Universal Healthcare and the Waistline Police

We Risk a Nanny State Contrary to American Ideals

Imagine a country where the government regularly checks the waistlines of citizens over age 40. Anyone deemed too fat would be required to undergo diet counseling. Those who fail to lose sufficient weight could face further "reeducation" and their communities subject to stiff fines.

Is this some nightmarish dystopia? No, this is contemporary Japan. The Japanese government argues that it must regulate citizens' lifestyles because it is paying their health costs. This highlights one of the greatly underappreciated dangers of "universal healthcare." Any government that attempts to guarantee healthcare must also control its costs. The inevitable next step will be to seek to control citizens' health and their behavior. Hence, Americans should beware that if we adopt universal healthcare, we also risk creating a "nanny state on steroids" antithetical to core American principles.

Other countries with universal healthcare are already restricting individual freedoms in the name of controlling health costs. For example, the British government has banned some television ads for eggs on the grounds that they were promoting an unhealthy lifestyle. This is a blatant infringement of egg sellers' rights to advertise their products.

In 2007, New Zealand banned Richie Trezise, a Welsh submarine cable specialist, from entering the country on the grounds that his obesity would "impose significant costs ... on New Zealand's health or special education services." Richie later lost weight and was allowed to immigrate, but his wife had trouble slimming and was kept home. Germany has mounted an aggressive anti-obesity campaign in workplaces and schools to promote dieting and exercise. Citizens who fail to cooperate are branded as "antisocial" for costing the government billions of euros in medical expenses.

Of course healthy diet and exercise are good. But these are issues of personal - not government - responsibility. So long as they don't harm others, adults should have the right to eat and drink what they wish - and the corresponding responsibility to enjoy (or suffer) the consequences of their choices. Anyone who makes poor lifestyle choices should pay the price himself or rely on voluntary charity, not demand that the government pay for his choices.

Government attempts to regulate individual lifestyles are based on the claim that they must limit medical costs that would otherwise be a burden on "society." But this issue can arise only in "universal healthcare" systems where taxpayers must pay for everyone's medical expenses.

Although American healthcare is only under partial government control in the form of programs such as Medicaid and Medicare, American nanny state regulations have exploded in recent years.

Many American cities ban restaurants from selling foods with trans fats. Los Angeles has imposed a moratorium on new fast food restaurants in South L.A. Other California cities ban smoking in some private residences. California has outlawed after-school bake sales as part of a "zero tolerance" ban on selling sugar products on campus. New York Gov. David Paterson has proposed an 18 percent tax on sugary sodas and juice drinks, and state officials have not ruled out additional taxes on cheeseburgers and other foods deemed unhealthy. These ominous trends will only accelerate if the US adopts universal healthcare.

Just as universal healthcare will further fuel the nanny state, the nanny state mind-set helps fuel the drive toward universal healthcare. Individuals aren't regarded as competent to decide how to manage their lives and their health. So the government provides "cradle to grave" coverage of their healthcare.

Nanny state regulations and universal healthcare thus feed a vicious cycle of increasing government control over individuals. Both undermine individual responsibility and habituate citizens to ever-worsening erosions of their individual rights. Both promote dependence on government. Both undermine the virtues of independence and rationality. Both jeopardize the very foundations of a free society.

The American Founding Fathers who fought and died for our freedoms would be appalled to know their descendants were allowing the government to dictate what they could eat and drink. The Founders correctly understood that the proper role of government is to protect individual rights and otherwise leave men free to live - not tell us how many eggs we should eat.

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Want a warning label with those fries?

by Jeff Jacoby



THE WORTHIES who govern Massachusetts haven't been able to keep the state's population from dwindling, its property taxes from soaring, its budget from imploding, its Big Dig from leaking, or its politicians from getting arrested. But failure hasn't diminished their ambition -- or their presumption: Now they're going to keep the rest of us from overeating.

On Thursday, Governor Deval Patrick's administration launched Mass in Motion, a new war on obesity that it calls "the most comprehensive effort to date to address the serious problem of overweight and obesity in the Commonwealth." Already up and running is a shiny new website, which appears to consist mostly of trite exhortations to eat sensibly and do more exercise. Needless to say, the administration plans to spend money on its crusade, current budget straits notwithstanding. After all, if the state doesn't pump $750,000 into such "wellness initiatives" as "expanding the availability of farmers' markets" and designing "transportation systems that encourage walking," who will?

But the heart of the new campaign, as with most government initiatives, is coercion. Following the lead of California, New York City, and Seattle, Massachusetts officials plan to compel restaurant chains to conspicuously post the calorie content of all their offerings, either on the menu or at the counter. Obesity warriors want restaurants to be forced to publicize the nutritional content of the foods they sell so that consumers can make a reasoned decision about what to eat. "People often really are not aware of what's sitting on their plate," the director of Boston Medical Center's nutrition and weight management program, Dr. Caroline Apovian, told The Boston Globe. "But if the information is sitting right in front of you . . . it's hard to deny."

Actually, not that hard. When it comes to nutrition as to so much else, human beings are quite adept at denying, ignoring, or discounting information they would rather not deal with. A 2006 study by researchers at the University of Vermont found that the more often one eats in fast-food restaurants, the less likely he is to pay attention to food labels. "These . . . data suggest," they concluded, that "recent legislation advocating for greater labeling of restaurant food may not be particularly effective."

Is it really the job of the state to coerce restaurants into confronting diners with information most of them aren't interested in? The food-service industry is exceptionally competitive and highly sensitive to customer preferences; if enough diners wanted to look at obtrusive calorie charts when eating out, restaurants would already be providing them. Jacob Sullum of Reason magazine puts his finger on it: "A legal requirement is necessary not because diners want conspicuous nutritional information but because, by and large, they don't want it."

Nanny-statists find it easy to disregard consumers' wishes. After all, they reason, it's for their own good -- obesity is a deadly scourge that government must not ignore. Massachusetts Public Health Commissioner John Auerbach warned darkly last week that "unless we make progress" -- that is, unless the government imposes new restrictions on liberty -- "overweight and obesity will overtake smoking as the leading cause of preventable death in Massachusetts." That always seems to be the nannies' bottom line, whether the risk is said to be from tobacco, global warming, or cars without airbags: We must take away some freedom or more people will die.

But what will the government do when mandatory calorie information in chain restaurants doesn't make a dent in obesity rates? Extend the mandate to all restaurants regardless of size? To supermarket display shelves and freezer sections? Will warning labels be required on packages of Oreo cookies and Oscar Mayer hot dogs? Will new regulations prohibit fast-food restaurants and confectioners from running ads on TV or in magazines? And if our collective waistline still doesn't shrink, will the most fattening foods be permitted only to consumers with a government-approved body-mass index? Or simply banned altogether?

For at least 30 years, the food industry has been labeling packaged foods with nutritional information; with the rise of the Internet, Americans have access to more such information today than ever before. Yet Americans are also fatter than ever before. Perhaps that is because hectoring people about calories doesn't usually make them thinner. It doesn't work when family members do it. It won't work any better when regulators do it. Not even in Massachusetts.

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