Why is hospital food so nutritionally bad?

Mario Rizzo asks me:

Why is hospital cafeteria food so poor from a nutritional point of view? Fried chicken, preservative-filled cold cuts, cheese everywhere, etc. Keep in mind I am not talking about the food served patients who may have appetite problems. It is food they serve everyone else including doctors and nurses, many of whom know better.

You'll find some proximate answers here, referring to the institutional arrangements for supplying the food.  Here is a UK discussion.  Here are some signs of progress.  I would make a few more fundamental points:

1. Few people choose a hospital on the basis of the food or on the basis of the food their visitors can enjoy.  Furthermore the median American has bad taste in food and the elderly are less likely to enjoy ethnic food or trendy food.  You can't serve sushi.  They are likely to use the same food service contract for the patients and the visitors.

2. For the patients, some of the food is designed for the rapid injection of protein and carbohydrates.  For a terminally ill patient who is losing weight and wasting away, this may have some benefits.  Since healthier people tend to have very brief hospital stays, they can undo the effects of the fried chicken once they get out.  Many of the sicker patients in for longer stays have trouble tasting food properly at all.

3. Taxing hospital visitors is one way of capturing back some of the rents reaped by patients on third-party payment schemes.

4. I would be interested to know more about the insurance reimbursement rates for hospital food, but at the very least I suspect there is no higher reimbursement allowed for higher quality.  Combine third party payment with a flat price for rising quality and see what you get.  Furthermore, low quality food is another way the hospital raises its prices to inelastic demanders, again circumventing relatively sticky reimbursement rates from the third party financiers.  It's one sign that the net pressures are still in inflationary directions.

5. You can take the quality of the food as one indicator of the quality of other, harder-to-evaluate processes in the hospital.


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