There is widespread acknowledgement of an obesity problem in the United States. Many factors are contributing to this problem of consuming more calories than are used.  There are an abundance of ways that are needed to reverse this trend, and that is true for society as well as true for individuals who need to lose weight. Part of the issue on the consumption side is expressed in the term “empty calories,” which means foods that are high in calories and low in vitamins, fiber, or other beneficial nutrients.  In simplistic terms, consumers have to eat considerably more food that has “empty calories” to get the nutrients the body craves.  Almost every list of “empty calorie” foods includes sodas.

Decades ago, sodas were sweetened with cane sugar and typically came in 8-ounce glass bottles.  Today, “regular” sodas in the United States are mostly sweetened with high fructose corn syrup and come in 12-ounce cans or 20-ounce plastic bottles.  Some people have made a connection between the switch to corn syrup and the increase in serving size, observing that corn syrup doesn’t make the consumer feel as full as does cane sugar.  If this is true, corn syrup would be magnifying the “empty calorie” issue.

Why do soda producers in the United States use corn syrup instead of cane sugar? It costs them less, after government programs are included in the costs. One set of such government programs are tariffs charged to those importing cane sugar into the United States, put in place to protect the small (and shrinking) domestic sugar cane business. Another set of government programs subsidies the production of corn beyond the quantities that the markets used to consume, ensuring an over-supply of corn.  Given these two disruptions in free market forces, the logical outcome is that, in the United States, corn syrup costs less for soda production than cane sugar.

It may be possible, then, that governmental agriculture policy is contributing significantly to the obesity problem… maybe…

This topic captured my attention as a fascinating example of unintended consequences of decisions, and as a cautionary tale for leaders and managers. Every policy decision we make has the potential for surprising results, and stories like this one urge us to be more thoughtful and observant whenever we make or change policy.

This is not a new problem.  Futurists have been discussing these possibilities since the impact of the Baby Boomer generation started to be recognized late in the 1950s. The broader health care debates started in this country in the high inflation era of the late 1970s, and has continued since then.  We’ve witnessed decades of rhetorical wrestling matches among medical providers, lawyers, insurance companies, and governments, with each seeking the advantage over the others in the gigantic marketplace of medical services.  As we, the medical patients, sat on the sidelines of this bout, we discovered:

• Malpractice, once a rare indicator of an incompetent doctor, became so prevalent that it is another cost of doing business for providers
• HMOs gave us to the nameless medical provider and taught us that personal attention was too expensive
• Insurance companies now pick our medical providers for us
• Our employers choose our insurance companies, with a predominant focus on corporate financial incentives
• Our medical providers prescribe treatments that are designed to protect themselves from lawyers
• If I were to be hurt by my medical treatment, the lawyers, insurance companies, and medical providers would all speak for me, but none would take the risk of having me actually speak

Most of us as medical consumers are convinced that something has to change. I’m a big believer in the value of common sense, and I’m a big believer in a rational chain of accountability, and both have been removed from our current healthcare environment.  I believe that the change agent has to come from outside the combatants whose battles have resulted in the situation we have, and I believe that we, as medical consumers, can be that change agent—if we’re permitted to regain our voice in our medical care.

To give us back our voice, something has to change.  If all employers were halted from providing group medical plans, insurance companies would answer to medical consumers instead of corporations.  If medical malpractice lawsuits were presented to medical review panels instead of public juries, cases would be decided more on medical issues and a reasonable assessment of the value of advanced treatment, and less by emotional histrionics accompanying outrageous monetary awards.  There are certainly more possibilities out there for how to re-introduce the consumer to the medical marketplace.

One of the trends that has been concerning me is the shift from company-sponsored retirement plans to individually-managed retirement plans, which includes 4.01(k) plans and IRAs. I am not saying that companies are wrong to have stopped offering pension plans, especially since the costs of pension plans have grown much faster than other costs.  The economic and actuarial models that were used to tune pension plans have changed dramatically in each decade for the last 50 years. In the last ten years, for example, pension funds had to cope with projections of continuing sizable cost increases in medical care, coupled with the increasing average life span, and the impacts coming from the sub-prime mortgage crisis.

The closure of traditional pension plans shifts these medical and longevity risks to individual future retirees. There are financial instruments (various annuities and insurance policies) that provide some measure of protection for subscribers. There also continue to be government programs to provide a basic level of coverage.  At the same time, these retirees bear the responsibility for funding almost all of their retirement plans, and indications tell us many are not.  Evidence is seen with recent laws relating to 4:01(k) accounts, where employees’ tax-free contributions are matched by company contributions.  Lawmakers have become so concerned that workers are ignoring their retirement funding that laws now compel companies to automatically take 1% of employees’ pay for the 4.01(k) plan, forcing an employee to explicitly opt out if they truly do not choose to save for retirement.

Still, if major corporations do not have sufficient information and financial resources to cope with these future trends for upcoming retirees, how likely is it that the majority of future retirees are making effective decisions to provide for their standard of living for the remainder of their lives?

As an amateur futurist, I want to focus this thought on the macroeconomic impact, rather than on the actions of individuals.  There is already a flood of anecdotal evidence on all sides of this subject that, so far, have obfuscated the policy issues at stake.  Let me discuss the possible impacts of the trends I touched on above, and I hope more talented futurists than me are performing the rigor required to assign probabilities to these outcomes.

First, this shift of responsibility for retirement funding means that a significant number of future retirees will not be as financially secure in their retirement.  Some percentage (10%? 50%?) of those who were in the middle class during their working days will be in poverty after retirement.  Our economy will shrink to the degree that this buying power is removed from the retail market.

Second, more people in poverty means more people covered by whatever poverty programs in existence, and this growth in the poverty class will most likely exceed funding.  Reduction in what are perceived to be promised services will increase instability in the stability of our society to a degree that most of us have never witnessed in the U.S.

I don’t have answers for this problem, except that I want to know that our policy makers are recognizing this challenge and increasing the dialog on the impact of these trends.