Sunday, June 17, 2012

Bloomberg Soda Ban Ignites Controversy. What's Next?

I’m a gastroenterologist and I should be against obesity. I should counsel patients who have reached a designated rung on the body mass index (BMI) ladder on the risks of carrying excessive poundage and the benefits of achieving a more streamlined silhouette. I should encourage them to pursue a regular pattern of exercise and to choose food and beverage items wisely. I should advocate that the optimal tactic to achieve and maintain weight loss is to adopt a sustainable lifestyle change, rather than engage in a short distance sprint.

Any controversy so far? I doubt it. While I want my patients, and indeed everyone, to make wise choices in life, I won’t make them do it. Doctors advise and patients decide. Intelligent folks who know the risks of their choices are entitled to make them freely.

Mayor Michael Bloomberg, a RINO (Republican in name only), has recently issued a citywide sugary drink ban that has made news across the country and beyond. While there are loopholes that will allow some of the sugary spirits to pass through, the ban is still far reaching and will leave many New Yorkers parched. Did the governor choose wisely here?

There’s a conflict between an individual’s right to make personal choices and the state’s obligation to create sound public policies to serve the greater good. The governor and his acolytes argue that the millions of excessive pounds that are weighing down the Big Apple are costing the city gazillions of dollars in lost productivity and medical expenses. Opponents reel from another governmental edict controlling their personal lives.

If you agree with Bloomberg, then how far can and should the government go to control our behaviors? Who makes the decisions on what activities we engage in, us or the government? Who decides if an activity is meritorious or injurious?

If you support the soda ban, explain why you wouldn’t support the following proposals.

  • Ice cream and candy will now be available only by a doctor’s prescription.
  • Any individual who is 10 pounds over ideal body weight, as defined by the government, will be terminated from their jobs.
  • Cigarette use will now be criminalized and convicts confined until they are rehabilitated to protect their health and the rest of us from the scourge of second hand smoke.
  • Car owners of gasoline engines will be taxed heavily to encourage electric car use. Society is entitled to clean air and polluters must pay a price.
  • Those who selfishly won’t exercise and are at risk for medical complications that the rest of us have to pay for, will have a percentage of their wages garnished.
  • Every Monday the government will choose a designated food item that it deems to be not healthful and it will be banned for the entire week. Restaurants, grocery stores and food trucks will delight in wondering when their ‘number will come up’. The government can set up a lottery where the public can wager on which ingestible item will be that week’s contraband. Revenue can be used to fund the special ‘cigarette police’ who will be working in 3 shifts rounding up inhalers.
Every day, diet soda and other caffeinated liquids slide down my gullet. Does this promote better health? Probably not, but I want the choice of what I can eat and drink. Let’s have some perspective here. I’m not asking for the right to drive 90 miles per hour on the highway which threatens the state’s interest much more than it would protect my right to speed on the open road. Banning soda and other sweet elixirs doesn’t meet this test. Indeed, if government encroachment continues, it may drive many of us to drink. See you at ‘happy hour’.


Janet said...

It really irks me when the government decides for us what we are allowed to eat/drink, etc. I am waiting for the government to step in and take over the recipe for my favorite fast food burger and make it into some kind of soy-based paste with fat-free mayo and whole wheat buns, which will completely defeat the purpose of going for fast food in the first place. If I want healthy, I stay home and make it myself. Any day now, I will cave in to my cravings and go for my burger and find that it is no longer available and that is when I will be defecting to France.

Michael Kirsch, M.D. said...

Janet, I feel your pain. In France, I suspect that the government encourages her folks to swallow Brie cheese and wine leaving the decision in the hands (and mouths) of the citizens. thanks for the comment.

Cole Durkee said...

I fully agree with everything you've said about "personal choice", except when it comes to cigarettes.

As far as I know, all of the other products you mentioned don't have highly-addictive chemicals added to them like the nicotine in cigarettes.

Research has shown that about 90% of current adult smokers became addicted to the nicotine in cigarettes while they were still in their preteen and teens years, and long before they were adults capable of making rational (and legal) "choices" to begin smoking.

Once those children become adults and realize the consequences of their actions, it's VERY difficult to change. They lost their ability to choose as freely as before because of their nicotine addiction.

So, because of that I believe that tobacco products need to be regulated by government, and for healthcare professionals to support their efforts.

Payam said...

Michael, as much as we may hate the idea of government controlling our "bad" behaviors, we cannot make light of the statistics. Extreme times call for extreme measures. Over 1/3 of adults and kids are clinically obese. The incidence of diabetes is higher than its ever been. We are talking about an epidemic. My time is spent looking at coronary angiograms all day long, and occasionally placing a stent when the damage is already done, hardly a cure....a mediocre treatment at best. Americans have proven incapable of policing their eating habits. The list of other bans you propose is, in my opinion, not as extreme as the statistics.

Anonymous said...

Dr. Hirsch, you might want to look up "slippery slope". Specifically, how these types of arguments are fallacious.

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