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    Is America’s Harvest Box a good idea?

    Editor's Note:  Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform.

    For approximately 16 million U.S. households, the government is proposing cutting their food stamp benefits and replacing them with a box of nutrition sent to their home.

    So, instead of Blue Apron arriving on their doorsteps, recipients would get a box from Blue Trump; or instead of Hello Fresh, a box of Trump Fresh. In actuality, the U.S. Department of Agriculture (USDA) plans to call these boxes “America’s Harvest Box.” The new program would go to households that qualify for $90 or more per month from the Supplemental Nutrition Assistance Program (SNAP), formerly the food stamp program. Households would still get some cash to spend as usual on their electronic benefit card, but part of their usual check would now come in a box from the government.

    The food packed into the boxes would be grown or made in the country. It would include canned fruit, vegetables and meats, juice, pasta, and other goods that remain fresh without refrigeration. This means no produce however. The boxes are estimated to replace about half of the current program’s cash benefits. The program as proposed currently is estimated to save almost $130 billion over 10 years.

    As with all government proposed changes, there are positive points and negative points to this. The shelf-stable goods in the box will be domestically provided. This is good. It may help our farmers. But, there is no fresh produce, and this particular subset of people really needs increased access to improved nutrition, so this is not so good. The grocery industry would suffer. It is estimated that SNAP users drive 7.5 percent of sales, so these stores would take a financial hit.

    And who is going to order and pick up the food and pack these boxes? Most government-run programs seem to be full of waste and duplicated services. They just aren’t run efficiently like a private business (think U.S. Postal Service which is drowning in debt). Would this idea just create another overblown government program that sucks away our tax dollars paying bureaucrats? Would there be a “Hello Trump Tsar” that collects an enormous salary? There is certainly a potential for mismanagement of such a program. This would be a definite negative.

    Per the USDA, states would have flexibility for distribution of boxes and could use commercial delivery services already established. Again, it sounds like even the states would have to inflate their employment rosters to hire people to coordinate this and, as mentioned above, this is probably not a cost-efficient way to go.

    What I see as a potential big negative, is the lack of choice in the indigent person’s life. The people receiving SNAP assistance don’t get to make a lot of fun or meaningful choices as it is. They are not out shopping for a new car, trying to pick a color. They are not flipping through brochures dreaming of where to go on their next vacation. They are not sitting with their kid choosing a college and if they are, chances are the affordable choices are minimal.

    They appreciate having a choice at the grocery store. Our local food pantry, Pennridge Fish, provides food for those in our community who are less fortunate or down on their luck. The clients get to push a grocery cart through our building and have choices in each area of the warehouse. They pick which canned good they want: peas or beans, peaches or pineapple. And I will tell you what. They love having a choice. Other local pantries hand out prefilled bags of food. Our clients repeatedly express how they love the feeling that they are shopping, not just getting handed a bag of food. This gives them a small piece of control in their lives. They have a choice. Losing this could be a big negative.

    And I am not naïve. I understand that there are a lot of cheaters. People abuse our pantry and abuse the SNAP program as well. People pick tattoos over nutrition when it comes to financial choices. Some people may believe that if we mail a box to a SNAP recipient at least we know they are getting some healthy foods, whereas if they go to the grocery store and buy all sugary nonsense, we have no control over that.

    But sometimes, it is better for a person to have control over at least something in their lives, even if it is just what foods to pick. Trump’s idea has some good and bad points, as do most suggestions. Time will tell if the pluses outweigh the minuses.

    4 Comments

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    • Anonymous
      Save the sarcasm abut the President, Dr. Rousche is right - the food stamp program can be abused, but nothing is more expensive than a federal government program - let alone one with not only bureaucrats but shipping expenses. Perhaps we return to the food stamp predecessor - "surplus food". My mom, raising 5 of us alone on a meager salary went monthly to the county seat and got a box of food. Cereal, pasta, sauce, canned meat and vegetables, butter, eggs, cheese, peanut butter and other staples. So shipping, we just picked it up. Federally funded but locally controlled and administered. That doesn't need to be a total substitute for money to buy produce and other food, but it assures SOME domestically produced nutrition as part of the program. Keith Gallagher, R.Ph.
    • Anonymous
      Save the sarcasm abut the President, Dr. Rousche is right - the food stamp program can be abused, but nothing is more expensive than a federal government program - let alone one with not only bureaucrats but shipping expenses. Perhaps we return to the food stamp predecessor - "surplus food". My mom, raising 5 of us alone on a meager salary went monthly to the county seat and got a box of food. Cereal, pasta, sauce, canned meat and vegetables, butter, eggs, cheese, peanut butter and other staples. So shipping, we just picked it up. Federally funded but locally controlled and administered. That doesn't need to be a total substitute for money to buy produce and other food, but it assures SOME domestically produced nutrition as part of the program. Keith Gallagher, R.Ph.
    • [email protected]
      Personally, I would HATE having foods picked for me. What’s next? Maybe doctors should have half their $ from Medicare and Medicaid supplied as pre-picked food from the government. And who decides what products go in and where they are bought? How many of Trrump’s cronies benefit? (Sorry, my suspicion of big government is showing). I thought Trump was for decreasing big government. Sounds like this will increase it big-time. These packages are going to cost about 100 times more than just adding $ to a card in POSTAGE alone.
    • [email protected]
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