanted to invade something, retaliation, we needed a target, and the media played along, and ojn and on. I can see Iraq happening.

    I can’t forgive them believing “death panels”. That was just goddamn stupid. That it took hold AT ALL and WITH ANYONE is embarrassing.

  211. 211
    Lesley says:

    Kay, you’re a bigger person than I am. I can’t forgive them for anything, from Iraq, to Katrina, to the lies about Obama, to the lies about health care.

    People who are willfully stupid infuriate me. Like Barney said, they are dining room tables, only actually, they’re more like TV trays.

  212. 212
    Anne Laurie says:

    @Darkrose:

    And I’ll never be able to eliminate one of the big risk factors for hypertension, since I’m pretty confident that I’m going to be black for the rest of my life.

    I {heart} you — and I hear you. I am the opposite of black (per George Carlin, “we Irish don’t go to the beach to tan, we go to lose the blue”). But as a fat person I have winced at too many remarks about people of color (especially women of color) who, it is alleged, “think they’re being discriminated against for the color of their skin, but it’s really just they have TOO MUCH skin”. For at least 30 years, just in my own experience, people have been pointing out that looksism reinforces racism reinforces sexism reinforces homophobia… but the Entrenched Resistance is still insisting that ‘correlation does not equal causation’, and besides, who cares what a bunch of fat ugly colored queer people think anyway?

  213. 213
    Makewi says:

    @kay:

    Huge percentages being a relative term I guess. If these percentages are so huge, why are they so busy blaming private insurance for the “broken” system. You can’t have it both ways.

    No, when the fed is the only game in town those choices you used to take for granted will be going away.

  214. 214
    Anne Laurie says:

    @crayz:

    If you’re going to bother with the debate at all, why not provide readers some facts or studies, like this estimate that obesity costs us $147 billion/year in health care costs. You could then point out that while high, it’s still only 9% of total costs, and so couldn’t account for our care costing 2x as much per capita than an average western european country with better outcomes.

    Thank you for this argument, which I fully intend to re-use.

    I have perhaps too much in common with Alice Liddel — what use is an essay without conversation or pictures?

  215. 215
    Deborah says:

    @Shinobi:

    I’m taking one more shot at the clothing: I can’t shop in most regular stores, because as a “petite” (an entire inch below average height) most of the clothes are too long. If you’re 6 foot, I’d imagine you’d have the opposite problem even if you were a size 8. My husband pretty much just shops online rather than try to find 32/36 pants. Both children got the tall-thin genes, plus they’re both athletes: In her middle school growth spurt my daughter couldn’t get things in most stores because she was too tall and thin. My son is way too thin for most pants, so when we finally find a pair that fit I buy 6 or 7 pairs and call it a day. We all find it annoying, even confusing from a market point of view (the average woman is technically petite, at 5’4″, so huge market, right?), but not a sign that American society is prejudiced and conspiring against us. Just that a lot of clothing lines figure there isn’t much profit in catering to us, and don’t, and so we shop loyally where they do.

    I’ve noticed a lot more plus size departments in the last decade. Someone upthread noted that LLBean now carries all their women’s clothing in a plus-line, which they didn’t do even 5 years ago. If the issue is just that a store where you’d like to shop doesn’t carry your size…evidently they don’t think it’s profitable. There are probably a host of other body types they aren’t stocking.

  216. 216
    Anne Laurie says:

    @GReynoldsCT00:

    However, I’ve seen family members and co-workers (400 lbs) over the years who have the means to take care of themselves, eat better and exercise but they choose not to. In spite of bad knees, diabetes, etc. nothing changes, they line up the pills. I know it runs in my family and I pay very careful attention to my habits because I don’t want to wind up living like that… Thoughts?

    Congratulations, seriously, on making good choices for yourself. As others have already said, we can agree that making good choices, even when they’re harder, should be encouraged. Punishing other people for making the “wrong” choices — eating badly, falling in love with someone of the same gender, not attending the proper house of worship — that’s a whole different issue.

  217. 217
    Anne Laurie says:

    @Billy K: Could not agree more. Really makes you appreciate John Cole’s hard work, dunnit?

  218. 218
    kay says:

    @Makewi:

    No, “huge percentage” being everyone over 65, and everyone in poverty. Government insurance.
    If they wanted to outlaw cigarettes, to save money, they woulda done it a long time ago. They outlaw plenty of things, usually with enthusiastic conservative “law and order” support.
    Stop threatening people with these unsupported accusations. No one is going to outlaw cigarettes or soda. It’s like “death panels”. You’re just making stuff up.

  219. 219
    ImJohnGalt says:

    I’m really conflicted about this issue, and have seen a great and reasonably civilized back-and-forth in this thread. I just want to say how glad I am to be part of this community – this is by far my most-read (and daily anticipated) blog. Thanks to John, Tim F., Anne Laurie, DougJ and all of you for really pushing my thinking.

    As someone who started a ridiculously intense fitness regimen 60 days ago to try to shock my body back into shape at 42, I can personally vouch for how hard it is to work a 12-hour day and still find time to be healthy. My greatest insight about myself and this process is that I’m not dieting, I’m trying to establish good habits so that better eating choices become automatic, with the understanding that I still want to enjoy the occasional chocolate dessert and pizza. My eating patterns took years to develop, so it’ll be a challenge to change them in a shorter period of time.

  220. 220
    Makewi says:

    @kay:

    The they would have done it years ago argument ignores the fact that when they are the only ones paying the health care bill, they will start looking at ways to minimize that cost. They outlaw smoking in Federal prisons now, and recently their was consideration of banning it in the military. So, it’s not a misplaced fear, and I’m not just making stuff up.

    As to the death panels, there is very good reason to worry about how the government will make it’s decisions. You can look now to places like Oregon, Maine and Massachusetts as examples of how the Commissioner might operate.

  221. 221
    Lesley says:

    Makewi’s a walking FOXidized talking point.

    Remember what Barney said. You can talk to plywood until you’re blue in the face… Pointless.

    I would encourage Makewi to smoke heavily and eat as much transfatty food as possible. With any luck, it will shorten her troll life.

  222. 222
    EthylEster says:

    @Nutella: EthylEster, you said you weren’t talking about enmity but there does seem to be a lot of hostility in this thread.

    Yes, I have detected it also. Two types: 1. about health care for folks who *may* have made poor lifestyle decisions 2. disliking fat people.

    I reject idea #1as a very slippery slope I don’t want to slip down. And for #2, I don’t hate fat people; I hate smokers. What have fat people ever done to me? Smokers, however, pollute the air and make me cough and they smell awful. Plus they litter.

  223. 223
    Makewi says:

    @Lesley:

    Yeah, wish death to those whose opinions don’t line up with yours. Hey, here’s a thought, grow the hell up.

  224. 224
    kay says:

    @Makewi:

    That’s your argument? They outlawed smoking in federal prisons?

    They outlawed smoking in the county jail 5 miles from my house. Are my county commissioners crazed liberals? Inmates are in custody. They don’t get Mountain Dew either, or a nice glass of burgundy. People can’t smoke in my workplace. Why are military exempt from what is essentially the norm in the workplace?

    You fell for the death panels? Dear God. Read the proposal. You can find government action encouraging consultations on advanced directives in any state code in the union. For the last TWENTY YEARS. It makes sense. Doctors don’t want this decision, and either do judges. Tough shit. You’re going to have to man up and write a directive. We don’t want to make your hard decisions for you because you can’t face mortality.

  225. 225
    Makewi says:

    @kay:

    The federal government and the states went after the tobacco companies and made them pay, in part because of the increased health care costs. So, yeah, your nuts to just think the idea that the government is going to start banning things that cost us more is nuts. Not only isn’t it nuts, its inevitable.

    Seatbelts, helmets, trans-fats, smoking – and those are things that government used its power to have a say in before they were footing the whole health care bill.

    But go ahead, pretend that its a liberal vs conservative issue.

  226. 226
    kay says:

    @Makewi:

    The tobacco companies negotiated a settlement because the government had them dead to rights on defrauding and misleading whole generations of Americans on the danger of their product.

    They got off cheap. There should have been criminal charges. You can sell a dangerous product. What you can’t do is spend 30 years suppressing evidence that it kills.

    We’ve had Medicaid for 40 years. Poor people smoke. Trust me, if conservatives could have found a way around tobacco state lobbyists to outlaw cigarettes, they would have. There’s nothing they like better than nattering on and on about personal responsibility to a captive audience.

  227. 227

    […] Roseanne the Riveter & the New Guilted Age […]

  228. 228
    EMY says:

    I want to add here Ann, that most of what you are saying I agree with, and your feminist comparisons to post world II “rosie the riveter” culture were insightful.

    However, I do want to add a little complexity to your claims:

    “Being too fat is a genuine medical problem.”

    I want to add some specificity here, that usually the “too fat” to start causing genuine medical problems usually means a BMI greater than 40 (BMI has it’s own problems but its the best measurement I could use here). Such people (BMI>40) are actually rarer than most of what people think as “obese.” A BMI smaller than 40 is not usally in and of itself as horrible as people think it is. In fact having a BMI in the range of the 30s may even have health benefits.

    Additionally, just because you are that fat (BMI greater than 40) does not necessarily mean you will have those medical problems . (though it sometimes does depending how much greater the BMI is, and age, and other factors).

    Obesity in general is not as bad in actuality compared to say, smoking. There is more hysteria and prejudice floating around than is actually currently warranted.

  229. 229
    Lesley says:

    @Makewi:

    That you’re a full blown bald-faced lying sack of shit is fully demonstrated in this thread.

    Who needs to grow up now?

  230. 230
    Lesley says:

    @Brachiator:

    Evidently you haven’t read Fast Food Nation, Diet for a New America or any of the other factual books on industrialized food production. You might want to check out madcowboy.com.

    If you think the average US supermarket is stocking healthy food – and the average American is eating for health – you’re delusional.

  231. 231
    Rob says:

    Too fat for a decent medical system? Rubbish. We Australians are as obese as Americans, but our healthcare system is much better. In fact, one of the reasons I returned to Australia was that our health care doesn’t screw you around (and by that, I am really talking about health care insurance, rather than the actual medical care). Here, I can go to a doctor of my choosing, not restricted by the insurance company, and don’t have to inform the company which doctor I chose. (One-time exemption, my a*** !) As you can guess, I was less than impressed than my encounters with the US health care system. And this was in a prosperous area of Maryland, not somewhere in the back of beyond. You guys deserve so much better than the healthcare system you have now.

  232. 232
    io says:

    @someguy — you’re provoking ire from so-called fat people. You’re also going to get the ire of a skinny person. Why? Because I’m less healthy than many people carrying around more weight, and you can’t tell, and that proves a certain simple-minded bigotry on your part. Some people eat more than they need to and some people starve themselves when they are depressed. Some people look skinny and yet cannot jog a full mile, some people look chubby and are in great cardiovascular shape. Some people will be significantly rotund and cost our healthcare system very little money (otherwise good genetics and good luck), and some people will be a size 0 and cost tons of money to treat. Me? 5’3″, 105 lbs, cholesterol through the roof (genetics), not the greatest cardiovascular conditioning, joint problems, back problems (hit by a hit-and-run driver), and a serious mental illness (genetics again). I am clinically bipolar, been in therapy/psychiatric treatment for 15 years, and only through EXPENSIVE maintenance like this can I be a productive member of society and not be in even more intensive treatment, more EXPENSIVE hospitalizations and unable to work (e.g. welfare or homelessness, I guess). So: a resounding fuck you to think you can judge people for problems brought on by genetics. Did you ever stop to think that your straw-sis-in-law was clinically depressed and self-medicating with food instead of receiving proper mental-health care? No, of course you didn’t think, you just judged.

  233. 233

    […] One of the new arguments against health-care reform: Americans are too fat to deserve quality health insurance. […]

  234. 234
    Superman says:

    Where you been? Maria Bartiromo is obese! They try not to show her lower half on TV.

    http://timothysykes.com/2008/0.....bartiromo/

Trackbacks & Pingbacks

  1. […] One of the new arguments against health-care reform: Americans are too fat to deserve quality health insurance. […]

  2. […] Roseanne the Riveter & the New Guilted Age […]

  3. […] Juice writes about the new media talking point that Americans don’t deserve better health care because we’re a bunch of big fat slobs. America’s obesity epidemic even explains, to Maria Bartiromo, our high infant mortality rates: […]

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