Historically, the public health community targeted infectious diseases to which people cannot control exposure and transmission. The results are longer lives for most Americans.
Of course, the fortunate success of public health also means that Americans who might have otherwise died of tuberculosis or diphtheria tend to die of something else (usually heart disease or cancer). Now, the public health community justifies its interventions in terms of public funds spent on so-called “preventable” conditions. The oft-cited costs to the medical system of individual choices are the justification for such heavy-handed policy proposals as salt restriction, “Twinkie taxes,” and chocolate milk bans in schools.
If saving money spent on healthcare is the end-all, absurd policy recommendations can result. And most importantly, as A. Barton Hinkle “modestly proposes” in the Richmond Times-Dispatch, granting the public health community the right to take away some choices on “social cost” grounds opens the way for these activists to take away even more personal choices–even ones today thought to be net-healthy.
Hinkle notes that some of the most “preventable” medical conditions are injuries sustained playing sports. He also correctly identifies the politically driven crusades against salt and obesity as precedents that could open Americans’ lives to unprecedented government intrusion (15 m.p.h. speed limits, anyone?).
It seems absurd to claim that public health activists could use precedents set by salt reduction to ban youth football (28 percent of youth football players get injured, according to Hinkle). But would the members of the American Public Health Association assembled at its first meeting in 1873 who were concerned with issues like local sanitation have expected future members to be fighting wars against salt and soda?
It is of course hyperbole to speculate that somewhere trial lawyers might be preparing for the day after victory in some “Master Settlement” with Coke and McDonalds by drawing up plans to sue Nike and Adidas for getting high school athletes hooked on the “runner’s high” and creating a stream of “victims” for a “marathon-industrial complex.” However, any enabling precedent will create opportunities for intrusion that the public cannot imagine. Even if salty food isn’t one’s particular source of pleasure, that doesn’t mean one’s own choices are immune from the “public health” fervor.