Wednesday, April 15, 2009

Sweet and Sour Politics

Ryan Sager has an interesting exposé on the Machiavellian nature of the efforts of Tom Frieden, the NYC Health Commissioner, to control what we eat: "Want a lesson in political cynicism, dressed up as concern for public health? Then grab the latest issue of the New England Journal of Medicine, and read city Health Commissar -- sorry, Commissioner -- Thomas Frieden's piece on how to line up support for a soda tax. His advice: Lure legislators with dollar signs -- but convince the public it's all about health."

Not that we weren't aware of this ploy from the very beginning of its introduction by Governor Paterson; after all, what kind of health measure is placed in a budget so it can generate revenues by not being an effective deterrent to behavior? By Frieden's candor is welcome-since it reveals the extent to which public health autocrats will go to control how we live: "The soda tax didn't make it into state law in the latest budget, but it's still a top priority for those like Frieden (the architect of the city's trans-fat ban) who think it's the government's role to tell all Americans what they can and can't put into their bodies."

And the good doctor believes that the tax can be revived because the folks are pretty clueless about what the tax actually means to do: "Poll results show that support of a tax on sugared beverages ranges from 37 to 72 percent," write Frieden and his co-author, a Yale professor of food policy. And when the public is clueless, you can easily manipulate it: "A poll of New York residents found that 52 percent supported a 'soda tax,' but the number rose to 72 percent when respondents were told that the revenue would be used for obesity prevention."

Which, says the manipulative meddler, is terrific in spite of the fact that this-in his view-is all a ruse because public education campaigns, you know the efforts to actually convince folks to alter some bad habits, are not normally successful: "A penny-per-ounce excise tax could reduce consumption of sugared beverages by more than 10 percent," Frieden claims. "It is difficult to imagine producing behavior change of this magnitude through education alone, even if government devoted massive resources to the task." We wonder what kind of reduction in usage would follow the threat of jail time?

And of course, Frieden knows that the money generated by a soda tax wouldn't be used for anything but budget fattening: "But if legislators are tempted by new revenue, it won't be because they want to spend it on new programs subsidizing veggies for kids (as Frieden proposes in the article). They'd use it, as happens with all funds supposedly "dedicated" to any one purpose, to plugging the state's multibillion-dollar budget gap."

So this is what passes as public health scholarship nowadays-pretty pathetic if you ask us. But, at the same time, no one is more qualified to pen this kind of sly sleight-of-hand duping of the public than the ultimate anti-business meddler-and it's the same rationale that Frieden used to promote menu labeling; and we can't wait to see the epidemiological study that emerges from this fiasco. Will it be done in time to grace the pages of a Bloomberg for Mayor brochure?-the only publication where it would pass peer review.

All we can say is that this kind of health intervention is likely to be the wave of the future-and particularly as more and more of our health benefits are controlled by the government. Remember the old maxim: He who pays the piper calls the tune.