Should African farmers care whether President Barack Obama succeeds in pushing serious health care reform through the US Congress? As odd as it may sound, they may have a real stake in the outcome of what to most would seem an exclusively domestic tussle. Here’s the connection.
The US devotes more than 16% of its GDP to health care. It’s in a league of its own. The next biggest spender, according to OECD figures, is Switzerland, at 11% of GDP. And yet for all these outlays, the US lags behind all nations in its economic class in terms of outcomes, and the gap may be widening.
If you turned 50 in 1975, you could have expected to live another 27 years whether you lived in the US or Western Europe. Since then, while life expectancies have increased on both sides of the Atlantic, a 50-year-old Frenchman is now likely to outlast his American counterpart by a full year and a half. To a statistician, that is not a trivial difference, especially given that smoking has remained much more prevalent in Europe than it has in the US.
One reason for the gap: nearly everyone in Europe has access to affordable health care while millions of Americans either have no health insurance or are underinsured. Another reason has to be excess avoirdupois.
Over 34% of Americans are now officially classified as obese, up from 15% in 1980. Obesity is closely linked to diabetes, heart disease, high cholesterol, stroke and certain forms of cancer. Not only does it shorten lives, but it adds immensely to medical expenditures. Researchers have calculated that, in the US, the obese incur health costs close to 40% higher than those incurred by people of normal weight. One recent study concluded that 27% of the increase in US health care spending between 1987 and 2001, adjusted for inflation, could be attributed to the rising prevalence of obesity.
What accounts for this epidemic of flab? One way or another, the population is consuming a lot more calories than it is burning off.
In 1980 annual per capita US consumption of “caloric sweeteners” was 55 kilograms. In 2007, it was up to 64 kg. Particularly striking is that in 1980, 69% of consumption was in the form of sugar refined from cane or beet, rather than sweeteners derived from corn (maize). In 2007, regular sugar accounted for only 44% of intake, while actual per capita consumption of corn-based sweeteners more than doubled from 16 kg to 34 kg, most of it now in the form of high fructose corn syrup (HFCS).
Coca Cola bottled in the US does not taste the same as what you drink in SA. The reason is that the US beverage is sweetened with HFCS while the much better tasting South African version is made with real sugar. But taste may not be the only reason to favour South African Coke. Studies have implicated HFCS in the obesity epidemic and as a possible trigger of diabetes in children. Safe or not, it is omnipresent in American soft drinks and processed foods. It’s much cheaper than sugar whose price is kept artificially high in the US by tariffs and import quotas while the price of corn has been kept artificially low by government policies that reward agribusiness for massive overproduction. This distorts global markets and hurts African farmers.
All the excess corn has to go somewhere. Some now goes into cars in the forms of ethanol. The bulk finds its way into America’s digestive tracts. One way or another, corn plays a role in most of what Americans eat, especially the things that make them fat. Almost everything on the menu at an American McDonald’s has corn in it. The beef and chicken is corn-fed. The cheese comes from corn-fed cows. Even the fries which are cooked in corn oil. And the sodas are full of HFCS.
Cheap, abundant corn has made the staple American diet relatively inexpensive. But it has also encouraged overconsumption of the unhealthiest calories. Fresh fruits and vegetables are not subsidized to anything like the same extent as corn, if at all. Meanwhile, because the marginal cost of “supersizing” a corn-based meal or a soda is negligible, it has encouraged marketers to use volume to differentiate their offerings.
Better farm policies would make for healthier Americans. If Obama gets his way and it becomes illegal for health insurance companies to cover only the healthy, the industry is going to have finds ways to make their customers healthier. That could well mean using the dollars they’ve been spending to lobby against health care reform to press for agricultural reform. And that might make it possible to get a global trade deal that actually benefits African farmers.