Regulators “agreed in principle to a five-year, $6.2 billion waiver for California’s Medicaid program,” California Healthline reported. “That was good news for California health officials, who plan to use the money mainly for Medi-Cal delivery system and payment reforms — the next big steps in implementing the Affordable Care Act.”

As state and federal officials work out the details of the new scheme, the current waiver, set to expire at the end of October, was pushed ahead to a new finishing date of December 31.

Ill health, rising costs

Medicaid has emerged as a centerpiece of the expansion of health coverage contained in the ACA. “Obamacare expanded eligibility for Medicaid, the government health insurance program for the poor, to people up to 138 percent of the poverty line — or about $33,000 for a family of four,” as The Hill reported. “The federal government picks up the entire cost of expansion in the early years.”

While Democrats have touted its growth, Republicans in Washington have questioned its budgetary sustainability. “A report from a federal government actuary in July found that enrollees who are newly eligible under Obamacare’s expansion of Medicaid cost $5,517 per person on average, 19 percent higher than standard enrollees,” noted The Hill.

In California, Medi-Cal cost projections have also raised concerns. “Medi-Cal serves about 12.5 million people — roughly a third of Californians,” Kaiser Health News noted. “Santa Clara County’s Valley Medical Center takes in $150 million a year from the federal government to help fund its safety-net care; Contra Costa County takes in $80 million annually.”

Meanwhile, in a report issued by the Alzheimer’s Association, expenses for state residents afflicted with the disease were seen “to rise nearly 59 percent to close to $4.9 billion annually,” according to the San Francisco Chronicle, with medical advances prolonging the lives of baby boomers identified as a driving factor of the spike. “The state-federal Medicaid program for the poor will take on a growing share of the burden of paying for the care of people with Alzheimer’s and other forms of dementia because average households will not be able to pay the high costs of having in-home caregivers, long-term nursing care and other forms of help[.]”

Another recent study indicated that California obesity rates would also hit Medi-Cal with additional burdens. Published in Health Affairs, it “found that medical care associated with severe obesity cost state-run health programs $8 billion in 2013,” the Los Angeles Times reported. “California’s program for the poor, known as Medi-Cal, took the biggest hit, spending $1.3 billion that year on severe obesity-related care.”

Shifting burdens

Adding to the challenge facing policymakers, the new waiver fell far short of what California had requested. “The original proposal was whittled down from $17 billion to $7.25 billion and finally to $6.2 billion during the negotiations,” KQED News observed. Although state health officials expressed relief and satisfaction once the deal was reached, state negotiators had hoped to settle on the $7.25 billion figure. “Instead of funding five years of care for the uninsured […], the plan only specifies $236 million for the first year. Funding for the next four will depend on an outside assessment of how much hospitals need.”

Unresolved budgetary issues surrounding Medi-Cal have hung heavily over Sacramento this fall. As CalWatchdog reported previously, Gov. Jerry Brown vented his frustration toward lawmakers last month, slamming their inability to restructure a key tax that affects participating health plans:

“Without the extension of the managed care organization tax that I called for in special session,” Brown said in his message explaining his veto of the nine bills, “next year’s budget faces the prospect of over $1 billion in cuts.”

In 2008, the Los Angeles City Council voted unanimously to freeze new fast food franchises. But as the Los Angeles Times reported, the ban’s imprecise language allowed “fast casual” outlets to flourish while failing to prevent new franchises from popping up anyway:

“The ban, supporters say, was meant to be a stop-gap measure to buy time as officials crafted initiatives to lure the sort of restaurants that area residents want. But when Gov. Jerry Brown dissolved redevelopment agencies in 2012, the city lost one of its best tools for enticing developers to invest in blighted communities. Without the leverage of tax incentives and other city support, attracting new restaurants is tough, city officials and business leaders say.”

Harsh findings

At first, the unprecedented effort to affect municipal diets had shown some gains. Four years after the moratorium, The New York Times reported that “no new stand-alone fast-food establishments have opened in the area,” while, instead, south L.A. saw its “first new supermarket in roughly a decade”:

“A handful of much smaller cities have enacted similar regulations for primarily aesthetic reasons, but Los Angeles, officials say, is the first to do so as part of a public health effort. The regulations, which the City Council passed unanimously last month, are meant to encourage healthier neighborhood dining options. Supporters envision more sit-down restaurants, produce-filled grocery stores and takeout meals that center on salad rather than fries.”

But a RAND Corporation study released in March revealed that, whatever its impact on businesses, the fast food moratorium failed to curb obesity levels. Investigating a five-year period of eating patterns, the study found that the City Council had little to show for its efforts. Although obesity and overweight rates were impacted by “a drop in soft drink consumption since 2007,” the authors concluded, “that drop is of similar magnitude in all areas.”

“In fact, obesity rates in the area had grown at a faster clip than elsewhere in the city,” the Atlantic noted. “As NBC News reported, the percentage of people in South Los Angeles who were overweight or obese in 2007 was 63 percent. By 2011, that figure was 75 percent.”

What’s more, the study also suggested that the affected restaurants even managed to squeeze in a few more franchises by exploiting a simple loophole in the new regulations. “Over the study period,” the New Orleans Times-Picayune observed, “the rate of new fast-food restaurants that opened in south Los Angeles in that period was ‘no different’ than in other parts of the county, in part, because in the affected area they skirted the ban by opening in shared spaces instead of ‘free-standing’ locations.”

Finally, according to the Los Angeles Times’ own analysis, what new restaurants did move into the South L.A. area clustered overwhelmingly around the University of Southern California campus:

“From 2009 through 2014, the roughly 32-square mile area covered by the ban gained 86 restaurants, a Times analysis of Los Angeles County Department of Health records shows. More than half of those new locations, however, were on or near USC.”

Strange bedfellows

Free-market and small-government advocates swiftly hailed the study, which seemed to confirm the criticisms they raised at the ban’s inception.

More notably, however, grassroots health and dietary activists have not done much to defend the ineffective law. “Nonprofit leaders were not surprised by the findings,” according to Southern California Public Radio. “They say the obesity epidemic is complex, and that solving it will require more than a ban on new fast food restaurants.”

“The answer is long-term, patient committed work,” said Neelam Sharma, director of a nonprofit that makes produce readily available in South L.A. “Like engaging with people. That isn’t sexy and doesn’t get immediate results.”

“Lawyers are pitching state attorneys general in 16 states with a radical idea: make the food industry pay for soaring obesity-related health care costs.

“It’s a move straight from the playbook of the Big Tobacco takedown of the 1990s, which ended in a $246 billion settlement with 46 states, a ban on cigarette marketing to young people and the Food and Drug Administration stepping in to regulate.

“There are plenty of naysayers, just as there were in 1994 when Mike Moore, Mississippi’s attorney general, famously suggested suing the tobacco industry. But a number of nutrition and legal experts think a similar strategy could be applied on the food front — especially as obesity-related diseases have surpassed smoking as a major driver of health care costs.

“’I believe that this is the most promising strategy to lighten the economic burden of obesity on states and taxpayers and to negotiate broader public health policy objectives,’ said Paul McDonald, a partner at Valorem Law Group in Chicago, who is leading the charge.

“McDonald’s firm has sent proposals to AGs from California to Mississippi explaining how suing ‘big food’ could help their states close budget gaps as billions in Medicaid expenditures eat a growing share of tax revenues.”

Sadly, many Dems will love the ‘twofer’

This is like a mini-greatest hits of everything that people who believe in liberty should hate.

Private firms that make legal products facing shakedowns not just from trial lawyers but potentially from state attorney generals who are supposed to stand for justice.

What’s really appalling is that Kamala Harris just might get on the bandwagon. Democratic voters have a lot of enthusiasm for the nanny state. They want to tell other people how to live. When they can act in this vein while bullying and legally extorting evil corporations, well, that’s a twofer!

What surprises me is that the trial-lawyer remoras haven’t gone after booze or beer makers. They seem way more vulnerable to legal blackmail than food companies. Former Georgia Congressman Bob Barr wrote about the possibility a decade ago.

There have been a number of efforts to increase the tax on sugary beverages in California in recent years, with little to show for it so far. But the next battle in the soda tax war, in San Francisco next November, could make or break the sour-on-sugar movement.

Proponents argue that increasing the tax on sodas by one or two cents per ounce will prevent obesity, thereby saving millions of people from diseases like diabetes, and the government millions of dollars in health costs. Opponents consider it a Nanny State tax grab that will do nothing except transfer more money from the people to the government.

Mixed poll results

The soda taxers are encouraged by a Field poll of 1,184 California voters in February, which showed 68 percent favor taxing sugary beverages if the money goes to school nutrition and physical activity programs.

Support is highest among Latinos (79 percent) and Bay Area residents (75 percent). It’s lowest among whites (62 percent) and those who live along the South Coast (61 percent). Forty-eight percent overall said they would “strongly favor” a soda tax if the money went for those programs.

But when asked about the soda tax by itself, without reference to how the proceeds would be spent, 53 percent opposed it. Sixty-one percent of whites and Northern California residents outside of the Bay Area were in opposition. Latinos were the only group to support it. Fewer than one in four overall said they “strongly support” the tax, while 37 percent strongly oppose it.

“These findings confirm that widespread support exists for policies that combat obesity, including significant support for a tax on junk drinks to help finance school nutrition and physical activity programs,” said Robert Ross, president and CEO of The California Endowment, which funded the poll.

“Support for these efforts is even greater in communities that carry the greatest burden of illness and costs from obesity-related conditions. As a state we need to support creative approaches to fighting obesity in California.”

Voters reject soda tax

But when voters actually had to put their money where their mouths are, they strongly rejected the soda tax. In Nov. 2012, two-thirds of voters in Richmond voted down a 1 cent-per-ounce soda tax. On the same ballot, nearly two-thirds approved an advisory measure asking that if the soda tax passes, the proceeds should be used for youth sports and health education programs.

On the same day, 76 percent of the voters in El Monte, a suburb in Los Angeles County, voted down a 1 cent-per-ounce soda tax. The strong rejection occurred despite ballot measure language tying the tax to the funding of police, fire, emergency services, gang prevention, graffiti removal, youth nutritional/fitness/health programs, senior services and pothole repair.

San Francisco pushes ahead

Despite those soda tax slap downs, San Francisco’s supervisors are intent on placing a soda tax measure on the Nov. 2014 ballot. Supervisor Scott Wiener introduced an ordinance on Oct. 29 for an initiative that, if passed, would tax sugary beverages at 2 cents per ounce, twice as much as the Richmond and El Monte measures. An estimated $31 million is expected to be raised, which would be targeted at city and school recreation, nutrition and health programs.

Three weeks later, Wiener joined three other supervisors in introducing a similar soda tax ordinance, which will likely be combined with the first. The board has yet to take action. The tax measure would require two-thirds approval from voters to pass.

Wiener is not discouraged by last year’s soda tax failures, telling the San Francisco Chronicle that it “was too easy to attack” because it did not require spending the proceeds on health programs. In contrast, his measure “was carefully crafted to ensure the money is spent on nutrition, physical activity and health — and that it’s not used as a replacement” for existing public health dollars.

Health ‘epidemic’

Wiener put out a fact sheet warning of an out-of-control problem:

“We are experiencing an epidemic of health problems directly attributable to sugary beverages — including spikes in diabetes and obesity afflicting adults, teenagers, and even young children. Teenagers, particularly in low-income communities, are now being diagnosed with pre-diabetes or full-blown diabetes. These cases of diabetes are attributable to significant consumption of sugary beverages. 

“Sugar-sweetened beverages are different — and more extreme — than other sugary foods in terms of their negative health effects. Extensive data on how the body processes sugar-sweetened beverages demonstrate that these are more than empty calories. These drinks do not satiate hunger, unlike foods that eventually create a feeling of fullness.

“Sugar in these beverages can be consumed in large quantities in a very short period of time, effectively rushing the liver — which processes the drinks as toxins — with large amounts of sugar and leading to fat deposits … that give rise to diabetes, cardiovascular disease, and other diseases. The consumption of sugar-sweetened-beverages has also been shown to raise triglycerides, leading to increased risk of heart attacks and stroke.”

Soda industry responds

The beverage industry’s political arm, Californians for Food and Beverage Choice, responded to Wiener’s first ordinance by noting the soda tax defeats in Richmond and El Monte:

“Californians have rejected beverage taxes like the one San Francisco Supervisor Scott Wiener proposes because such measures are unnecessary, wasteful distractions from serious policymaking. Providing people with education, opportunities for physical activity and diverse beverage choices to fit their lifestyles are proven strategies for maintaining health.”

It responded to the second San Francisco soda tax ordinance with this statement:

“Regressive beverage taxes that raise the cost of living for consumers and hurt local businesses are no way to improve community health, and have been soundly rejected by voters each time they have been proposed.

“Fortunately, across the country, there is evidence that the prevalence of obesity may have peaked, and progress is being made through collaborative measures to provide nutrition education, opportunities for physical activity and delivering diverse beverages choices that fit a healthy lifestyle.”

Ironically, even without extra taxation, consumption of soda has been declining for several years as consumers switch to energy and sports drinks. The Field poll shows that only one in four strongly believe that Gatorade-type sports drinks contribute to obesity. But if those drinks contain more than 25 calories of sugar per 12 ounces, they could be taxed in San Francisco under Wiener’s ordinance.

Legislature stalls soda tax

There also have been several soda tax attempts in the state Legislature, all of them bottled up in committee. The latest was Senate Bill 622, which proposed a  1 cent-per-ounce tax on sugar-sweetened beverages.

It would have brought in an estimated $1.74 billion to state government. But due to a reluctance to take on the upfront costs to state government that would be required to collect the tax, the bill was placed in the Senate Appropriation suspense file in May. That allows it to be brought back for a vote in 2014.

“I remain committed to enacting SB622, as it will improve children’s lives and significantly reduce the amount Californians will pay to treat chronic diseases,” said the bill’s author, Sen. Bill Monning, D-Carmel, in a statement. He noted that it passed both the Senate Governance and Finance Committee and Senate Health Committee.

Committee debate

The debate at the May 1 Senate Health Committee hearing was a preview of the arguments to come in San Francisco.

“With the money collected from the sweetened beverage tax, we can start to reverse obesity trends and do the things we know we should to ensure that our children are healthy,” Monning told the committee. “We cannot afford to sit by while the obesity crisis overwhelms our health care system and shortens our children’s lives. A tax on sugary drinks is not the cure all, but it can be a valuable tool in a broader public health campaign.”

He was backed by Dr. Harold Goldstein, executive director of the California Center for Public Health Advocacy, who said that nearly 40 percent of children in California are overweight, and that 10 percent of Californians have diabetes.

“It’s expected that if the obesity epidemic isn’t turned around, a third of all children born in the year 2000, and half of Latino and African-American children, will have diabetes sometime in their lives,” said Goldstein. “Imagine what will happen with health care costs if diabetes rates double or triple.

“Sugar drinks are not the only cause of the obesity epidemic, and they aren’t treated as such in this bill. Instead, they are being held accountable for the unique and proven harm that they are doing to the health of Californians, especially California’s children.”

Bob Achermann, representing the California-Nevada Soft Drink Association, responded that information, not regulation and taxation, would accomplish a lot more toward the legitimate goal of curbing obesity:

“We share the concern over the problem. The question is the best way to address it. We think the marketplace is changing. There’s a wide variety of products available in the marketplace now. Low- and no-calorie products. The industry is doing a lot in terms of making more caloric information available to people on the packaging, on the container, on the package in the store, on the vending machine selection button, the fountain when you fill your cup.

“We think that accomplishes a lot more in terms of making people aware of the issue. Moderation in diet and the need for exercise is certainly the way to address obesity problems.”

Achermann warned that the tax could lead to increased beverage prices across the board, thereby negating any deterrent effect a soda tax might have on soda purchases.

“When you look at the beverage aisles or a vending machine, you will see prices are consistent across product lines,” he said. “So if you have a Diet Coke versus a regular Coke, the prices are still the same. We think this [soda tax] will raise the price on all products … and will simply raise a lot of money for the state, take a lot of money out of consumers’ pockets and not be good for the economy.”

After the bill failed to advance, the beverage industry issued this statement, “Thousands of Californians and local businesses joined our coalition to stop Senate Bill 622, which would have raised grocery prices and hurt business on which California livelihoods depend. This is the second time a tax like this has failed in Sacramento. Unfortunately, this fight isn’t over.”

But could this study merely help to continue the efforts to legitimize and legalize drug use, and bolster the war on some foods?

It’s time to “Just Say No’ to Oreo Cookies

Some of the groups funding the college and study are ardent supporters of “sustainable communities,” and “principles of social justice.

While most cocaine or heroin drug addicts are rail-thin, an addiction to Oreos may be a little more obvious.

Joseph Schroeder, an associate professor of psychology and director of the behavioral neuroscience program, and Connecticut College students found that eating Oreos activated more neurons in the brain’s ‘pleasure center’ than exposure to drugs of abuse, the Connecticut College News reported this week.

“Connecticut College students and a professor of psychology have found “America’s favorite cookie” is just as addictive as cocaine – at least for lab rats” the Connecticut News said. “And just like most humans, rats go for the middle first.”

“While it may not be scientifically relevant, it was surprising to watch the rats eat the famous cookie,” said Jamie Honohan, the student who originated the study idea. “They would
break it open and eat the middle first.”

Rather than treatment for cocaine or alcohol abuse at the Betty Ford Clinic, the addicted will need treatment at the Betty Crocker Center for Oreo addiction.

The study, obesity, and hunger

The study was done in the College’s Holleran Center for Community Action and Public Policy. The Connecticut College News said student Jamie Honohan was interested in how the prevalence of high-fat and high-sugar foods in low-income neighborhoods contributed to the obesity epidemic.

Ah. The obesity epidemic in America. But we also are barraged with stories of the hunger epidemic in America, and food insecurity. If one in six Americans is hungry, how can more than one-third of U.S. adults be obese?

“The Holleran Center for Community Action and Public Policy  (at Connecticut College) is a multidisciplinary academic center that advances teaching, learning, research, and community collaborations,” the website says. “It works to create more just and equitable communities through programs that cultivate intellectual and ethical judgment.”

Even more interesting is the vague description of the Holleran Center which says it “prepares students for lives of civic engagement and leadership while collaborating with community partners to advance the public good.”

The History of the Holleran Center says Center faculty and staff have presented on research, course development and college/community partnerships throughout the United States and in international forums such as the Open Space, People Space Conference in Scotland. The Open Space movement studies “Urban lifestyles, which even rural children often live these days, place many restrictions on their freedom to explore and enjoy their environment.”

Who funds this venture?

Major grants from the Surdna and the Lucent Foundations funded the initial years of the Center.

“The Surdna Foundation seeks to foster sustainable communities in the United States — communities guided by principles of social justice and distinguished by healthy environments, strong local economies, and thriving cultures.”

The Lucent Foundation also supports “sustainability,” whatever that is. “Its prime mission is to respond to today’s global challenge of digital inclusion and sustainability, focusing on providing innovative programs for underserved communities across the world that enable youth, and particularly young women, to access educational and life skills programs,” the Lucent Foundation website says.

Sustainability

There's that word “sustainability” again. Organizations which push “sustainability” and claim to be supporters of it, are not entirely truthful about intentions.  What does sustainability do for  a developing country?  Recycling, the preservation of nature and endangered species, and renewable energy are hardly the concerns of emerging or developing nations.

As important as these issues may be to many, people who are hungry, and living squalor in third world countries or in ghettos don't ever think about “sustainability.”

And really, the groups who claim to support sustainability end up placing the poor at the centre of the sustainability cause. They make improving the lives of the poor a “sustainability” issue. But they are not working on behalf of the poor.

And it's not about Oreo cookies.

Katy Grimes: Did you know that more than “one in five children don’t know where their next meal will come from?” Over the weekend I caught the commercial, sponsored by childhungerendshere.com that made this ludicrous claim.

This appears to be a shady organization funded by First Lady Michelle Obama’s “Let’s Move,” and Con Agra foods foundation, a creative conglomoration of federal grant money grabbers.  Con Agra is a packaged food giant, and claims that 97 percent of American households use their products. 

Be very wary of these suspicious hunger claims–especially when there has never been such a high rate of obesity in children in America. With more than 50 percent of the population receiving some form of government benefits, most of these same kids also receive four meals a day from public schools.

Take a look for yourself–this taxpayer funded hunger boondoggle needs to be exposed. One of the Con Agra solutions to ending hunger is food drives; they encourage Americans to organize food drives using Con Agra packaged and canned food. Brilliant.

While Con Agra has a lengthy, fascinating history, this cooked-up hunger-in-America scam is a big lie and should anger taxpayers. Giving to legitimate charities is the best way to help those who are really hungry.

With many public schools now feeding children breakfast and lunch, and even forbidding parents to send homemade lunches to school for their children, it is obvious that the state has decided that it is a better parent.

Many school principals say they are encouraging “healthier choices” and claim they are trying to protect students from their own unhealthful food choices, while making an impact that extends beyond the classroom.

But many parents are not happy and are rebelling.

This totalitarian control over students’ diets, which really only seems to be benefiting the school food service providers, is not the role of the state, nor a part of the education plan.

But it is part of statists’ agenda.

Another Statist Agenda

A recent essay in the Journal of the American Medical Association argued that in extreme cases of obesity, state intervention is needed to save the lives of fat children. The “experts” recommended that obese children should be taken from parents and placed in foster families.

The essay, written by Dr. David Ludwig and Lindsey Murtagh, said that temporarily removing children from the custody of their parents and placing them in foster care is more ethical than surgery as a strategy for fighting life-threatening complications arising from obesity.

Ludwig is an obesity specialist at the Harvard-affiliated Childrens Hospital Boston, and Murtagh is a lawyer and researcher at the Harvard School of Public Health.

Teachers, educators, researchers, lawyers and Harvard doctors have decided that they are better equipped to parent America’s kids.

Too many American dimwits have been lauding First Lady Michelle Obama for her “Let’s Move” initiative aimed at combating obesity. But I think she needs to butt out, and worry about her own family’s weight and eating habits. Obama is hardly a healthy vegan, and rarely is she the picture of how to eat.

Ironically, many of the people making these decisions on behalf of the state are also overweight.

“Inadequate or unskilled parental supervision can leave children vulnerable” to these obesity-causing influences, wrote Ludwig and Murtagh.

And I have yet to read an explanation of what constitutes a “skilled parent.”

State intervention already occurs in many areas, beginning with state-run schools. Teachers claim to advocate for “healthier choices,” but have been caught assisting young girls seeking birth control pills or even abortions in some cases, instead of involving parents.

The leftist agenda is full of holes and is not at all about healthy lifestyles or caring for children.

Teachers already report parents to Child Protective Services for neglect and abuse, but the state meddling is extending to far too many areas of parenting.

Schools long ago sold out decent lunches for profit motives. When I was growing up in the 1960’s, my neighborhood public elementary school had a cook who made hot lunches in the school’s kitchen. From our classrooms we could smell the bread baking every day. It was a treat to be able to buy an occasional hot lunch, as my parents made me bring my lunch from home most days.

But by the 1990’s, when my son was in elementary school, the schools were trucking in Taco Bell and McDonald’s for meals. So he too brought his lunch from home. I wouldn’t let him eat at the school.

Even today, the supposed “healthy” school lunches are frozen foods, pre-packaged and usually taste like cardboard. Kids throw most of the food away.

State Lunch Program

The California School Lunch Program and the State Meal Programs are child nutrition programs funded by the State of California. The programs provide money to public school districts that serve “nutritious” meals, free or at a reduced price, to “needy children.” The program is administered by the California Department of Education.

While this may sound sincere, the meal programs at schools are feeding far more kids than just the needy children. Lazy parents of all social and economic classes are regularly dropping kids off at school in the morning for a free meal, and partaking in the free lunch programs.

Is it any wonder children are obese? Parents don’t prepare meals.

It doesn’t take a registered dietician to know what a healthy meal is, or if a child has a weight problem.

And schools are a big part of the problem. School physical education programs and recess activities have been greatly limited thanks to lawyers. Monkey bars, dodge ball and other physical recess games are no longer allowed. And because so many female teachers complained about sweaty, smelly children in the classroom after recess and PE, programs have been cut.

A lack of PE and outdoor playtime during the school day have coincided with the increase in the diagnosis of Attention Deficit Disorder. Kids just don’t get to blow off enough steam — particularly little boys. Many teachers prefer that parents medicate their boys instead of running them ragged in sports or physical play during the school day.

Many parents are rebelling against statist schools and reminding teachers and administrators who the rightful parent is, as well as reminding them of the correct role of schools.

But with lawmakers continuing to intervene, crowding out parents with increasing anti-parent laws, it feels as if we are all becoming wards of the state. In California “Mother may I?” will soon be replaced with “Governor may I?”

— Katy Grimes