The Benefits of Morality and Really Good Math
Floor Speech
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Mr. HARRIS. Mr. Speaker, I thank the gentleman from Arizona for yielding me some time today.
Mr. Speaker, to those who see the gentleman virtually every week come up here and talk about the economics of the United States and our debt problems and things like that, today, we will take a little different view because we are going to talk about something that doesn't just have to do with economics; it has to do with providing a healthier America. An America where, yes, we would save money if we were healthier, but the other benefits are so tremendous.
We are not doing this just because we want to save money; we are doing this because we think this is actually the right approach for Americans. If you look at the cost of healthcare, about 70 percent is to take care of chronic diseases and the big chronic diseases are hypertension, diabetes, and obesity. They are the big chronic diseases.
Cancer is not a chronic disease. It is an acute disease. It is the chronic diseases that are costing literally hundreds of billions of dollars to the United States.
Today, we are going to focus on obesity. Now, hopefully in the future, we will focus on diabetes, maybe on hypertension. The reason why it is so important to start with these three is that the amount of spending, as the gentleman indicates, is tremendous.
I am going to pull some data from this study from the Milken Institute. It is called America's obesity crisis. It is from 2018, so 5\1/2\ years ago, October 2018, but it is subtitled, ``The Health and Economic Cost of Excess Weight.'' The health and economic costs because they are both costs.
Again, it is not just dollars and cents. They count, but the fact of life is just not as good for someone who has a chronic disease, so let's do something to prevent it.
However, the first thing you have to do is say, what is the history of obesity in the United States?
Look, I have been on this Earth 67 years. I will tell you that it has been noticeable that more Americans are obese or overweight. It is true throughout the world, but let's concentrate on America.
These are medical definitions. If you are higher than the normal range of weight, you are overweight, if you are slightly higher; then you are obese if you are higher than that; and then severe obesity or morbidly obese, as well.
Using these definitions, the same definitions in 1962, 3.4 percent of adults were considered obese. Again, it is not overweight; it is obese. If it is more than overweight; it is obese.
From 1962 to 2000, 30.5 percent. In 2016, 39.8 percent. Mr. Speaker, 8 years ago, it was 39.8 percent. The latest data the CDC has which is from 2017 to 2020, 41.9 percent. Mr. Speaker, 41.9 percent of Americans classified as obese.
Now, why is that classification important?
By the way, the demographic breakdown is very interesting because what we ought to be doing is, we ought to be looking at the demographics and paying attention to where it exists in the population: 49.9 percent of Black adults are obese, 45.6 percent of Hispanic adults, 41.4 percent of White adults, 16.1 percent of Asian adults.
It actually is overrepresented in the Black and Hispanic communities, but why is that important? By the way, that is adults.
The striking thing is for children in the last year that we have data: 16.1 percent overweight; 19.3 percent obese, one in five children are considered obese; one in 16, 6.1 percent, severe obesity in children. Again, that severe obesity in children number is actually higher at 6.1 percent than the entire adult population back in 1962.
It begs the question of why it is so important that we identify obesity. It is because I think a lot of people don't understand the broad range of diseases, including expensive healthcare diseases, in which the risk of that disease is higher if you are obese. It is not everybody who is obese who has these problems, but if you are obese, you are statistically more likely to have these problems.
I want to read the list so you understand why this is such a large economic problem. Alzheimer's and vascular dementia, most people don't realize obesity is a risk factor for that. We worry a lot about that because the cost of Alzheimer's in America and the treatment, again, is measured in the hundreds of billions of dollars. Other diseases include asthma and COPD; breast cancer--we know that cancers are; chronic back pain; colorectal cancer; congestive heart failure--again, a large consumer of healthcare dollars; coronary artery disease; diabetes, of course. Again, diabetes and obesity kind of go hand-in-hand, but only 20 percent of the cost of obesity, again, the approximately $1.7 trillion annual cost back in 2016, only 20 percent of that can be attributed to the coexistence of diabetes and obesity. Again, diabetes has to be handled by itself, but obesity is a risk factor for that.
Dyslipidemia, so people with high cholesterol and lipids; end-stage renal disease; endometrial cancer; esophageal adenocarcinoma; gallbladder cancer; gallbladder disease; gastric adenocarcinoma, so stomach cancer; hypertension; liver cancer; osteoarthritis; ovarian cancer; pancreatic cancer; prostate cancer; renal cancer; and stroke-- all of these have a higher incidence in someone with obesity.
Scientifically, we say that if we can reduce obesity, we will reduce the incidence of all these diseases and the costs associated with them. The costs associated with them attributable to obesity are over $1.5 trillion a year, both direct costs, the cost to actually treat someone, and the indirect costs, the cost of decreased productivity and decreased contribution to the GDP and the economy by someone who is ill, all these indirect and direct costs. These numbers are just staggering.
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Mr. HARRIS. Sure. I chair the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Subcommittee of the Appropriations Committee, and we are in charge of funding the Supplemental Nutrition Assistance Program, the SNAP program.
If you were paying attention about an hour ago, an hour and a half ago, to the folks from the other side of the aisle, all they wanted to do was push more money into the Supplemental Nutrition Assistance Program.
The second word there, by the way, is ``nutrition.'' If you go back to the original founding, the program was founded to provide nutrition. In the early days of the program, there was a significant number of people in the country who actually did not receive enough calories. Literally, they didn't receive enough calories. At that time, the emphasis was to get food of all kinds to these folks so that they are not calorie starved.
Again, I talked about the trend in obesity, and what we see is that something is happening. We have programs like the Supplemental Nutrition Assistance Program where the last time they looked at it was in 2016--it might have been earlier than that--where 10 percent of the funds went to sugary soda. Remember, this is a $122 billion a year program of taxpayer dollars. We ask taxpayers to pony up or to borrow $122 billion to put into the Supplemental Nutrition Assistance Program. Ten percent is on sugary soda, $12 billion, our best estimate, is spent on something that we now know--maybe 40 or 50 years ago when the obesity rate was 6 percent or 3-plus percent, we didn't know that.
We do know now what contributes to obesity. We do know that insulin resistance, the presence of sugars and processed foods in the diet, directly cause obesity. Of course, diabetes, which again we will get to in the future, and probably also hypertension to some extent, are all interrelated diseases. We actually know that that is bad.
I have proposed taking out nonnutritious--it is about 20 percent. It is 10 percent sugary soda beverages and another 10 percent salty snacks, ultra-processed food. Again, it raises your insulin levels. It does all the bad things that ultimately lead to an increased amount of fatty tissue and obesity.
Let's just say that we will allow States to restrict that in a program and take that money and spend it on fruits and vegetables or something. That sounds like a pretty novel idea. That sounds like a pretty good idea based on the scientific evidence.
The pushback has been tremendous, mainly from the other side of the aisle, which is: No, all we need to do is spend more money on this program.
I would suggest to the gentleman from Arizona that we have enough proof that what we have been doing hasn't been working. In fact, it has been making the problem worse because the data on people who receive Supplemental Nutrition Assistance Program shows they are more obese and more overweight.
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Mr. HARRIS. Of course, they are sicker because we know these diseases relate to it. The studies were done against individuals who had the same socioeconomic status, same income, but were not getting SNAP benefits.
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Mr. HARRIS. I agree. This is not just about economics. It is using borrowed money to actually cause the need for more borrowed money in the future.
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Mr. HARRIS. It is direct. Again, even if this were economically neutral--but it is not--one would make the argument that the right thing to do for people is to give them a better, healthier life.
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Mr. HARRIS. In the hearing today, we had someone suggest that all we need to do is do public service announcements, that we will just do education.
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Mr. HARRIS. One of the experts said, quite accurately, that when you deal with an addiction--and we won't get into that today, but by the way, just so everybody understands, it is now pretty clear from brain chemistry that sugar--and when we say sugar, mostly it is fructose because the other sugar is cane sugar, which is sucrose, a combination of fructose and glucose. Fructose, basically, we understand that it is actually physically addictive in the brain because it results through the modifier of MGO, a chemical called MGO, which binds to receptors in the brain. It actually releases dopamine.
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Mr. HARRIS. It could. Every single addictive issue in front of us involves--whether it is an addiction like opioid addiction, an addiction like sugar addiction, an addiction like gambling, or your cell phones and the fact that our youth now spend 7 hours a day on their cell phones, on the internet and playing games and things, it is because this is designed to release dopamine in the brain.
We understand it is the exact same mechanism, and it is up to us. People say to educate. Our government shouldn't be involved in this. Wait a minute, we are talking about regulating the industry for children with regard to apps, regulating the opioid industry because it is addictive, dealing with gambling because it is addictive. Why wouldn't we talk about a food addiction that leads to misery and huge economic costs?
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Mr. HARRIS. There is no question that that is true. The fact is that we can send a strong economic signal through our ability to modify what is available under food programs, not only direct payments but also the fact that, over the past 50 years, we have kind of funneled all the production, as you said, into only a handful of major crops.
In my district, for instance, they used to grow tomatoes. It used to be one of the tomato capitals of the country. I didn't even know this, but it is not anymore. It is just soybeans and corn, partly because we have a big poultry industry, but the variety of crops has just disappeared.
Again, everything comes together. Everything points in the same direction. We must address the obesity crisis. We know what causes it.
We actually have a pretty good idea of how to solve it, how to get there, but we have to decide that that is something we are going to do. I think the average American understands it. I think they do.
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Mr. HARRIS. That is right. You bring up a good point.
The first thing you start with is say that we don't have to change-- let's do a few pilot programs. Let's get some data. Otherwise, it is incredibly difficult to see whether some of these ideas work to change the way people buy and their habits. Obviously, it will take a generation for the obesity that already exists to plateau.
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Mr. HARRIS. I mean, with Ozempic and Wegovy, maybe it is quicker, but these are not the solution. The solution is not to become obese and then take a drug to reduce the obesity. It is not to become obese in the first place, but your point is critical.
Right now, a 3-year-old has a lower life expectancy than a 60-year- old had at the same age. That is because our adults are getting these chronic diseases at an increasing rate. That 3-year-old, if we don't change the trajectory, will have much less of a chance to live to the same age as their grandfather did or their father did.
We cannot accept that in America. We are actually in a situation where our children have a lower life expectancy than us.
This is the opposite of everything anybody does anything for. As a father, you want to do everything for your children so they have it better than you.
We are kind of intentionally, because we are intentional in how we spend dollars, forcing our children to a lower, shorter life expectancy than we have. Shame on us if we don't fix this.
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