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Columnist Michael Levin: Pepsico May be Our Guru on How to Reduce Behavior-based Healthcare Costs PDF Print E-mail
Written by John Weeks   

Columnist Michael Levin: Pepsico May be Our Guru on How to Reduce Behavior-based Healthcare Costs

Summary:  Did you know that Pepsico is threatening to move all its operations out of New York if the state passes a "sin-tax" on soda pop? Integrator columnist Michael Levin recognized in this story that the giant firm has a rather strong perspective on whether economic incentives can be a powerful stimulus for behavior change. Levin uses the story to wade into questions raised in a recent British Medical Journal article on what it will take for people to make healthy decisions. Fascinating piece. Levin invites you to weigh in on the topic.  
Send your response to Levin's question to
for inclusion in a future Integrator.

Michael Levin
Integrator columnist Michael Levin has a knack for spotting thorny issues and bringing them forward. Here he first reviews a British Medical Journal article which found consumers not very moved to make changes in their habits, despite much information on cancer risks. Levin juxtaposes this with an article on how Pepsico is battling with legislators in the state of New York to stop legislation to add a "sin-tax" on soft-drinks. Levin wonders whether Pepsico's fear of sales losses should be an insight into effective public policy: If we want to change behavior, perhaps taxing/economic incentives may be more powerful than coaching or education.

Levin's professional work includes executive positions with both Big Pharma and companies in the dietary supplement industry. Among his other interests, Levin is an outspoken proponent of quality control initiatives in the dietary supplement industry.
This email address is being protected from spam bots, you need Javascript enabled to view it 

Promoting Healthy Behaviors to Reduce Healthcare Costs: 
Do We Educate or Tax?


Michael D. Levin, Health Business Strategies

Excluding environmental issues for the moment, US healthcare costs are largely driven by treating preventable chronic diseases caused by poor lifestyle choices in our aging population.

The strategy of wellness coaching is being championed by certain thought leaders as a cure for our financial woes. While there is certainly an important place for education, coaching alone will not change the public behavior.

Economic incentives, however, will.

    “They want more information,
but when they get it
they don’t do anything about it.”

Karol Sikora, Medical Director,

The BBC reported on April 6th the results of a survey performed on 1000 adults. They found that "two thirds of people have not changed their diet or lifestyle to reduce the risk of cancer.” Although 48% of women said they “knew enough about cancer symptoms” and 45% of all surveyed reporting they had “enough information on all of the four most common forms” of cancer, still more than a third polled said “they tried to ignore cancer or hardly ever think about it.”

Of course, the vast majority would run to their doctor immediately if they experienced signs of cancer. In this example, education alone clearly was ineffective in changing behaviors and, by extension, was ineffective in reducing future costs.

Professor Karol Sikora, medical director of CancerPartnersUK, put it this way: “They want more information, but when they get it they don’t do anything about it.”

 Meantime, faced with a tax on soft drinks
in MNew York, Pepsico is threatening to pull
out of the state. They know taxes, not
education, will reduce consumption.

Back on our side of the pond, the New England Journal of Medicine article which argued that a 10% tax on soda and similar drinks could cut consumption by 10% has Pepsico threatening the state of New York. The battle lines have been drawn. Pending legislation which would place a state tax on sweetened beverages prompted Pepsico to tell New York: if you do that, we’re pulling out of your state and (horror of horrors) taking those jobs and tax revenues elsewhere. Pepsico is playing hardball!

Hmmm. Pepsico knows the truth:  taxes, not education, reduces consumption.

I’ve long agreed with Pepsi – economics drives consumer behaviors.  Education informs, but does produce meaningful behavior change. Education without economics will not, in my view, reduce healthcare costs or meaningfully increase healthy choices in our population.

What do you think?

Michael D. Levin, Founder
Health Business Strategies
12042 SE Sunnyside Road
Clackamas, OR  97015
503-753-3568 (direct)
503-698-7565 (fax)

Comment: Levin's answer is in the current choices of our population. Yes, the number of "educational" messages in our culture from Pepsico and its ilk to consume their products is something like infinitely more than healthy eating messages. Yes, most people certainly have had not had the luxury of a personal health coach to assist them through lifestyle changes. Yes, it would be great if our medical system was actrually a healthcare system in which such life-change interventions were prioritized.
Still, one has to believe that the message of diet and lifestyle as a contributor to health and disease has reached most people. Here we are, still awfully unhealthy, as a population, in our choices. I'm with Levin. Tax away. Besides, raising prices on unhealthy foods and drinks makes healthier fare more competitive. 

Send your reponse to Levin's question to
for inclusion in a future Integrator.


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