2023 TJC H1General Paper P2 Insert

TEMASEK JUNIOR COLLEGE 2023 JC2 PRELIMINARY EXAMINATION Higher 1 GENERAL PAPER 8807/02 Paper 2 Insert 22 August 2023 1 hour 30 minutes No Additional Materials are required. READ THESE INSTRUCTIONS FIRST This Insert contains the passage for Paper 2. This document consists of 3 printed pages and 1 blank page.

2 A journalist considers the battle against unhealthy eating. 1 When New York began its battle of the bulge, its mayor, Michael Bloomberg, thought he knew best, and he was rich enough not to care if others disagreed. He did encounter vocal opposition when he proposed a ban on the sale of giant containers of sugary drinks. In a hearing conducted by New York City ’s Board of Health, Marty Markowitz, the borough president of Brooklyn, testified against Bloomberg ’s plan. “I’m overweight not because I drink litres of Coke, but frankly because I eat too m uch pasta, pastrami sandwiches, pizza, bagels with cream cheese and smoked salmon, red velvet cake and cheesecake, don ’t exercise as much as I should, and my genes are working against me. I was an overweight kid and I’m an overweight adult.” 5 2 In the same vein as John Stuart Mill, a 19th-century philosopher who wrote about the limits of state intervention , Markowitz argued that governments can educate, inform, advocate and inspire, but should not be the final decision-maker when it comes down to what is best for the individual . Many agreed with Markowitz, but the Board of Health approved Bloomberg’s ban. 10 3 Governments around the world are faced with the same questions. How can they get citizens to take in fewer calories and exercise more? Should they even try? In the past, governments concentrated mainly on treating diseases rather than preventing them. But as the world grows older and rounder, chronic disease has attracted new attention. Ageing may be inevitable but unhealthy eating can be prevented, and chan ges in behaviour can make older people healthier. The United Nations has even devoted an entire meeting of its General Assembly to chronic disease, including tho se brought on by an unhealthy diet. But there was confusion over what the state can or should do. The World Health Organisation has since set a target to reduce deaths from chronic disease by 25% by 2025. Governments now have to find ways of meeting that goal. 15 20 4 Some think that governments have no business telling people what to eat and ho w to move. Those who overeat, like Markowitz, take pleasure from it. According to John Stuart Mill, “over himself, over his body and mind, the individual is sovereign. ” But Mill allowed for state intervention when an individual’s actions might harm others. The more each person eats, particularly meat, the greater the pressure on food supplies. And as overweight children turn into fat adults, military strategists already worry about the health of future soldiers and employers gripe about productivity. 25 30 5 The biggest costs fall on healthcare. Estimates vary widely, but Ameri ca’s Institute of Medicine reckons that Americans spend between $150 billion and $190 billion a year on obesity-related illnesses. Healthcare costs for obese patients are about 40% highe r than for those of normal weight. That has made many governments more inclined to act. But what can they do? 35 6 The obvious model is the battle against smoking, which at least in rich count ries has been wildly successful. The campaign started in the 1960s, mostly with efforts to educate people about the dangers of smoking. In the 1970s, the argument against smoking was strengthened by evidence that cigarettes might harm bystanders. Stronger measures followed, including bans on cigarette advertising, tax hikes and restrictions on where smokers can light up. Where such policies have been adopted, smoking ra tes have dived. But unhealthy eating is much harder to fight than smoking. The food industry finds it easier to resist regulation because it is three times the size of the tobacco industry. A cigarette has no place in a healthy lifestyle, but junk food, enjoyed in moderation, can still play a part in a varied diet. 40 45 7 Despite this, governments have not given up the battle of the bulge . In an attempt to bring down healthcare costs, Japanese employers must provide waist measurements for all 40 to 74-year-olds. If they do not reduce the number of fat workers on their

3 payroll, they may get fined. Only in a skinny country could such a scheme be come law. American companies are also adopting measures to achieve the same outcome, and the government is encouraging them. For example, some companies give employees who are not overweight a discount on their health insurance. 50 8 As can be seen, some governments are trying various tactics such as punishing the obese for their excessive girth. However, a crudely designed penalty will do li ttle to change behaviour. What works best is frequent prompts, not once-a-year puni shment. And strict penalties assume that obesity is due to lack of willpower, when research suggests it has as much to do with biology and the fact that socio-economic conditions can be an obstacle to healthy eating. 55 9 Governments struggle to find policies that are strong enough to work well bu t subtle enough not to get up people ’s noses. The approach that governments favour is to nudge citizens into healthy behaviour by making it easier than the alternative. S oft paternalism is increasingly in vogue in all areas of government. Barack Obama ’s regulatory tsar in his first term, Cass Sunstein, wrote a book about it ( ‘Nudge’, with Richard Thaler). When he was Britain ’s prime minister, David Cameron set up a Behavioural Insight Team or ‘nudge unit ’ to suggest strategies for tackling social problems. Nudging holds particular promise for fighting obesity. The idea is to provide small impulses so that healthy eating becomes the obvious choice. 60 65 10 To nudge things along, governments are persuading people to eat more healthily by providing them with more information, as was done with smoking. New Yor k was the first city in America to require chain restaurants to list the number of calories per serving. Subsequently, this was extended across the country. But evidence on the effect of menu labelling is mixed. One study in the British Medi cal Journal found that only 15% of customers used New York ’s calorie information in making their choice, though those who did, went for meals that contained, on average, 106 fewer calories than the rest. 70 75 11 But the simplest – and most contentious – way to lower consumption of junk food is to make it more expensive. Removing corn subsidies is one way to raise prices. How ever, it would likely only result in a small dip in the production and consumption of corn syrup, which is used in sugary food . Consequently, a more popular measure is to impose taxes. France taxes sugary drinks and has considered a levy on palm oil. Hungary ’s exchequer penalises not only fizzy drinks but also sugary, fatty foods. Bu t so far, such measures have been ill-conceived or too timid. To have much effect, taxes of this kind must be levied at 20% or higher, according to a paper in the British Medical Jour nal. Furthermore, such taxes are easily circumvented. Denmark had to scrap a one-year-old tax on saturated fat and a planned tax on sugar. The fat tax had resulted in fatty shopping sprees abroad. 80 85 12 It would be easier to advocate big changes if it were clear which ones are effective. In one small study, Cornell University examined the impact of a soda tax in N