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  #1   ^
Old Wed, Mar-20-19, 08:11
teaser's Avatar
teaser teaser is offline
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Default "Healthy" food subsidy

https://www.sciencedaily.com/releas...90319163532.htm

Quote:
Prescribing healthy food in Medicare/Medicaid is cost effective, could improve health

A team of researchers modeled the health and economic effects of healthy food prescriptions in Medicare and Medicaid. The study, published today in PLOS Medicine, finds that health insurance coverage to offset the cost of healthy food for Medicare and/or Medicaid participants would be highly cost effective after five years and improve health outcomes.

"We found that encouraging people to eat healthy foods in Medicare and Medicaid -- healthy food prescriptions -- could be as or more cost effective as other common interventions, such as preventative drug treatments for hypertension or high cholesterol," said co-first author Yujin Lee, Ph.D., postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts.

"Healthy food prescriptions are increasingly being considered in private health insurance programs, and the new 2018 Farm Bill includes a $25 million Produce Prescription Program to further evaluate this approach," she continued.

The study estimated the economic and health benefits that would accrue if 30 percent of the cost of healthy food purchases in supermarkets and grocery stores were covered through Medicare and Medicaid, through an electronic debit card. Two scenarios were modeled: 30 percent coverage of fruit and vegetable purchases; and 30 percent coverage of purchases of fruits, vegetables, whole grains, nuts/seeds, seafood, and plant-based oils.

The model estimated that both of these programs would improve health and lower healthcare utilization. Over a lifetime of current beneficiaries, the fruit and vegetable incentive would prevent 1.93 million cardiovascular disease (CVD) cases; while the broader healthy food incentive would prevent 3.28 million CVD cases and 120,000 diabetes cases. (Only the latter incentive was predicted to reduce diabetes cases because of the role that whole grains and nuts/seeds have in diabetes prevention.)

Both the fruit and vegetable infcentive and the broader healthy food incentive were estimated to reduce healthcare utilization, with savings of $39.7 billion and $100.2 billion, respectively. Total food subsidy and other policy costs were $122.6 billion for the fruit and vegetable incentive and $210.4 billion for the broader healthy food incentive. Considering net costs vs. savings and health benefits, both programs were highly cost-effective, with incremental costs of $18,184 per quality-adjusted lie-year (QALY) gained for the fruit and vegetable incentive, and $13,194 per QALY gained for the healthy food incentive. (The conventional cutpoint for a medical intervention to be considered cost-effective is less than $150,000 per QALY gained; while costs less than $50,000 per QALY gained are considered highly cost-effective and medical 'best buys.')

"Our findings support implementation and evaluation of healthy food prescriptions within healthcare systems to improve the diet and health of Americans," said co-senior author Renata Micha, R.D., Ph.D, research associate professor at the Friedman School.

"Medicare and Medicaid are the two largest healthcare programs in the U.S., together covering one in three Americans and accounting for 1 in every 4 dollars in the entire federal budget," said co-first author Dariush Mozaffarian, M.D., Dr.P.H, dean of the Friedman School.

"These new findings support the concept of Food is Medicine: That innovative programs to encourage and reimburse healthy eating can and should be integrated into the healthcare system," he continued.

A validated micro-simulation model (CVD Predict) generated samples representative of the Medicare, Medicaid, and dual-eligible populations. The model utilized national data from the three most recent National Health and Nutrition Examination Surveys (NHANES 2009-2014), as well as data from published sources and meta-analyses, which included demographics, dietary intakes, policy effects, diet-disease effects, policy costs, and healthcare costs. The two intervention scenarios were applied to each of the three samples and assessed the impact at 5, 10, and 20 year horizons and at a simulated lifetime horizon.

This study is a part of the Food Policy Review and Intervention Cost-Effectiveness (Food-PRICE) research initiative, a collaboration of researchers working to identify cost-effective nutrition strategies to improve health in the United States.

The researchers caution that the study cannot prove the health and cost effects of the incentives modeled. The study is intended to provide the best available national estimates of potential impacts that can be considered at the federal level when designing and evaluating incentive programs.


This is the part that got me putting this in the war zone...

Quote:
(Only the latter incentive was predicted to reduce diabetes cases because of the role that whole grains and nuts/seeds have in diabetes prevention.)


Although if that hadn't been there, this might have done it;


Quote:
30 percent coverage of purchases of fruits, vegetables, whole grains, nuts/seeds, seafood, and plant-based oils.


I don't really understand why a subsidy for whole grains and plant based oil is even considered, before you get to the argument over whether they're actually healthful, it's not like they're even expensive.

There's also the question of whether the discount would apply to whole grain pop tarts...
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  #2   ^
Old Wed, Mar-20-19, 08:46
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Ms Arielle Ms Arielle is offline
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Good stuff, as always.

SUBSIDIES also support some area of agriculture. It is a less than straightforward system. Like, support peanut farmers by providing peanut butter to schools at a better break point. A ready market thru the school lunch program.

Production of grains in this country depend on farmers getting loans to buy the seed. And who can find $1 in their own bank account to buy that one big piece of equipment. Their margin of profit is ridiculously low. And this is how prices are kept down. AND why the producers need to sell to other countries to drive up the prices here.

( Im all for letting these fields go back to grasses and run a few head of cattle for the grass-fed beef market.)
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  #3   ^
Old Wed, Mar-20-19, 09:53
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GRB5111 GRB5111 is offline
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Ms A is correct on subsidies. The U.S. has long subsidized its agricultural producers through programs like food stamps, today it's SNAP, and others where it is developed under the guise of helping low income families and is a form of welfare. After gallons of powdered Tang and other similar extremely healthy solutions that food stamps were used for, it started on the Food Pyramid, MyPlate mantra. Farmers have been paid to overproduce and paid to not produce.

Now, some brilliant mind is proposing to apply this to Medicare (I'm covered by Medicare), and it appears the proposal will make it the equivalent of the Standards of Care, food version. When will the enforcement of healthy eating occur? If I choose to eat meat, no fruit, and some vegetables, will I be threatened? Interesting to say the least . . .
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  #4   ^
Old Wed, Mar-20-19, 11:46
CityGirl8 CityGirl8 is offline
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Quote:
30 percent coverage of purchases of fruits, vegetables, whole grains, nuts/seeds, seafood, and plant-based oils.
Berries, cauliflower, almonds and other nuts, maybe almond flour, Omega-3 rich cold water fish, and avocado oil. I wouldn't mind a 30% discount on fresh raspberries and salmon.
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  #5   ^
Old Wed, Mar-20-19, 12:11
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WereBear WereBear is online now
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Sounds like the "helpful" questionnaire I got from my health insurance company. I don't dare tell them my cholesterol, that I'm not on statins, I refused screenings for cancer, and most of all, how I eat, especially lately on Keto.

They'd send someone to shoot me just in case.
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  #6   ^
Old Wed, Mar-20-19, 12:48
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Meme#1 Meme#1 is offline
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Quote:
Originally Posted by Ms Arielle
Good stuff, as always.

SUBSIDIES also support some area of agriculture. It is a less than straightforward system. Like, support peanut farmers by providing peanut butter to schools at a better break point. A ready market thru the school lunch program.

Production of grains in this country depend on farmers getting loans to buy the seed. And who can find $1 in their own bank account to buy that one big piece of equipment. Their margin of profit is ridiculously low. And this is how prices are kept down. AND why the producers need to sell to other countries to drive up the prices here.

( Im all for letting these fields go back to grasses and run a few head of cattle for the grass-fed beef market.)


Peanut allotment is something on it's own that I know nothing about. My Dad had an allotment of certain amount of acres in an area that had stopped raising peanuts and he was raising cattle so didn't need it and sold it to someone who was going to grow peanuts. Apparently you can't grow them without that Allotment.

Another thing I know nothing about is Crop Insurance and farmers must enroll and pay a premium but I guess it's federally backed and pays in case of crop losses. Think about the risks due to rain, temps, disease, drought etc...

Prices and subsidies are connected to the Commodities Market which again, I know nothing about.

All I know is that only 1% of our population produces the food in the US. We do not need them to go out of business, unless you want to depend on China for your food supply.
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  #7   ^
Old Wed, Mar-20-19, 12:59
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Ms Arielle Ms Arielle is offline
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Well said Meme.

Yes, for years I talked with a friend in the mid west-- one summer a total crop failure due to hail. Knocked everything to the ground. Needed the insurance money to spray the field with herbicide to kill off the crop completely, and get ready to plant the next year.

Dependency on 1% is too scary for me!!
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  #8   ^
Old Wed, Mar-20-19, 13:06
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WereBear WereBear is online now
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One thing that heartens me is the rise of small, local, farms with more organic and humane practices. THIS is the way to combat processed food corporations, and have farmer's markets much of the year where you can buy from them directly.
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  #9   ^
Old Wed, Mar-20-19, 13:26
Meme#1's Avatar
Meme#1 Meme#1 is offline
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Quote:
Originally Posted by WereBear
One thing that heartens me is the rise of small, local, farms with more organic and humane practices. THIS is the way to combat processed food corporations, and have farmer's markets much of the year where you can buy from them directly.


I hope it's more than hobby farms because what I've seen through the years are farms and ranches closing. It's tough, hot, dangerous work. A lot of young people don't like getting their hands dirty so don't follow in their parents footsteps. They want the reliability of salaries or guaranteed income too.
Not to mention the tiny profit margins. Farmers have to buy seed as Arielle said, big chemical companies now control the patents on many of them.
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  #10   ^
Old Wed, Mar-20-19, 15:01
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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We have a new farmer's market that started about 3 years ago-- this will be the 4th.

The big orchard was bought by the only in-town farm stand when that family wanted to retire from the business after several generations.

It is hard work. Full stop. Good life lessons, too. On utube it is gratifying to see many jumping into food production with no back ground or family farm .
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  #11   ^
Old Thu, Mar-21-19, 09:23
Bonnie OFS Bonnie OFS is offline
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Quote:
Originally Posted by WereBear
One thing that heartens me is the rise of small, local, farms with more organic and humane practices. THIS is the way to combat processed food corporations, and have farmer's markets much of the year where you can buy from them directly.


One thing that helps those of us who are older & low-income is the farmer's market vouchers we get. Once the vegetables I like best are in, I'm down at the market early every week with my vouchers in hand. If I don't get there early enough, my favorites are sold out.

Cleaned out my deep freeze the other day & found packets of Swiss chard that I froze last summer. I thought we had eaten them all.

The program that issues the vouchers also has an incentive for using food stamps - for every $5 of food stamps used, you get $2.50 in more vouchers.
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  #12   ^
Old Sun, Mar-24-19, 06:07
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Calianna Calianna is offline
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Quote:
Originally Posted by CityGirl8
Berries, cauliflower, almonds and other nuts, maybe almond flour, Omega-3 rich cold water fish, and avocado oil. I wouldn't mind a 30% discount on fresh raspberries and salmon.



This might not be so bad, as long as we oldsters could pick and choose which fruit, veggies, nuts, seafood, and plant based oils we wanted.


Hmm... wonder if it would include all seafood? I'd love a 30% discount on shrimp and crab too. Oooh, lobster at 30% off would be fabulous!
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  #13   ^
Old Sun, Mar-24-19, 07:22
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WereBear WereBear is online now
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If they subsidized foids that were actually GOOD for us...
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  #14   ^
Old Sun, Mar-24-19, 08:36
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Calianna Calianna is offline
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Quote:
Originally Posted by WereBear
If they subsidized foids that were actually GOOD for us...



The thing is there is some overlap in what's considered healthy by the USDA, and what us LCers consider good (LC friendly veggies, berries, avocados, salmon, olive oil, etc), so I don't have a problem with that part of it. It only becomes a real problem if they start tracking everything we buy, penalizing us for not buying potatoes, legumes, and whole wheat bread, while further penalizing us for buying butter, beef, pork, and HWC.



I see this at work - we have an in-store nutritionist, and several months ago, they started giving employees a very small discount on "healthy" food. Of course that includes whole grain bread, all fruit and veggies, and a lot of middle aisle canned or boxed items that are low fat, low cholesterol, high fiber, and/or low in sodium and added sugar. But since each food and product is analyzed individually according to their entire nutritional profile (not just macros and cholesterol, but all vitamins and minerals), some things that are surprising to me have merited that little discount on my order, such as chicken livers. I knew that chicken livers were an extremely good source of folate (several times more folate by weight than spinach), but was amazed to see that wasn't counteracted by the fact that they contain a lot of fat and cholesterol. So there are lots of things I can buy that merit that discount - berries, all the LC friendly veggies, seafood, most poultry, some beef, and even eggs and chicken livers.
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