What to Eat and How to Live: Government as Your Nanny?
It is all about the role of government is setting limits on
what you eat and how you live your own life vs government being simply a
teacher, an instructor of the facts and allow its public to live their own personal
lives as they see fit. The recent
limit-setting regulations of food, drink and other health issues by Michael
Bloomberg as the previous mayor of New York city has provoked controversy both for and against
these actions. A series of articles in
Bioethics Forum, website of The Hastings
Center, bioethics "think tank",
presents views regarding this controversy. Lawrence O. Goslin (University Professor and Founding O’Neill Chair in Global Health Law at
Georgetown University Law Center, and a Hastings Center Fellow) writes
"Bloomberg's Health Legacy: Urban Innovator or Meddling Nanny",
originally published in the Hastings Center Report September-October 2013, with the following Abstract.
Michael Bloomberg assumed office as the 108th mayor of
New York City on January 1, 2002. As he leaves the mayoralty—having won
re—election twice-his public health legacy is bitterly contested. The public
health community views him as an urban innovator—a rare political and business
leader willing to fight for a built environment conducive to healthier, safer
lifestyles. To his detractors, Bloomberg epitomizes a meddling nanny—an elitist
dictating to largely poor and working—class people about how they ought to lead
their lives. His policies have sparked intense public, corporate, and political
ire—critical of sweeping mayoral power to socially engineer the city and its
inhabitants.
Here, I seek to show how Bloomberg has fundamentally changed
public health policy and discourse. He has used the engine of government to
make New York City a laboratory for innovation-raising the visibility of public
health, testing policy effectiveness, and probing the boundaries of state
power. Even though the courts have blocked some of his boldest initiatives, he
has offered a paradigm for the “new public health”—reaching beyond infectious
diseases to upstream risk factors in everyday life and the human habitat. I
also critically probe various arguments designed to derail his policies, along
with the overarching charge of unjustified paternalism.
Apparently,
after much negative feedback Goslin received about the article supporting
Bloomberg, he wrote his response to the Bioethics Forum titled "Bloomberg’s Health Legacy: What Inflames Consumer Passions in the Food
Wars? Goslin argues for some governmental control with the following:
Making the healthy choice is exceedingly hard, with
so many forces pointing in the direction of cheap, accessible, aggressively
marketed food, alcohol, and tobacco. Consumers, far from having unconstrained
choices under the status quo, are actually heavily influenced in their
purchasing and lifestyle decisions.
In
a semi-rebuttal article written to the Bioethics Forum, Ann Barnhill, an assistant professor in the Department of
Medical Ethics and Health Policy in the Perelman School of Medicine at the
University of Pennsylvania, states:
While I agree
with this analysis, I think it is incomplete. The charge that Bloomberg is a
meddling nanny reflects not just distrust with government influence on our
lives; it also expresses indignation at Bloomberg’s putative attitude towards
us: like little children being minded by a nanny, we can’t be trusted to make
decisions for ourselves. What troubles some citizens about Bloomberg’s policies
is not just the material impact of these policies on their choices and
pocketbooks but also the symbolic value of these policies.
Go and read the complete short articles and then return and tell us what
you think of government setting regulations regarding what we eat and what we
drink and even more personal choices.
..Maurice.
Graphic: Nanny State. Expression from Missouritenth.com and graphic created by me using ArtRage and Picasa 3.
posted by Maurice Bernstein, M.D. @ 5:11:00 PM
3 comments
3 Comments:
I've always felt that government leave matters like this to the individual's choice except in situations where the individual doesn't know enough to make an informed choice (e.g. the FDA shouldn't definitely ban foods that would but too much arsenic in unknowing consumers).
As we're approaching universal, tax-funded healthcare, my feelings on the issue are starting to shift. I still feel people have the right to live unhealthy lifestyles… as long as I'm not footing the bill. However, when we, the taxpayers, have to start shelling out tens of thousands of dollars to treat every 300 lbs patient with preventable heart disease and diabetes I think that we, the taxpayers, have the right to tell people who make flagrantly bad health choices to either commit to paying their own way or stop putting a pound of sugar into their bodies every day.
How about my other readers here: do you feel also like R Williams that as taxpayers get more involved in the cost of healthcare for others, beyond themselves, there is a rationale for the government representing all the taxpayers lay down some restrictions which might reduce the expense of treating those "others" in the future? ..Maurice.
Upon further reflection, I've realized two things:
1) I need to proofread my posts before submitting. I'm kind of embarrassed by that first paragraph up there.
2) Before we legislate health choices, I'd like to see some good, hard data about how much of a burden these choices are placing on the healthcare system. Consider a man who smokes and drinks his way to an early death via heart attack. All things considered, a heart attack is a pretty cheap way to die, and he probably would have cost the taxpayer more if he had lived up into medicare age. On the other hand, other individuals who make the same health choices might end up being in and out of hospitals for a couple decades. The tough part of this is that I know I will never see good data about this. It's one of those issues where people can (and will) select, filter, and interpret data in such a way that it supports whatever pre-existing agenda they have.
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