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Health Insurance Industry Underwrites Fast Food

If the insurance industry actually cares about health and well-being, it ought to stop investing so heavily in the fast food industry.
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Health insurers peddling French fries and double cheeseburgers? Now that should raise your blood pressure.

Although fast food can be consumed responsibly, frequent fast food consumption is linked to obesity and cardiovascular disease, two leading causes of death. The fast food industry markets heavily to children and often builds restaurants within walking distance of schools. Children who live near fast food restaurants consume fewer servings of fruits and vegetables, drink more sugary soft drinks, and are more likely to be overweight.

The life and health insurance industries would seem to have obvious interests in keeping people healthy. However, in this week's American Journal of Public Health, we report the results of a study showing that life and health insurance companies in the US and abroad are heavily invested in fast food.

Just how big is the insurance industry's investment in fast food? U.S., Canadian and European-based insurance firms hold at least $1.88 billion of investments in fast food companies.

Among the largest owners of fast food stock were United States-based Prudential Financial, Northwestern Mutual and Massachusetts Mutual Life Insurance Company and European-based ING.

Northwestern Mutual and Massachusetts Mutual Life Insurance Company both offer life insurance as well as disability and long term care insurance. Northwestern Mutual owns $422 million of fast food stock, with $318 million of McDonalds. Mass Mutual owns $366 million of fast food stock, including $267 in McDonalds. Prudential Financial, which sells life insurance and long-term disability coverage, has total fast food holdings of $355 million, the biggest stake being $197 million of stock in McDonalds.

ING, an investment firm that also offers life and disability insurance, has total fast food holdings of $406 million, including $12 million in Jack in the Box, $311 million in McDonald's, and $82 million in Yum! Brands. A number of other worldwide insurers also hold significant investments in fast food.

The insurance industry does all it can to be as profitable as possible. As physicians working in a public hospital, we have seen firsthand the ways in which the industry seeks maximum profitability by rejecting legitimate medical claims, terminating insurance coverage when illness strikes, and cherry picking healthy individuals to enroll (who cost them less than sick enrollees). And, as we now know, they will invest in fast food and tobacco (something we've previously researched), if doing so generates profit.

It might seem inconsistent that insurance firms invest in industries whose products cause illness and death that might require significant payouts. But the insurance industry is merely doing whatever it takes to generate as much money as possible. They directly invest in those industries that make people sick and die and also charge higher premiums for patients with conditions caused by their fast food habit, such as obesity, diabetes, or coronary artery disease. They also profit off patrons who avoid fast food and stay healthy, because these folks require fewer payouts for health care or a later life insurance payout because they live longer. Given their win-win position, these investments are not unlike the combination veterinarian-taxidermy office that promises that either way you'll get your pet back.

If the insurance industry actually cares about health and well-being, it ought to stop investing in fast food. However, if they continue to invest in fast food, they could mitigate the harms of fast food by leveraging their position as owners to force the adoption of practices consistent with widely accepted public health principles, such as encouraging fast-food companies to improve the nutritional quality of their products, reduce calorie density, serve smaller portions and change marketing practices.

Lawmakers have begun to recognize some of the root causes of the epidemic of obesity in the US. Congress included a provision in the recently passed health care reform law that requires 200,000 fast food and other chain restaurants to include calorie counts on their menus. Unfortunately, the same health care reform law dramatically expands the role of private insurance companies in the health care system.

While this may be a boon for sales of French fries and cheeseburgers, we fear the insurance industry's desire to turn a profit will trump any concerns about health and fitness.

J. Wesley Boyd, MD, PhD, is a staff psychiatrist at Cambridge Health Alliance and an assistant clinical professor of psychiatry at Harvard Medical School. Danny McCormick, MD, MPH, is a primary care physician at Cambridge Health Alliance and an assistant professor of medicine at Harvard Medical School.

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