Investing in America’s Health

Prepared by Peter Li-Chang Kuo

According to World Health Organization (WHO) statistics, approximately 16% of adults worldwide were obese in 2022. Over the past 30 years, the "global prevalence of obesity" has more than doubled. Obesity can lead to a wide range of serious health problems, including diabetes, heart disease, cancer, sleep apnea, osteoarthritis, digestive issues, and more. Additionally, it may impact mental health—such as increasing the risk of depression and anxiety, while reducing self-confidence and social participation.

U.S. Secretary of Health and Human Services (HHS), Robert F. Kennedy Jr., has proposed the "Make America Healthy Again" (MAHA) policy to promote the concept of "whole food diet", and to which we have developed a corresponding specific "Healthy Mini Hot Pot" pilot program for America, expecting to work together to reduce the obesity rate in the United States, which is as high as 42%.

Fig 1: "Whole Foods Diet" - Eat foods that are not overly processed

At the expert meeting held the day before yesterday, there was a discussion about the 5.15 million "eStores" planned for global commercial use of "TES" (The eStore System), which will generate USD 10 trillion in business opportunities and tens of millions of jobs; a fully phygital retail model that includes AI-powered services and primarily uses “electronic payment” (cashless) systems, with satellite support at each store location. What products should such stores sell?

One proposal was the “Healthy Mini Hot Pot”—designed to align with the health policy in the United States.

We advocate for "boiled, low-calorie foods" instead of fried or pan-cooked foods.

Based on the healthy hot pot menu and a rough cost estimate using 2025 prices from major suppliers in the DC and Maryland area (e.g., Costco, Restaurant Depot, Sysco), the costs are as follows:

A serving of healthy hot pot includes "broth, vegetables, meat, hot pot items, staple food, dipping sauces, and extras," and is primarily boiled in line with the MAHA policy.

1) Broths: Original, vegetarian, kelp, herbal, pickled cabbage, spicy, curry, etc. Cost: $1–4

2) Vegetables: Cabbage, Napa cabbage, bok choy, lettuce, enoki mushrooms, shiitake, wood ear fungus, corn, baby corn, pumpkin, taro, etc. Cost: $1–3

3) Staple foods: White rice, mung bean noodles, rice noodles, wheat noodles, etc. Cost: ~$0.50

4) Dipping sauces: Green onions, ginger, garlic, soy sauce, vinegar, chili, etc. Cost: ~$0.30

5) Meats (optional): Fish slices, chicken, pork, beef, lamb, etc. Cost: $4–6

6) Hot pot items (optional): Meatballs, konjac, tofu, fried tofu, tofu skin, fish cake, imitation crab, shrimp dumplings, shrimp balls, fish balls, roe rolls, mochi balls, steamed dumplings, egg dumplings, fish paste, tofu cubes, duck blood, rice blood cake, oden, assorted seafood. Cost: $1–2

7) Extras: Hot water, tea, soda, coffee, ice cream, etc. Cost: ~$0.80

Fig 2: Eat a variety of vegetables

Summing up, the basic ingredient cost per person (meat + vegetables + broth + staple + sauce + extras, not including labor/utility) is approximately “USD 9” per customer.

The set retail price is “USD 30” per customer, giving a gross margin of roughly 63–70%, and an Internal Rate of Return (IRR) of around “0.77.”

Estimated daily traffic per store is 80 customers, at USD 30 per customer. With 350 operating days per year, each store can generate “USD 840,000” in annual revenue, with operating expenses of “USD 538,000” per store, including food costs, labor, and admin expenses.

The pilot project will launch with 10 "eStore" locations, targeting $8.4 million in total annual revenue.

Each store’s investment cost (including equipment, buildings, and renovations) is about “USD 200,000.” An additional “USD 1 million” will be used to establish a central management and enforcement team.

Estimated annual gross profit is “USD 1.82 million,” maintaining stable cash flow and an overall IRR of “0.23.”

Fig 3: U.S. eStore Pilot Initiative

Each USD 30 healthy hot pot meal, when precisely controlled, contains roughly "600~1000 kcal"— a moderate caloric range for one meal. In fact, if you subtract staples like rice, it becomes a low-calorie meal, which, combined with adequate physical activity, can be part of a healthy daily diet.

Fig 4: Healthy Hot Pot

A National Institutes of Health (NIH) analysis of 34 randomized controlled trials using "Low-Calorie Diet" (LCD) weight loss strategies—defined as daily calorie intake between "800~1500 kcal"— shows a weekly weight loss of about “0.5 kg” and an 8% weight loss over 3~12 months. This supports the rationale behind the caloric design of the TES Healthy Hot Pot.

In his June 2009 speech, President Barack Obama emphasized creating electronic health records, preventing costly diseases, and "reducing obesity." During his 8-year term, efforts were made to reduce obesity through:

1. School Nutrition Programs;

2. Healthy Food Financing Initiatives;

3. Local Community Grants: Federal agencies such as the Department of Health and Human Services (HHS) and the Department of Education provided funding for childhood obesity prevention and screening services, as well as school physical education programs.

The Obama administration invested heavily in obesity reduction and achieved certain successes. However, from 2009 to 2014, the obesity rate among children aged 2 to 19 remained approximately "17%"— higher than the global standard. This suggests that while some age groups benefited, childhood obesity remained a major concern, underscoring the complexity of the issue and the need for sustained, multifaceted strategies.

The WHO recommends using "Body Mass Index" (BMI) to assess obesity. In April 2002, Taiwan's Ministry of Health and Welfare defined "BMI ≥ 27" as obese and 24–27 as overweight. For example, a person 170 cm tall weighing 80 kg has a BMI of 27.68 (obese), whereas if weighing 69 kg, the BMI would be 23.87 (normal range).

Using the BMI ≥ 27 standard, over 60% of the U.S. population may be considered obese, especially since the U.S. typically defines obesity as "BMI ≥ 30"—e.g., a 170 cm person weighing 87 kg has a BMI of 30.1. Still, the U.S. obesity rate remains at "42%."

Obesity increases the risk of "cardiovascular disease, type 2 diabetes, sleep apnea, certain cancers, degenerative arthritis," and other conditions. The WHO estimates that by 2025, the global obesity rate may reach "20%," with wasted healthcare costs expected to reach "USD 3 trillion" annually by 2030, and potentially exceed "USD 18 trillion" by 2060.

According to the World Obesity Federation’s “2025 World Obesity Atlas”, adult obesity worldwide will continue to rise. Without effective intervention, global healthcare costs due to overweight and obesity are projected to hit "USD 3 trillion" annually by 2030, accounting for "2.9%" of global GDP, and placing immense pressure on national healthcare systems.

Former Singapore Prime Minister Lee Hsien Loong once made an urgent appeal to improve dietary habits to combat the country’s rising "diabetes rates" (around 14.3%), even declaring a “War on Diabetes” and warning that by 2050, one in three Singaporeans may suffer from diabetes without effective action. This clearly demonstrates the scale of the problem—a national security-level battle.

According to research by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC), individuals with obesity are "7 to 10 times" more likely to develop type 2 diabetes compared to those of normal weight. Over 80% of type 2 diabetes patients are overweight or obese, as excess body fat— especially abdominal fat—interferes with "insulin function," leading to elevated blood sugar levels.

The National Institutes of Health (NIH) promotes the "Low-Calorie Diet" (LCD) strategy for weight loss, which is considered one of the most effective non-pharmacological methods for managing obesity and type 2 diabetes. It can lead to significant weight loss and improved insulin sensitivity.

The UK's "Diabetes Remission Clinical Trial" (DiRECT) found that some type 2 diabetes patients were able to achieve "remission" (normal blood sugar levels) through a low-calorie diet. Recommended dietary practices include:

1.Reducing intake of refined sugar and starches;

2.Increasing consumption of vegetables, protein, and healthy fats, and

3.Decreasing total calorie intake while maintaining balanced nutrition.

Various studies and clinical trials highlight the global severity of the obesity crisis and emphasize the urgent need for active intervention to prevent and manage obesity in order to reduce its public health and economic impacts. The conclusion is clear: the "LCD" is effective.

Turning to the United States, what impact does its 42% obesity rate have?

According to data from the CDC and other research institutions, approximately 42% of U.S. adults are obese. If measured by Taiwan’s standard of "BMI ≥ 27" (compared to the U.S. standard of BMI ≥ 30), the obesity rate would be over 60%. This high percentage places a tremendous burden on the U.S. healthcare system.

1. Annual healthcare costs: Obesity adds approximately "USD 173 billion" in annual costs to the U.S. healthcare system.

2. Increased per capita medical expenses: Obese individuals spend about "USD 2,505" more per year on medical care than those of normal weight.

3. Government budget impact: According to the U.S. Congressional Joint Economic Committee, the federal government spent about "USD 283 billion" in 2023 on direct medical costs related to obesity—representing 12.3% of total expenditures for major health programs.

4.Long-term fiscal impact: If current trends continue without effective intervention, the federal government’s obesity-related healthcare spending could reach "USD 4.1 trillion" by 2033.

In response, newly appointed U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. has expressed serious concern over obesity and has introduced multiple measures under the “Make America Healthy Again” (MAHA) initiative aimed at fundamentally improving the nation’s food and health policies.

Robert F. Kennedy Jr.’s Perspective on Obesity

Kennedy believes obesity is closely tied to a range of "chronic diseases"— such as diabetes, cardiovascular disease, and cancer. He attributes the root cause of obesity to the prevalence of ultra-processed foods, chemical additives, and unhealthy lifestyles in the American diet. He has famously stated:

“We have a generation of kids who are swimming around in a toxic soup right now.”

This statement encapsulates the core philosophy of his MAHA campaign: to improve children's health by reforming food policies, restricting harmful chemicals, and preventing widespread toxic exposure.

Kennedy’s key proposed reforms include:

1. Restrict ultra-processed foods and additives:

He calls for a ban on hundreds of food additives and seeks to eliminate ultra-processed foods (e.g., frozen pizzas, sugary cereals) from school lunches, while promoting "whole-food diets" (A diet that is based on whole foods and not highly processed) and increased investment in child nutrition research.

2. Reform school nutrition policies:

Kennedy advocates for improving school meal quality by offering fresher, locally sourced ingredients. However, while promoting healthier school meals, he also supports cutting funding for programs like the “Local Food for Schools” (LFS) initiative, which has posed challenges for some school nutrition efforts.

3. Launch a “Marshall Plan for Obesity”:

He proposes a large-scale, "community-based public health campaign"— modeled after the original Marshall Plan—where federal grants would support local governments in promoting healthy eating and physical activity to reduce obesity rates.

4. Restrict SNAP purchases of unhealthy foods:

Kennedy supports limiting the Supplemental Nutrition Assistance Program (SNAP) benefits from being used to purchase sugary drinks and candy, arguing this could improve nutritional outcomes for low-income families.

5. Criticism of seed oils:

Kennedy describes seed oils like soybean and sunflower oil as “poison,” claiming links to chronic diseases. However, nutrition experts argue that these claims lack strong scientific evidence and recommend healthier alternatives like olive oil.

In summary, Kennedy views obesity as "a major public health crisis" in the U.S. and has proposed multiple reforms under the MAHA initiative to address it—from banning unhealthy foods and additives, reforming school nutrition, to launching large-scale health campaigns. These efforts aim to fundamentally transform American eating habits and lifestyles, though they have sparked controversy among agricultural and food industry stakeholders. The effectiveness of these policies remains to be seen.

The MAHA Policy and Our “TES Healthy Hotpot eStore U.S. Pilot Program” share strong conceptual alignment, especially in the following areas:

1. Shared Core Values in Combating Obesity:

Robert F. Kennedy Jr. attributes the obesity crisis to ultra-processed foods, food additives, and unhealthy dietary habits. He emphasizes the importance of whole food diets and improving food systems in schools and communities. The TES Healthy Hotpot aligns with this vision through its core principles: "boiling as the cooking method," use of fresh natural ingredients, and low oil, salt, and sugar content. It offers a practical, healthy alternative to ultra-processed meals—convenient and nutritious.

2. Complementary Policy Synergy: MAHA + eStore

1) School Nutrition Policy:

MAHA’s push to eliminate processed foods from school lunches can be complemented by integrating TES Healthy Hotpot eStores into school campuses, offering customizable, temperature-controlled, non-fried, low-calorie meals.

2) Community Health Infrastructure:

MAHA’s federally supported, community-based health initiatives (modeled after the "Marshall Plan") align well with setting up "TES Health Stations"— community-based eStores combining healthy food, nutrition education, and local job creation.

3) SNAP Reform:

MAHA seeks to restrict the use of Supplemental Nutrition Assistance Program (SNAP) funds for unhealthy food. TES eStores adopt "electronic currency" (cashless) to ensure subsidies go toward healthy meals and encourage responsible food choices.

4) Food Policy Reform:

By limiting food additives and emphasizing whole foods, MAHA's goals are embodied in TES eStores that serve additive-free, whole-ingredient hotpot meals— acting as policy-aligned demonstration sites.

3. Total Solution of Innovation, Industry and Employment:

1) HEP Model (Healthy Entrepreneurship Program):

TES supports a job-creation model where young people, single mothers, and community members can run local "TES Healthy Hotpot stations," sourcing local produce and serving low-calorie meals—creating a “Health Economy.” This aligns with MAHA’s community health grant logic under the "Obesity Marshall Plan."

2) Food-Education Integration:

TES eStores in schools and communities include nutrition education, teaching children how to choose healthy ingredients. This model supports MAHA's educational goals and transforms the eStore into a “Living Food Lab.”

3) Digital Health Management:

TES features nutrition data tracking and personal analytics (via IoT, meal records, etc.), supporting public health policy evaluation and quantifying the real impact of dietary interventions on community obesity rates.

4. Spending Reduction: Reducing the Projected USD 4.1 Trillion in Obesity-Related Healthcare Spending by 2033:

1) Meal Structure Transformation:

If 10,000 TES eStores across the U.S. serve 800,000 to 5 million people per day, the system could replace 280 million to 1.75 billion high-calorie meals annually. A modest BMI reduction of 1 point per person could significantly reduce diabetes and cardiovascular cases.

2) Healthcare Savings:

CDC data indicates that a 1% reduction in national obesity rates could save USD 26 billion in healthcare annually. If TES helps achieve a 2% reduction, potential savings could reach USD 50~80 billion per year.

3) Shifting Social Consensus Toward Health Investment:

The concept of "One eStore, One Business, One Job" aligns with MAHA by turning health investment into opportunities for employment, community revitalization, and food system reform— expanding Public-Private Partnership (PPP) potential.

Conclusion

TES (The eSore System) has a track record of originator in digital commerce— having achieved to gain the APEC E-Commerce bill in 1998, and proposed “Global Channel-TES” to win the best practice policy at APEC 2003. It champions "electronic payment" (cashless) system to build a hygienic and safe economic society.

Today, TES and MAHA are moving from conceptual alignment to strategic integration. MAHA provides the federal policy platform and resources, while TES offers a scalable, self-financed and specific healthy eating tools and social innovation models. This collaboration ensures health reform goes beyond slogans, reaching every home, community, plate, and eStore. Such a “Health Infrastructure Project” is the key force capable of turning back the tide of obesity and saving trillions in future healthcare expenditures.

Fig 5: TES Advocates for Electronic Payment Transactions

The TES Policy Proposal under the “Invest in America” (IIA) Initiative

This proposal frames each eStore of TES not just as a shop but as a pattern for entrepreneurship and job creation. With support from a "Cross-departmental Task Force Committee" —including the Departments of Health (HHS), Agriculture (USDA), Education (DoE), Defense (DoD), Small Business Administration (SBA), Labor (DOL), National Science Foundation (NSF), Housing and Urban Development (HUD), and the CDC—the program would be launched that operation activity through "PFI" (Private Financing Initiative) and is expected to bring the following contributions to the U.S.:

1. Health Education: Promoting data-driven awareness and healthy food choices.

2. Public Health: Reducing obesity, diabetes, hypertension, and related diseases.

3. Economic Impact: Creating localized supply chains and small business opportunities (e.g., ingredient sourcing, logistics, packaging).

4. Job Creation: Generating “Health Economy” jobs in low-income communities.

5. Sustainability: Promoting local produces and reducing carbon footprints.

6. Key Performance Indicators (KPIs):

1) Health Metrics: BMI reductions of 1–5% among participants; improved blood sugar control.

2) Dietary Metrics: Lower high-calorie food intake in target communities; monthly LCD product growth 10% or more.

3) System Metrics: User satisfaction >85%; platform usage growth >20%.

4) Fiscal Impact: Estimated public healthcare savings of over USD 10 million in pilot areas.

5) Economic Indicators: "One eStore, One Business, One Job"— the more TES eStores, the more people are helped. This could position the U.S. as a global leading paradigm in health reform.

“Donateto the NDART”

Peter Li-Chang Kuo, the author created Taiwan's Precision Industry in his early years. Peter was a representative of the APEC CEO Summit and an expert in the third sector. He advocated "anti-corruption (AC)/cashless/e-commerce (E-Com)/ICT/IPR/IIA-TES / Micro-Business (MB)…and etc." to win the international bills and regulations.