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healthpopuli.com

Springtime is finally emerging on the east coast of the U.S. and my local CSA farm is on my mind. It’s timely, then, to re-visit a research paper on subsidizing fruits and vegetables from a March 2019 issue of PLOS as an introduction to a new initiative growing out of The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) on produce prescriptions. Timely, too, that Chef José Andrés has been called to President Biden’s White House to help address food security in America. First, let’s look at the research in PLOS: Cost-effectiveness of financial incentives for improving diet and health through Medicare and Medicaid: A microsimulation. The bottom line of the study was that subsidizing healthy food prescriptions in large government-sponsored health programs like Medicare and Medicaid can drive healthy population outcomes and conserve costs. That’s health cost savings at scale, given that Medicare and Medicaid cover about 1 in 3 U.S. health citizens and together consume 25% of the U.S. Federal budget. The research was supported by the National Institutes of Health, National Heart, Lung, and Blood Institute and conducted by a Boston-based team from Tufts and Brigham and Women’s Hospital. The team constructed a model that estimated cardiovascular disease and diabetes cases along with patients’ quality-adjusted life years (QALYs); health care, indirect and lost productivity costs; and, cost-effectiveness modeled for two scenarios: A 30% subsidy on fruits and vegetables, and A 30% subsidy on a broader portfolio of healthy foods in addition to fruits and veg, adding in whole grains, nuts/seeds, seafood, and plant oils. Using a predictive model, Scenario 1’s food and veg (F&V) incentive would prevent 1.93 cardiovascular disease events and 350,000 CVD deaths, saving $40 billion in health care costs. Scenario 2’s savings in lives and costs were even greater: 3.28 million CVD events, 620,000 averted deaths due to cardiovascular disease, and $100 billion sa