You can hope that electronic medical records will make health care more efficient. You can cross your fingers that hospitals will be nudged into less utilization of care, procedures that often do more harm than good. You can wish that a smarter payment system, based on whole of care rather than fee for service, will also reduce expenses. You can hope that the one-year reduction in growth in Medicare spending reflects a trend and not an anomaly. You can even push for a single-payer system that delivers quality care at a fraction of the cost of the current procedures. But if the United States doesn’t get a handle on this, you can forget about ever saving money on health care in the future.

Based on trends, half of the adults in the United States will be obese by 2030 unless the government makes changing the food environment a policy priority, according to a report released Thursday on the international obesity crisis in the British medical journal the Lancet.

Those changes include making healthful foods cheaper and less-healthful foods more expensive largely through tax strategies, the report said. Changes in the way foods are marketed would also be called for, among many other measures [...]

Changes over the past century in the way food is made and marketed have contributed to the creation of an “obesogenic” environment in which personal willpower and efforts to maintain a healthful weight are largely impossible, the report noted.

It also laid out a new way of calculating how many calories to cut to lose weight, giving what it said is a more accurate means of estimating projected weight loss over time.

Emphasis mine. Basically, the food we’re sold is crap, and no matter how careful you are, you cannot escape the eating of said crap. The food production industry is perhaps as powerful as any lobby in Washington, and they have successfully fought off most attempts to curb their power. Just this week, the Department of Agriculture rejected a proposed ban on using food stamps to buy sugary soda drinks.

There have been improvements on the margins in the Obama Administration – healthy eating and reducing food deserts has been a priority of the First Lady – but nothing is being done at the scope needed to avoid a nation of obese people. We got calorie labeling on some menus of chain restaurants. That’s mostly it.

This will destroy any efforts to “bend the cost curve” in health care, as heart disease, diabetes, and other obesity-linked medical problems will proliferate. It won’t end until we stand up to an industry that is basically poisoning us.

Support your local farmer’s market.

UPDATE: Sounding a more positive note, Sarah Kliff reports that small changes could make a big difference here:

Very small changes in behavior could have very big effect. The Lancet researchers gamed out what would happen if the average weight in the United States decreased by about 1 percent, which works out to an average weight loss of 2.2 pounds per person.

“This change might sound small,” they write, “but such a scenario would have a substantial effect on consequent health burdens.” We would avoid up to 2.4 million cases of diabetes. We would see up to 1.7 fewer cases of cardiovascular disease. As a population, we’d add 16 million more “quality life years,” a scientific measurement of both lifespan and quality of life.

How do we get there? The Lancet researchers say that, on average, it would mean each person eating 20 fewer calories each day for three years. That’s equivalent to a seventh of a can of Coca Cola or two M&Ms. That’s a pretty big health outcome for a very small amount of change.

Yes, but a reduction of 2.2 pounds per person will not move us from 50% obesity in 2030 to, say, 35%. So relative to a really horrible scenario, reducing 2.2 pounds per person has benefits. Relative to where we should be for a healthy society, that would not get us remotely close.