Thursday, April 22, 2010

Sugar in the Tank

The NY Daily News has an interesting defense of the fat tax in yesterday's paper from Linda Fried of the Mailman School of Public Health-and is a testament to why public health advocates, like small children and fire, should be kept away from policy making: "Given high rates of obesity (about 60% of New Yorkers are overweight or obese) and diabetes (which afflicts more than a million people in New York City alone), this would seem a logical proposal: one that reduces consumption of sugared drinks, a leading culprit in these conditions, and raises much-needed resources for health care, disease prevention and education."

Well, one woman's logic is...But Fried goes on to explain just why the proposal makes so much sense-from the standpoint of public health ideology: "Does the soda tax pass the public health test? It depends on three key questions. First, to what extent will this tax actually change the drinking habits of New Yorkers, rather than simply making bad habits more expensive? The answer: Studies estimate that a tax of this size will reduce consumption by 10%, and that's a significant start."

Ah, the old, "studies estimate," gambit-but there is no current evidence that indicates with any degree of certainty that there will be this kind of cause and effect relationship between the tax and behavior. And in our experience, when the folks fail to act like Pavlov's dog, the government simply ups the ante-and raises the tax even further, But this template has even more ominous implications.

That's because this public health mentality-once it has the government wind at its sails-will certainly not stop with sugar; fat and salt will be the next items on the menu. And Fried's world view isn't hard to decipher: "Influencing these kinds of behaviors may seem to be a goal that should be beyond government concern. But our nation has an urgent need to control health care costs. The best way to do that, without reducing health care services, is to prevent illness. Obesity is often a preventable condition, and diabetes, as well as heart disease and other illnesses, is directly linked to it."

We like that turn of phrase about the role of government, individual behavior and public health: "...may seem to be a goal that should be beyond government concern." But in the public health Weltanschauung there is literally no individual behavior that is beyond the purview of government meddling.

But Fried, not content to dog paddle in  the shallow end of the pool, goes on to butterfly in the deep water with the following stretch: "Second, will the proposed bill help public health sufficiently, if some of the funding winds up going to education? The answer to this is absolutely yes. The quality of education not only prepares our children and young adults to be successful and productive citizens, but it is a key predictor in how healthy they will be in their longer lives."

And if some of the funds go to public safety than that's good for health as well. But what if some of the funds are directed-since all money is fungible-to a corrupt member item? The Fried argument is a a classic example of Reductio ad Absurdum reasoning (if that's true than I'm a monkey's uncle)-and underscores the progressive belief that any money that the government is able to con out of the public is in the public's interest.

Fried, however, elides the possibility that this kind of tax policy writ large will have an unhealthy impact on the economies of neighborhoods where the products in question are distributed and sold. Memo to Fried: Employment is also in the interest of public health because people with jobs...well, you get the picture.

And one other important point that underscores the philosophical fragility of Fried's advocacy. In our view, it is inherently healthy for individuals to be in full charge of how they live their lives. And the corollary of this position, is that when folks are dictated to by tax policies designed to control behavior, they are unable to live their own lives to the fullest and healthiest extent.

So, the public health meddlers need to be told to back off of their intrinsic ideological impulse to coerce. It is a dangerous slippery slope, one that leads to the kind of soft tyranny predicted by Tocqueville-an unhealthy, less democratic, and less productive society where public health managers will all be employed dispensing Soma to comatose subjects.