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How much government intervention is required for a healthy population?

The Weekend Australian (3/10/2009) printed a very telling article by Christian Kerr titled Backlash looms on smoking, drinking. The article quotes a leading social trend researcher, Neer Korn from Heartbeat Trends – “People just don’t want outsiders to interfere, particularly government or corporations, in their own private lives. They’re very sensitive. You can’t tell people anything negative”.


Mr Korn seems quite alarmed at the recommendations of the recent National Preventative Health Taskforce report which floated among other things higher taxes on fatty foods, cigarettes and alcohol and a ban on TV advertising of junk foods. The telling thing in this article is the politics and the sneaky way vested interests are protected, while the wellbeing of the public are largely ignored.


The Seat of Government

The Seat of Government

In terms of “outsiders interfering in our personal lives”, why does Mr Korn think the sellers of junk food spend billions of dollars on advertising? As an act of generosity or so people can enjoy their free to air TV?


The notion of spending $3 for a bottle of perfectly good water contaminated with sugar, additives, colours and CO2 has got to be one of the more bizarre behaviours of modern living. In a world where we are saturated with clever messages from the biggest brands, corporations have been successfully engineering our habits for the past 100 years. From a health perspective, it’s only recently that we have become conscious of the crisis this is creating. The stakes are high and the politics is brutal.


Now let’s take a closer look at Mr Korn’s company Heartbeat Trends and his high profile clients who no doubt pay his substantial consulting fees. His clients, the likes of CocaCola, Pepsico, Cadbury Schweppes and Nestle are the very companies implicit in the engineering of consumer habits for profit at the expense of public health.


I am not sure of the figures for Australia but in the US an astounding ¼ of their caloric intake comes from soft drinks.


Although I consider myself a conservative and very skeptical of government intervention, there are times when it needs to act to protect the public interest.


There are broad political responses to this dilemma, the true libertarian will say… “Let people do what they want and don’t interfere with their personal lives. However, don’t expect society to rescue you from your own poor choices”. So, the obese smoker and heavy drinker with type 2 diabetes should be refused public health treatment when at the age of 55 they are going to place enormous burdens on the system.


Whereas the socialist left would say… “We know what’s best for you, we need lots of government services and we will save you in a time of crisis. You are safe with us, we will look after you from cradle to grave”. They do this by heavily taxing cigarettes, alcohol, junk food and most things unhealthy and subsidise the healthy choices. They will regulate TV advertising of unhealthy foods and the manufacturers of those foods. They will also regulate all aspects of health service delivery.


The best response may lie somewhere in between, but can you trust the political process to get the right balance?


We can’t just allow big corporations to hoodwink the public with their deceptive practices and claim all profits and accept no responsibility. We don’t want big government but it makes sense to let taxes help direct the hand of the economy by placing imposts on unhealthy choices and subsidising the healthy.


Where do you think the balance should be?


UPDATE: I think this letter to the editor from a doctor says it all…
Why Pay for the Care of the Careless?
During my last shift in the ER, I had the pleasure of evaluating a patient with a shiny new gold tooth, multiple elaborate tattoos and a new cellular telephone equipped with her favorite R&B tune for a ringtone.
Glancing over the chart, one could not help noticing her payer status: Medicaid.

She smokes a costly pack of cigarettes every day and, somehow, still has money to buy beer.
And our president expects me to pay for this woman’s health care?
Our nation’s health care crisis is not a shortage of quality hospitals, doctors or nurses. It is a crisis of culture – culture in which it is perfectly acceptable to spend money on vices while refusing to take care of one’s self or, heaven forbid, purchase health insurance.
Life is really not that hard. Most of us reap what we sow.
Starner Jones, MD
Jackson, MS

UPDATE 2 –  20th October 2011
This excellent interview with Kelly Brownell on ABC’s Lateline confirms most of what is written above and also touches on the potential liability of food manufacturers. I think this is the elephant in the room that policy makers are still paying lip service. I agree that people should take responsibility for their own health and lifestyle choices and shouldn’t need the government legislating on their behalf telling them how they should eat.

BUT WHO IS HOLDING THE FOOD MANUFACTURERS TO ACCOUNT TO TAKE RESPONSIBILITY FOR THEIR ACTIONS? Should food manufacturers be allowed to use cutting edge neuroscience to develop addictive products that contribute to our obesity epidemic and subsequent health costs blowout? Should they be allowed to extract as much profit out of the market as possible and leave the consequences for the public health system?

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