Blaming Consumers for Government Failures

Obesity is a major health problem in the United States. The traditional response to unhealthy dietary choices was to educate and inform consumers through the Dietary Guidelines for Americans and the nutrition label. Yet as the nutrition label failed to improve consumers' dietary choices, health advocates shifted to more intrusive measures like the recently adopted soda tax in Berkeley, California or former Mayor Michael Bloomberg's (I) failed attempt to ban large size sodas in New York City. What all these measures had in common was that they no longer relied on consumers' decision-making but attempted to substitute decisions made by regulators.

Advocates of these intrusive measures argue that the failure of the nutrition label demonstrates that policies that focus on informing and educating consumers do not work — even fully informed consumers may still make unhealthy choices. Advocates claim that unhealthy purchases are driven by limited willpower, rather than limited information. Consequently, they recommend policies that would actively manipulate consumers' choices in order to nudge them toward healthier diets.

As I discuss in my recent paper, "Why the Nutrition Label Fails to Inform Consumers," there are two problems with such a paternalistic approach. First, it seeks to blame consumers for failed government policies. Studies evaluating the nutrition label reveal that it is poorly designed. Proper use of the nutrition label requires considerable nutrition knowledge and extensive mental effort at the time of purchase, which time-pressed consumers at the grocery store do not have. In many cases, consumers do not use the nutrition label because they find it difficult to understand and use in purchasing decisions. Moreover, the label does not account for the difficulties that less-educated or elderly consumers could have interpreting the label. The label is essentially designed by the health experts for the health experts and therefore fails most consumers.

The federal government recognizes the issues with the nutrition label's design. In a recent report, the Institute of Medicine (IOM) examined front-of-pack nutrition facts panel (NFP) labels as a way to address the information overload and confusing design of the nutrition label. Based on its analysis, the IOM recommended that the Food and Drug Administration (FDA) produce a "simple, standard symbol translating information from the NFP on each product into a quickly and easily grasped health meaning, making healthier options unmistakable." The IOM found that a simple symbol would be easily understood by consumers at different literacy levels and would act as a cue to opt for healthier choices.

More generally, the Office of Management and Budget instructed the federal agencies to consider how and when consumers would use the disclosed information to inform their decision-making. To be useful, the information should not be merely available, but also accessible, usable and salient.

Despite the FDA's awareness of the label's problems, its proposed regulation to overhaul the nutrition label fails to improve its design. The proposed label marginally improves readability by increasing white space and calorie count font size. But it still requires consumers to have considerable nutrition knowledge and motivation.

The second problem with the paternalistic approach is that it largely absolves policymakers from responsibility for producing ineffective policies. The fact that the regulators at the FDA, and the broader health expert community that advised them, produced a failed policy should call into question both the regulators' expertise and the effectiveness of the regulatory process that allowed a flawed policy to go forward.

Yet if experts can pin the blame for the failure of existing anti-obesity policies on consumers, they do not have to reevaluate the effectiveness of the regulatory process that has produced these disclosures. Nor do they have to question their ability to effectively intervene and enact policies that reduce obesity.

Intrusive policies, soda bans and taxes simply shift the blame for the failure of the existing anti-obesity policies on consumers. Before implementing more restrictive policies that limit consumer choice, health experts should first examine the design and implementation of previous failed policies and try to understand the deeper causes for their failure. Otherwise, policymakers risk repeating the same mistakes and creating policies that will similarly fail.