Tuesday, April 28, 2009

Put Down That Soda and Step Away Slowly? Taxing Sugared Beverages to Address Obesity.

While the Disease Management Care Blog is distrustful of big government involvement in health care, there can be little doubt about the important role it has to play in old fashioned public health. Taxpayers have gotten their money's worth in the many Federal, State and County programs of surveillance, disease prevention and health promotion. This link is a good example. While there is a resemblance to disease management, that’s a topic for a different post.

That’s because the DMCB is too busy agreeing with Drs. Brownell and Frieden in their April 30 New England Journal of Medicine Perspective on taxing sugared beverages. This is the right mix of public health, leveraging government power and, while we’re at it, getting our collective hands on some serious coin.

According to the authors, sugar-sweetened beverages may be the ‘single largest driver of the obesity epidemic.’ While food manufacturers would have you believe it’s a matter or exercise, don’t believe it. Too many studies have shown that that last can of soda you had is consistently associated with being overweight, having a poor nutritional status and being at greater risk for diabetes.

Since simply educating people about the need to reduce sugared beverage intake has limited impact, why not turn to an approach that worked to reduce consumption of tobacco? According to the authors, some locales have used taxation in the soda wars and they’ve found that every 10% increase in the price results in a drop in consumption by 7.8%.

Yes you, like the DMCB, may be leery about Big Brother nosing into another corner of our lives, but consider: 1) all that sugar consumption means more Medicare and Medicaid and less work-tax revenue, 2) manufacturers are very good at touting the faux-health benefits of their products and there is no other way to level the playing field and 3) er, hellooooo, this is one tax that many Americans might support – especially if the revenue were used to credibly support health programs.

Drs. Brownell and Frieden raise some other good points. A tax may represent a bigger burden for persons of low income. Just because everyone drinks less soda as a result of the tax won’t necessarily mean that, as a result, people will eat better. Imposing a small tax may raise revenue, but it will probably require a bigger tax (say, a penny an ounce) to meaningfully reduce consumption.

While this notion circulates around policy circles, the DMCB asks whether our hospital, clinics, retail phamacies and disease management organizations’ places of work should reconsider even selling soda in our cafeterias and vending machines. Instead of banning them, just jack the price up. Why not?

So, no need to put the soda down. Pay up instead and wonder if you can really afford it.

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