One of the bill's provisions is a menu labeling proposal for chain restaurants with more than 20 locations. The proposal requires chains to post the caloric content of each item (and the total calories of combo meals) next to its listing on the menu, the menu board, and even the drive-through menu kiosk. This goes into effect next year, and will be one of the most visible effects of the health-care bill. You can read the provision here (pdf).
The early evidence on menu labeling has been undeniably mixed, but this is good information for people to have. In 20 years, I think we'll be baffled that there was a time when it wasn't easily available to us.
So here's my thing. The immediate parallel, to my mind, is the nutrition facts labels on food products. I know I have a hard time imagining buying prepared foods, whether that means orange juice or microwavable Indian food, without being able to see what-all's in 'em.
But the difference is you have a choice. I can pick up, buy, unwrap, and eat a candy bar without ever looking at the calorie count or the saturated fats percentage or the nature of the carbohydrates locked within it. When that number is splashed big and loud and in red on a menu--a menu that in some situations will be the equivalent of a poster--that is a whole different story. Furthermore, nutritional information gives you much more than the bare number of calories. At least it gives you information that you can use to manage your diet in the way that works for you, if you so choose.
I understand that its inescapability is the point of the provision. But my god, what about the eating disordered in this country? Many will be perversely overjoyed: no need to privately estimate calorie counts, round up wildly to be "safe," google around for others' tallies. But many will also be terrified. They will be terrified that if they consistently pick the lowest-calorie option when obliged to eat out at a chain restaurant, their friends and family will notice; and they will be terrified that on the occasion that they venture, manage, or feel obliged to pick a higher calorie option, someone--anyone who knows what they picked, whether a dining companion or a server or a bystander, will be thinking, "what is that fatass doing eating anything but naked lettuce." Fat people who want to be left alone to eat a goddamn meal will face even more detailed commentary and well-intentioned, yet ultimately hurtful advice from friends, family, and random strangers than they do now. "Normal" people (i.e. those not included in the previous two categories) will find themselves competing with themselves or others to limit their calories while restaurants compete to offer the lowest calorie options (with no incentive to do so with regard to nutritional content or to provide customers with the ability to consider nutrition, rather than calorie-counting, themselves).
This is not to mention three larger points: 1, not all calories are created equal; 2, weight loss is not health. It is not necessarily not-health, and I am not saying that this provision is the only mechanism in the bill (lord knows if it were Ezra would be singing a much different tune), but I would really like to see some work on urban food deserts, for example, before we start giving ourselves even more tools for public body and diet shame.
Finally, 3: in many ways one of the biggest issues around food and health for Americans is that our culture can't conceive of food as food. It's all calories and good fats and bad fats and antioxidants. Having to intellectualize and moralize the shit out of everything we eat is not good for us. It leads to deprivation/binge cycles, depriving ourselves of things we need because they're "bad," sometimes relying on companies or fads to figure it all out for us (read: diets). Many of these diets are not very nutritionally sound, and almost none of them promote healthy relationships between mind and body--which is really one of the bases of health.
I think this further standardization and commodification of food into points which are good or bad but ultimately to be conquered will do nothing to help this pathologization of food and plenty to further it.
MeMe Roth: "We’ve gotten ourselves to the point where we’re behaviorally and neurochemically dependent upon food."
Michael Pollan: "Eat food. Not too much. Mostly plants. That, more or less, is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy."
Our culture, sadly, is much more in tune with the former sentiment than the latter. I don't think putting calorie counts on menus nationwide will help.