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    Wednesday, September 09, 2009

     

    Whole Foods and Health Care

    by Dollars and Sense

    John Mackey, the CEO of Whole Foods (or as we call it here in Boston, Whole Paycheck), wrote a hide-bound and ideological op-ed for the Wall Street Journal last month (find it here). The first tip-off that it's going to be silly is that it calls health-care reform "Obamacare" (nothing like a little derision right in the title of an op-ed to command the interest of the readers of the WSJ opinion pages). What follows are all the usual canards of the Right's views on health care, and all their usual free-market, individualistic, deregulatory policy solutions.

    A movement has developed to boycott Whole Foods because of Mackey's opposition to meaningful (i.e., single-payer) health-care reform. The group Single Payer Action is also part of this boycott. Now would be a good time to shift over to farmers' markets and food co-ops to send Mackey and Whole Foods a message.

    Here's an interesting tidbit from the Boycott Whole Foods website: Michael Pollan, author of The Omnivore's Dilemma and other books about food and food production, has weighed in against the boycott, because although Mackey is wrong about health care, "Whole Foods is often right about food," Pollan tells us. According to the Boycott Whole Foods website, Pollan has spoken at a conference put on by America's Health Insurance Plans (the main lobbying organization for the health insurance industry), on a panel entitled "Leaving the 'Fast Food Nation' Behind: Challenging American's Attitudes Towards Personal Responsibility and Health." (The other speaker on that panel was Richard Thaler, co-author of the pop-behavioral economics book Nudge.) And he posted against the Whole Foods boycott on the website of archconservative David Frum (newmajority.com).

    Now, I don't begrudge Michael Pollan an appearance at an AHIP conference (Howard Dean also spoke on a panel at the conference), or a comment on a website "dedicated to the modernization and renewal of the Republican party and the conservative movement," as its "About" page says. The man is pretty much omnipresent, so why not in these venues? But it doesn't surprise me that he doesn't seem to get the importance of collective action. I heard a radio version of a talk he gave a couple of years ago--it was about the prevalence of corn in the American diet (via corn syrup, mostly, but also as feed for the animals that become our meat), and the history of overproduction of corn post WWII. A terrific talk--the whole time I was craving broccoli (which I don't usually care for too much), because I figured there's no way they'd figured out how to make broccoli with corn. But in the question period, someone asked him early on what we could do about this, and all he had to say was something about making good choices about what we eat, choosing to shop at places (like Whole Foods) that offer fresher food, etc. There doesn't appear to be a truly political bone in his body--for him it's all about individual consumer choice. (It reminded me of Al Gore's otherwise terrific movie, ending with rousing call for us to change our lightbulbs.) So I'm not surprised that Pollan blandly opposes this boycott.

    Joel Harrison, who wrote this terrific article for us last year, has written a point-by-point rebuttal of John Mackey's WSJ op-ed. Here are the basics; click on the links to get the details on each point.

    YES, TO HEALTHCARE FOR ALL, NO, TO MACKEY'S WHOLE FOOD CARE

    Rebuttal to John Mackey's Wall Street Journal Op-Ed, "The Whole Foods Alternative to 'ObamaCare'"

    By Joel A. Harrison, PhD, MPH | September 8, 2009

    John Mackey's editorial in the Wall Street Journal is merely a continuation of the myths propagated by the for-profit health insurance and pharmaceutical industries and the right-wing think tanks they fund. His suggestions would take us farther in the direction that has already failed.

    For this rebuttal I'll focus on the following points:

    * Healthcare IS a right in other countries. So, what does our Constitution "guarantee?" The European Union's Constitution includes Health Care as a Right. The U.S. Supreme Court ruled in 1936 that Article II Section 8's "Promote the General Welfare" applied to Social Security. Medicare falls under this ruling. Though not binding, the Universal Declaration of Human Rights, signed by the United States, includes medical care as a right. (Details and references)
    * Does health reform mean a "government take-over?" Ridiculous question but NO! Free markets do not work without rules and an independent arbiter. All Bills before Congress maintain the private sector for delivery of health care, both hospitals and doctors; but include regulations such as protection from arbitrary loss of health insurance and greater transparency. (Details and references)
    * Repealing mandates on what insurance must cover & state laws which prevent insurance companies from competing across state lines. Without some minimum national regulations and means of enforcement, companies will incorporate in states with the least regulations and enforcement, leaving consumers vulnerable. (Details and references)
    * Health Savings Accounts—Why they don't work. 80% of health care costs for individuals in the U.S. exceed $2,500 and 73% exceed $5,000, so people would rapidly exhaust their health savings accounts. Sick and injured people trust their doctors to make appropriate decisions and neither have the skills for making the decisions nor the availability of data to base such decisions on. High deductibles leads to reductions in both appropriate and inappropriate care, e.g. blood pressure monitoring. (Details and references)
    * Medicare reform and finances—Why we will not allow Medicare to go bankrupt. Medicare has done a better job than private insurance companies in keeping costs down. Medicare covers the costliest sector of our population, altogether over 43 million Americans. Private insurance would either be denied due to pre-existing conditions or prohibitively expensive. Medicare pays for all specialty residencies and subsidizes hospitals with a high proportion on uninsured. Without Medicare, besides the human tragedy of seeing our loved ones experience both reduced quality and length of life, emergency rooms will collapse under the additional strain, hospitals will close, and many doctors will go out of business. Medicare's cost cannot be separated from a health care system whose current projectory is unsustainable. (Details and references)
    * Wait times here and abroad (including emergencies)—Mackey's misleading statistics. Wait times in Canada are far better than reports given here and they are investing vast sums in improving both quality and timeliness of care. Wait times in many other nations with non-profit universal health care are actually quite good. And wait times in the U.S., especially for the un- and underinsured are worse than in many other countries and, even for those with insurance, wait times exist and are deteriorating. (Details and references)
    * Medical Liability/Tort Reform—why this won't solve the healthcare crisis. Malpractice costs are an infinitesimal portion of total health care costs. Up to 100,000 Americans die from preventable medical errors. Just five percent of all doctors are responsible for approximately 40% of malpractice suits. Truly bad doctors seldom lose their licenses. Only about 1/10th of all medical errors that cause death or serious disability lead to malpractice suits. So-called "defensive medicine" is often just an income generator for physicians who own or are invested in labs and radiology facilities. (Details and references)
    * Healthy life styles are good but don't save us enough. Many factors affect health, including genetics, air and water pollution, infectious diseases, commercial food interests targeting children, even in our schools, availability of recreational facilities, physical education in our schools, and longer and longer working hours. Healthy life styles are important; but almost everyone will sometime in their lives need health care. A healthy life-style can often delay the onset of chronic diseases and/or if ill or injured contribute to a more rapid recovery; but it is naive to believe that healthy life styles can solve our health care system problems. (Details and references)

    CONCLUSION: John Mackey doesn't know what he is talking about. In essence, he is just parroting the myths and propaganda created by the for-profit insurance and pharmaceutical industry together with their well-funded right-wing think tanks.

    I don't wish to support a platform of policies that allow private insurance companies to continue to take undue advantage of average citizens for profit, much less make it easier for them by adopting any of Mackey's ideas. I am joining thousands of former Whole Foods loyalists to redirect my dollars to support organic co-ops and local farmers' markets. I hope you will join me.

    Joel A. Harrison, PhD, MPH, lives in San Diego, where he does consulting in epidemiology and research design. He has worked in the areas of preventive medicine, infectious diseases, medical outcomes research, and evidence-based clinical practice guidelines. He has lived and studied in both Canada and Sweden.

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    9/09/2009 09:43:00 AM

    Comments:
    3 weeks after the op ed was written and you're to lazy to read the original, posted on Mackey's blog? Your article starts out critical to the title as run in the WSJ, but it was WSJ editors who changed the title. Had you done a shred of research you'd be aware of this.
     
    No--I didn't visit Mackey's blog, and no, I didn't do any research before doing this blog post (beyond re-reading Mackey's op-ed and reading Joel Harrison's critique of it.

    I haven't bothered to go to Mackey's blog now, even. So maybe you can tell me: how does the fact that the WSJ editors picked the title affect my claim--that the title led me to believe it would be silly, and in fact I found it silly?

    The only way I can think it would is that Mackey is not as shrill as to pick that title. But his editors are! And his op-ed is still right-wing nonsense.
     
    As I started to read this I thought: "Oh good, reasonable, respectful debate over ideas rather than a rabid response to an opinion that doesn't exactly match that of the more liberal in society." Unfortunately, I was wrong. Rather than simply rebut Mackay's opinions and assumptions with facts and alternatives the article eventually degenerates into dogmatic name calling.
    Who cares if the ideas are right, left or in the middle? The idea of a discussion about health care is to share ideas and find the best solution, not just one that is touted by the intellectual bastions of either wing.
    For the record, I am Canadian, I love our healthcare system and would choose it over a system which does not involve government, but it is not perfect and we too suffer from dogmatic positional diatribes when the subject comes up for discussion.
     
    This goes to show the silliness of socialist thinkers. "Boycotting" is the use of capitalism to make an appeal (I won't buy from your store because I don't want to support your ______) yet socialists would suggest that "capitalism is evil", so why would they use free choice(capitalism) in the market place to make their point. It is ironic that even when denying the truth with your mouth, your actions declare the reality that capitalism is the best economic solution in existence.
     
    To Anonymous #2: Respectfully: When I read Mackey's piece, I see the standard (ok--I won't call them right-wing, because that would be name-calling) market-based, individualistic, deregulatory positions that economists and health-care professionals and public health researchers have consistently said would drive up costs and leave people vulnerable. And when I read Harrison's piece, I see precisely facts (and citations!) to counter those proposals, and alternatives. So maybe you could be more specific: where does Mackey depart from right orthodoxy? and where does Harrison fail to be fact-based?

    "Who cares if ideas are right, left or in the middle?" What you might not be able to appreciate, as a Canadian, is the extent to which the right (by which I mean reflexively support free-market and pro-corporation policies) have captured the political culture. So we on the left here *do* care about whether policy proposals are from the right--we have been battered over thirty years by the right and their policies have really made life worse for most people.
     
    I think it also needs to be pointed out that the Organic Consumers Association, while not yet endorsing the boycott, has weighed in against WFM, connecting Mackey's stance on health care and union organizing with Whole Foods' greenwashing. http://www.commondreams.org/view/2009/09/09-12
     
    Reply to Anonymous poster from Sept 10th (somehow missed your comment):

    I don't *quite* see the silliness you see. If a boycott will get an employer to stop doing something activists don't want him/her to do, it can be a good strategy. If those activists want to work toward a society in which all workers are, essentially (collectively) self-employed, where's the contradiction? Would a self-consistent socialist just simply have nothing to do with any capitalist whatsoever? Only on a bizarrely principled (and impractical!) approach. At any rate, using "free choice in the marketplace" is sometimes in the spirit of capitalism (as its proponents view it), e.g. when I "vote with my dollar" and buy organic food as a way to encourage producers to make more organic food available. Not a particularly radical approach. Boycotts are a much less individualistic approach--they depend on collective action, and not just on withholding your dollars from a particular business but publicizing the fact that you are doing so, publicizing the offending actions or stances of the company you're boycotting, etc. This requires organizing, vs. just (individually) directing your dollars one way vs. another.

    With that said, I agree with you that it is silly to think of capitalism as evil. And most people I know who think of them as socialists don't think of capitalism that way. It's not that capitalism (or capitalists) are evil, it's that there are ways of arranging society that would make most people better off. Capitalists aren't being evil by accumulating capital; they are just being capitalists.
     
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