Eating cultures, food safety, and health insurance as a refrigerator
To many people, “food safety” can sound…well, let’s face it, kinda boring. “Who cares whether COOL (country-of-origin-labeling) passes Congress, let’s get cheesesteaks for lunch!” Yet food safety is about more than where that cut of beef was born, grew up and slaughtered.
Food safety has a symbiotic relationship with eating culture. After all, what we eat varies depending on what food is available, what risks are associated with that food and social norms. In the U.S., government food safety regulations have mitigated the occurrence, and thus the effects, of foodborne illness in society.
We accept that food safety inspections are a necessary part of processing cattle, pigs and poultry before they make it to a frypan, oven, or grill. We accept that meat must be cooked to a certain temperature to be “safe.” We accept that fruits, vegetables, nuts and related byproducts need to be kept at certain temperatures to prevent rot – who recommends those temperatures but the government? These regulations have shaped the landscape of our modern eating culture as farmers, manufacturers and the agribusiness industry approach food production with these regulations in mind.
Are there any lessons to be learned from food safety regulations? How would the health care reofrm debate evolve if we consider the role food safety plays in our standards of health?
Eating Cultures
Lutefisk. Kimchi. Headcheese. What do these foods have in common? For many modern eaters in the U.S., the processing behind these foods makes noses wrinkle and heads shake with disgust. These are “gross” foods. Preserving fish in lye (lutefisk), burying vegetables in the earth to pickle them (traditional Kimchi), and congealing simmered head organs (headcheese) typically do not whet the modern appetite.
These foods, and others like them, are part of food folklore. Despite their high entertainment value when members of another generation tell stories of war, depression, or hard life on the farm, they are not part of everyday meals for most modern eaters in the U.S.
The traditions behind these food preparations offer hints about the eating cultures who produced them. Although some “gross” foods are particular to a region, headcheese or some variation of it can be found on each inhabited continent. No matter what you call it or which animal organs it is made from, headcheese and its kin offer a lens through which we can observe traits of an eating culture. Among the headcheese cultures, two common themes seem to be preserving foods and avoiding waste; that is, to produce as many edible products as possible from a food source and then preserve the food to feed the family during the off-season.
An eating culture is an metamorphic concept, ever shifting, evolving and redefining itself based on food availability, social norms and economic trends. After modern technologies, including a refrigerator in every household, diminished the necessity of using traditional preservation methods, modern eating cultures were free to respond to other cues. Some eating cultures value perceived health benefits, such as discouraging dairy intake after a particular hour, believing dairy interferes with digestion late in the day.
Other eating cultures value social cues such as offering tea as a part of any social, familial or business interaction. In the U.S., some families strive to keep a consistent dinner hour or to turn the TV off during dinner, while others value food portability and eat at their desks, in the car or away from home.
Food Safety
Eating culture traditions infiltrate our approach to other aspects of food – such as food safety and health care. As Congress authorized food regulation bodies in the early twentieth century, the eating culture changed in response to concerns over foodborne illnesses.
Themes like preservation and waste avoidance were rendered nearly obsolete for the everyday family in the U.S. following World War II. Families lived off the land less, and family farms closed down as more people moved to the cities – where the jobs were.
Other technologies and policies made processed foods widely available at cheap prices. Food safety regulation went through a new phase of government legislation and U.S. consumers began to expect food safety from all vendors. The modern U.S. eating culture began to emerge, themes focused on ease of preparation, marketability and taste.
Purchasing food in the U.S. differs from doing so in countries that lack a food safety infrastructure, or other locations where food safety is not widely expected. For instance, there is probably not an agency that regulates food processing of roadside butcher shops or “street food” vendors common to many developing countries. Foods being sold on the side of the road may have been prepared in the home, whereas the U.S. requires food for sale to be prepared in a commercial grade kitchen.
In non-regulated countries, consumers assume a larger part of the risk associated with eating unsafe foods. The risk ranges from mild discomfort and indigestion to full-blown food poisoning, and death is an eerily real possibility.
In contrast, U.S. consumers have come to rely on purchasing predictably safe foods in the marketplace. Without polling consumers about their food safety regulation knowledge, we can see that the expectation of safe food is ubiquitous among U.S. consumers. When a consumer becomes ill from a food purchase, whether from a grocer or restaurateur, the consumer expects to be compensated for that illness and its interference in the consumer’s life.
The risk of a foodborne illness is significantly diminished in the U.S. food marketplace. U.S. consumers rely, at least in part, on government regulation to hold food producers and processors accountable for food safety.
The intensity of foodborne illness risk influence the eating culture. In some locations where food safety is less rigorously enforced, or non-existent, wiping a bottle’s mouth with a tissue or a lime (to cleanse the glass) is an expected part of drinking a soda or beer. If someone fails to observe this practice, it is easy to determine that person is an outsider or is perhaps less concerned with health and cleanliness. Though this practice may not reflect any actual threat, it is an ingrained behavior reflecting that culture’s beliefs about food safety. Consumers in the U.S. would tend to find this practice rather absurd; we rely on the bottler to follow government standards to ensure the bottle is suitably clean and safe.
With the relatively low risk of foodborne illness, the U.S. consumer has been able to focus on the role of food as entertainment, comfort and status symbol. The widespread practice of excessive consumption is evident in the portion sizes at restaurants and the expanding waistlines that plague our health statistics.
Government’s Role
Since humans began forming governments (voluntarily or not), the debate over government involvment in citizen autonomy has raged. In the U.S., the debate was recently reignited (some might call it arson) by opponents to a government run health insurance option. Because what we eat is inarguably linked to our health, food safety and our eating culture also relates to our health care.
After accepting government inspection into every step of food production, from farm to plate, is it that hard to accept that the government has a meaningful role to play to insure adequate health care is available?
The consumer product at the heart of this debate is “health insurance.” “Health insurance” is supposed to be a product that consumers purchase to pay for the costs of medical bills. Several other government activities and consumer products already function to offset those costs. Car insurance, required in all 50 states, provides some coverage of medical bills associated with automobile accidents. Boaters’ insurance, travel insurance, and other activity-specific insurance often have provisions for specific medical care.
Government regulations for product safety reduce the number of people visiting emergency rooms, and reduces the number of injuries that require ongoing care. Likewise, food safety regulations are supposed to reduce the number of foodborne illnesses, and associated medical costs.
Seat belt laws, helmet laws, workplace safety laws, the list of government regulations that reduce doctor visits goes on and on. Yet, none of these quasi-health-insurance methods apply to genetic or chronic illnesses, thus the need for “health insurance.”
Note that “health insurance” as it stands now is essentially a consumer product–and health insurers are businesses. Businesses that sell consumer products survive and thrive by…selling more products. What incentive does a health insurer have to promote a healthy populace?
Despite this predictament, some health insurers take measures to promote healthy customers. A minority of health insurers rewards its insured for healthy practices such as joining a gym. Mostly, these rewards are reduced monthly fees, a rebate on premiums paid or reimbursement for the gym membership.
By necessity, health insurers reward behaviors that they can measure. In the gym membership example, the insured must sign-in at a prescribed number of visits per month, in order to qualify for the reward. And, while what we eat is equally important, if not more important, than exercise, health insurers do not reward those who maintain a healthy diet on a regular basis. Such a system would require a challenging first step of defining just what is a “healthy diet” –which can vary from person to person. For this and numerous other reasons, such a system will never materialize.
Even without such a formal system, health insurance influences our eating culture. Many health-conscious folks believe they realize their own rewards by having fewer doctor visits – and thus fewer health insurance claims, which leads to lower premiums…right?
With the current mess of health insurance, it is too hard to tell. Insurers raise premiums on healthy clients, and drop ill clients; they cut benefits on the eve of treatment, they deny payment of claims that were pre-approved. The resulting chaos has led to consumer frustration, industry profits and health statistics that lag drastically behind all other industrialized countries and even some developing countries.
In the face of such dismal results, citizens should be outraged that the government is not doing more to regulate health care insurance in the U.S.
Health insurance should function like a refrigerator –we should expect to see it in every household, though the contents will vary.
The current model of the health insurance system has failed. Currently, too many citizens are struggling to survive from illness to illness, hoping no emergency will arise to bankrupt them and their family. This existence mirrors the struggles that produced lutefisk, kimchi and headcheese in eating cultures.
Those members of society struggled to stretch one season’s harvest to sustain a family until the next harvest. Unlike the modern technologies that freed our eating culture from its dependence on food preservation and waste avoidance, health insurance in the U.S. has thus far failed to free the masses from depending on emergency care and self-help remedies.
A successful health insurance system should allow us to focus on preventing illness through promoting healthy habits. A competitive and universally available health insurance industry could be the key that gives us the freedom to modify our health culture and could result in a healthier lifestyle overall.