July 05, 2007
Suprisingly, given the low profile of health issues in the federal election, the 2007 Adelaide Festival of Ideas has a strong theme of health running the different sessions with a strong emphasis on good nutrition. Eat well be well is an argument running through the 'Before You Eat' session on Friday. Kerryn Goldsworthy at Pavlov's Cat has some interesting comments on this.
It is most explicit in Marion Nestle's ' 'What to Eat' talk on Saturday which takes us into food and health policy. Fox News, that Republican cheer squad, is not impressed by this kind of approach, which it sees as another example of junk science.
This approach works within the health policy reform agenda of prevention and primary care. This health reform argument persuasively expressed by the Centre of Policy Development is a simple one:
Governments are always talking about taking the pressure off public hospitals and reducing spiraling costs. The current Howard Government says it can do it by subsidising the Private Health Insurance industry, which hasn't worked. The states argue that they could cut hospital waiting lists if only the feds gave them more money. Both arguments miss the point. The best way to take the pressure off hospitals is to ensure that most people don't need to go there in the first place.
Australia faces spiraling rates of chronic illness, including many that could be prevented, mitigated or cured through early intervention. Without change, we will keep spending more and more to achieve less and less. Too many people have to fight their way through a complex maze of services and funding systems to deal with common illnesses that could easily be addressed at their local health centre or family medical and non-medical practice.
What is missing is the willingness of state and federal governments to take on the challenge of real health reform despite obesity being a real problem. The establishment of 'one stop shop' primary health care centres staffed with all the expertise needed to manage the overall health of the local population. These centres would form the backbone of a high-quality universal health system, benefiting Australians of all backgrounds and incomes, rather than a limited ‘safety net’ service designed to catch the fallout from a two-tier system.
Robert Phiddian's notes for the 'Before You Eat' session say that though food is at the centre of our lives constantly, a social as well as a physical staple, we in the developed world are further from the production of food than we have ever been before. The chain from farm to plate is now fantastically long and increasingly invisible to individual consumers, many of whom even do precious little cooking these days.
He says that his main point is that the food chain is attenuated, and we consumers don’t know much about what we are putting in our mouths. In particular, we could afford to know more about any or all of:
the risks to health (real as opposed to imagined) from chemical inputs in the food chain; the costs and benefits to individual health of highly processed foods; the costs (nutritional as well as environmental) of having everything in season all the time; the further dietary implications of affluence that mean most people in the developed world can eat what would once have been luxury foodstuffs most of the time; the alleged ‘obesity epidemic’ and what we can do about it.
We are right in the core of food and health policy. Nestle's talk, based on her 'What to Eat' book, directly tackles junk food and food politics from a health perspective. As she observes when it comes to the mass production and consumption of food, strategic decisions are driven by economics—not science, not ethics, and certainly not health.
A consumer driven society we have lost sight of wellbeing as a flourishing life understood as healthy functioning. We are reaping the consequences with obesity and ill health.