References that Republican Gov. Jeff Landry made in his state of the state speech earlier this week to “Make Louisiana Healthy Again” may have puzzled many viewers, but the initiative could become a significant game-changer for both state finances and public health—if done right.
Landry mentioned only three specific agenda items in his address: he spent considerable time on insurance reforms, briefly touched on reorganizing the Department of Transportation and Development, and slipped in a reference to a spinoff of the national “Make America Healthy Again” initiative somewhere in between. That program aims to have government incentivize dietary habits that produce better health outcomes.
Half a century ago, the concept—bowdlerized into the phrase “you are what you eat”—was backed by scant evidence and carried the odor of anti-capitalist hippie musings. (It probably didn’t help that one of its early advocates, Dr. Andrew Weil, was at the time knee-deep in psychotropic drug research—and usage.) There’s still a fair share of shaky (or “nutty”—but let’s not lean too hard into the pun) thinking in the space, like the idea that eating meat will cause catastrophic anthropogenic global warming via livestock methane. But if you strip away the evidence-free political hyperbolism, what remains is a set of emerging, research-backed insights worth taking seriously.
Thanks to a burgeoning body of research and more sophisticated methods of tracking biological processes, the field has matured into what is now called “integrative medicine”—a more holistic approach to health that emphasizes dietary choices as a factor in longevity and disease prevention. While debate remains (for example, perhaps the biggest controversy is eggs vs. no or few eggs in a diet), the evidence is mainstream enough that Medicare now reimburses adherence to a heart-health diet developed by another pioneer in the field, Dr. Dean Ornish.
Incidentally, early efforts to legislate food content—raw or prepared—often emanated from Democrats. But as the field has gained scientific credibility, Republicans have taken an interest, drawn by the promise of reduced government healthcare costs, especially as Medicaid expansion and the specter of single-payer loom closer. The leading proposal this session is SB 14, authored by GOP state Patrick McMath. It’s a good case study in both the potential and pitfalls of this policy approach.
Much about the bill is good. It mandates nutrition education for healthcare professionals, prohibits tax dollars from paying for “ultra-processed” foods (those using certain additives for aesthetics or cost-reduction) in schools, and requires manufacturers to label any product containing ingredients banned elsewhere in the world. It also urges the state to apply to the federal government to prohibit SNAP funds from being used to purchase soft drinks.
None of this infringes on liberty. Taxpayers have a right to say how their money is used. Expanded warning labels impose a microscopic cost and leave the ultimate choice of reading the information to the consumer. The weak spot in the bill is its requirement that restaurants post menu warnings about the use of certain seed oils. That’s misguided—not only would the cost to businesses be nontrivial (the real intent is clearly to stigmatize the oils), but consumers can simply ask if concerned. More importantly, the science is unsettled. There’s broad consensus against some oils, but disagreement on others. (That said, the bill’s list does include the so-called “hateful eight,” which have earned widespread condemnation—plus flaxseed.)
For that reason, SB 117 by Republican state Sen. Blake Miguez may be the stronger bill. It limits school-served food to exclude ultra-processed products and restricts only safflower oil. However, it lacks several of McMath’s stronger elements. A merger of the two could offer a more balanced approach.
The Landry administration, however, hasn’t waited on the Legislature. In partnership with a national effort launched under GOP Pres. Donald Trump, the state successfully petitioned to join a pilot program across six parishes—usable at Wal-Mart—that gives SNAP users a bonus for buying fresh fruits and vegetables. The program could continue through the rest of the year.
If the behaviors encouraged in these bills take hold, as the evidence suggests they will, they could yield a healthier, longer-living population—and eventually reduce government healthcare costs. Not tomorrow, as some might hope, and not even within a few years. But within a couple of decades, the long-term impact of reduced obesity and healthier consumption habits–including reduced chronic illness–will begin to be felt.
The sooner we start, the sooner taxpayers reap the benefits.
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