What Health Care Can Learn From Whole Foods

I've gotten a couple requests to respond to John Mackey's op-ed advocating a series of health-care reforms that wouldn't solve anybody's health-care problems. The ideas in there aren't interesting and aren't new. The archives of this blog contain plenty of posts explaining why, for instance, it wouldn't help matters for the federal government to declare it illegal for Arizona to mandate that insurers cover mammograms and diabetic care.

What is new to people is that Mackey is writing the op-ed. Mackey founded Whole Foods, a traditional favorite of liberals, and so his libertarianism comes as a surprise to some. But the interesting insights on health-care reform don't come from the CEO of Whole Foods. They come from the stores.

Food is more like health care than it is like cable television. We worry if people don't have enough food to eat. We worry quite a lot, in fact. So we have a variety of programs meant to ensure that people have sufficient food. If you don't have much money, you rely on these programs. As of September 2008, about 11 percent of the population was on food stamps. It's probably somewhat higher now. Millions more rely on the Women, Infants, and Children nutrition program, and reduced-price school lunches.

The insight that people need food has not led us to simply deregulate the agricultural sector (though that might be a good idea for other reasons) or change the tax treatment of food purchases or make it easier for rich people to donate to food banks, which is what Mackey recommends for health care. It's led us to solve, or try and solve, the problem directly by giving people money to buy food. And that works. These programs, as every Whole Foods shopper knows, haven't grown to encompass the whole population or set prices in grocery stores. If you have more money, you shop for food on your own. And if you have a lot of money, you shop at Mackey's stores. That's pretty much the model we're looking at in this iteration of health-care reform. We're also laying down some rules so grocery stores -- excuse me, health insurers -- can't simply refuse to sell you their product, or take it away after it's already been purchased..

Mackey, playing to type, has offered a Whole Foods solution for health care: It makes the system even better for the rich and the young and the educated -- the sort of people who shop at Whole Foods, in other words -- and doesn't do a lot for those who really need help. But the existence of a vibrant institution like Whole Foods within a broader system that considers it unacceptable -- at least in theory -- for the poor to go hungry, and so subsidizes their purchase of food, does have lessons for heath-care reform.

Photo credit: AP Photo/Stephan Savoia.