Sunday, July 18, 2004

The Fat Police are Coming

I was one of the few physicians way back when Big Tobacco was being vilified to point out to my collegues that smoking was a choice made by individuals and that teaching those individuals that they were simply the victims of evil businessmen who wanted them to get lung cancer would be non-productive.  It also opened the door to such absurdities as government telling us what to eat and that we have to exercise.  Of course, I advocate for individuals to be responsible in their personal choices -- but I never forget that it is their choice, not mine.  The underlying problem, it seems to me, is that as we as a society have pushed government to take over health care insurance (e.g., medicare, medicaid, etc.) we have opened the door to justifications to intrude on our everyday personal choices--like what to eat.  This is by far a greater threat to our individual rights than anything written in the Patriot Act, but there is nary a word spoken against this obscene violation of our personal freedom.
Ed Hudgens, the executive director of the Objectivist Center has written an excellent essay on this topic, reproduced below.
In the mid-1990s I used to argue against the war on tobacco as follows: Supposedly 400,000 individuals die each year because of smoking. (It's closer to 200,000; the government fakes the numbers, but that's another story.) Since governments pick up many of the health-care costs of people who are sick from smoking, governments claim the right to wage a war on tobacco. But nearly as many individuals allegedly die from bad diets and lack of exercise. By this logic, it will only be a matter of time before you're limited to two Big Macs per month, potato chips are kept behind the counter and not sold to anyone under 18, and there's a five-day waiting period to buy Twinkies so government bureaucrats can check your medical records.My reductio ad absurbum is one step closer to surrealist reality, thanks to Health and Human Services (HHS) Secretary Tommy Thompson who has now defined obesity under Medicare as a "disease." Thompson is on a jihad against extra pounds and expanding waistlines in this country. This change in the Medicare rules undermines freedom on four fronts.First, lots of Americans have unhealthy eating habits. But obesity is not a "disease"; it is the result of poor choices and habits over which individuals have control. Yes, some might be more prone to binge on chips, chocolate or other tasty treats, but the difference between we humans and dumb animals is that we can control our appetites; we can develop the good habits and practices necessary to live healthy lives. To suggest otherwise is to suggest that we are not in control of ourselves and are not responsible for our actions and thus undeserving of freedom.Second, by classifying obesity as a disease, Thompson has created a new, multi-billion-dollar government entitlement, without congressional approval, that will bloat an already monstrously obese Medicare program. Let's remember that when Medicare was created in 1965 the federal government estimated that it would cost $9 billion per year by 1990; instead it cost more than $66 billion that year. Today it costs about $275 billion with another $160 billion going to Medicaid to provide health care for the poor. And let's remember that in 2003, when the Bush administration proposed its new Medicare prescription drug benefit, it estimated the cost over the first decade at $400 billion. The ink of the president's signature on the legislation was barely dry when the administration announced that, oops, it had miscalculated; the cost would actually be $534 billion.Third, this new entitlement removes a principal and powerful incentive for individuals to treat their bodies in a responsible manner. If individuals believe the government - read, their fellow taxpayers -- will pick up the tab for their poor dietary choices, paying for their Weight Watchers or Jenny Craig, their stomach-stapling surgery or clogged artery treatments, they will be less likely to take their health into their own hands.Fourth, aggressive government diet controls cannot be far behind. With government paying the bill comes government control. As Medicare costs rose in past decades, the feds tried to save money by creating and forcing people into Health Maintenance Organizations that provide poor service, thus harming health. They also fine and even jail doctors for paperwork mistakes in Medicare filings, which are impossible to avoid because of the thousands of pages of incomprehensible Medicare regulations, thus driving many doctors, sick of being persecuted for curing patients, into early retirement.We now can expect the food fascists in this country -- those who want to restrict or ban foods of which they don't approve -- to join with the government - the guys with the guns - to make sure you only eat what they want you to eat.Obesity and poor health habits are certainly problems in this country. But the solution lies in true personal responsibility, a sense that one's life is so important and of such value that one would commit moral treason to one's self by allowing one's body to fall into disrepair.A greater threat to the health of our country is the obese size of government, with Medicare the overweight poster child that illustrates the danger to the heart of our liberties. Our biggest problem is not with fat in our waistlines but, rather, in the heads of politicians who want to micromanage our lives. The lesson of HHS's classification of obesity as a "disease" is that the government should go on a diet, shedding hundreds of billions in needless spending, starting with the entire Medicare program.
Amen, brother.
UPDATE:  Here are some more thoughts on the matter.

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