We must address our food system if we want to reduce the increasing costs of health care. The health care reform debate can be divided into two major issues: increasing access and decreasing costs. On one hand, no reform is complete until we find a way to provide all Americans with adequate insurance coverage. But even after we insure all Americans, we must deal with rising medical costs that result from preventable illnesses.

The easy way to refer to health problems related to food is by pointing a finger at the obesity epidemic. Obesity directly bears the blame for 9% of all health care costs in the U.S. and the health care costs for the obese are rising faster than the costs of non-obese patients. However, blaming obesity is oversimplifying the problem: chronic, lifestyle-related illness can strike people of all sizes, fat or thin. The obese are more likely to suffer from these illnesses, but let’s not forget the true causes – poor diet, lack of physical activity, smoking, stress, and lack of sleep – that lead to many of the chronic diseases burdening our health care system. Furthermore, as recent CDC statistics show that the percent of Americans who engage in recreational physical activity is holding constant over time while obesity and diabetes rates rise (and smoking declines), it’s clear that our eating habits are getting worse.

The USDA recently partnered with Sesame Street to promote healthy eating. Secretary Vilsack, who revealed last year that he struggled with a weight problem as a child and deeply cares about childhood obesity, personally participated in the effort alongside Sesame Street characters Cookie Monster and Broccoli. But what is the impact of a small public health campaign when it’s up against $1.6 billion per year in food marketing aimed at children? The Sesame Street campaign is wonderful, but almost certainly doomed to failure. Public interest advertising campaigns will never be any match for junk food marketing, so politicians interested in promoting healthy eating should advocate for other tactics.

Another problem comes from the conflict of interest shows like Sesame Street face when promoting healthy food. As Sesame Street probably does not wish to lose its sponsorship by McDonalds, it might hesitate to partner with the USDA on any healthy eating programs that actually work. Sesame Street is not the only one with a conflict of interest: the USDA is simultaneously tasked with promoting American agricultural products and promoting healthy eating by Americans. Members of Congress also face a conflict of interest as passing any bill that limits the profitability of the junk food industry may result in their defeat in the next election. Perhaps that is why the standards controlling which foods are not allowed to be sold in schools have not been updated since 1978.