The New England Journal of Medicine continues its move towards less personal liberty and more paternalism. Ounces of Prevention — The Public Policy Case for Taxes on Sugared Beverages serves as a text on how academia and government government are certain that they know how the rest of mankind should behave. It’s up to the enlightened and informed to force the public to act properly regardless of whether they want to or not.
The piece can be summarized thus: Americans are too fat. Part of the reason they’re overweight is they drink too many sugared beverages. We’ve told them to drink less of them but they don’t listen. Therefore we (possessed of superior knowledge) must force the witless public to consume less by taxing these wicked drinks.
There’s so much wrong with this short article that I’d have to write a rebuttal longer than the original to cover all its demerits so I’ll just hit the highlights. I’m not a fan of ad hominem attacks but the background of the authors is pertinent. Kelly Brownell, PhD is is a professor and director of the Rudd Center for Food Policy and Obesity at Yale University while Thomas Frieden MD, MPH is the health commissioner for the City of New York. Thus both are concerned with man in the aggregate. People who view the big picture seem typically to lack sympathy for man as an individual. They naturally favor top down solutions to herd problems. This is fine when you’re dealing with an outbreak of typhoid fever or the swine flu, but such an approach to complicated human behavior like overeating almost invariably leads them to mischief.
They see obesity and a lot of other human behavior in terms of an epidemic. They go from the narrow confines of epidemiology’s approach to infectious diseases to using the same tools to “solve” behaviors they see as undesirable. They discern no difference in the approach to a polio epidemic and an “epidemic” of obesity. They almost uncontrollably turns to coercion as the solution to unhealthy behavior.
The coercion advocated by Brownell and Frieden is the tax code. They view taxes not just as the means to raise revenue for the government, but as an instrument to force people to act as they deem best. Such a use of the tax code is hardly unique. Every social democracy of the West uses it this way. It’s one of the reasons that the tax code is such a monstrosity. But its commonality does not render its impact less onerous.
Their initial justification for a tax on soda is that it makes you fat and obesity leads to illness which then raises the cost of publicly funded medical insurance. If this is sufficient reason to tax behavior unapproved by B & F we’re in for a lot of taxes. Make rounds on any busy teaching hospital, something they either have never done or have not done for a long time, and you’ll find that most of the patients there are largely responsible for their own ailments. Using their logic we should tax not taking your medicine as prescribed, missing clinic appointments, not getting inoculations. Then raise the gasoline tax, not just to protect the environment or reduce oil imports, but to discourage driving; there are so many reckless drivers who cause accidents that cost Medicare and Medicaid money that reducing driving would inevitably decrease the 40,000 deaths from auto accidents that happen every year, ie fight the epidemic of traffic deaths.
Tax salt as too much of it may raise your blood pressure and exacerbate a slew of cardiovascular diseases. The obesity epidemic is small beer compared to the hypertension epidemic. Upwards of 50% of the adult population is at risk for high blood pressure. Tax salt like alcohol or cigarettes and we can fund Medicare until General Motors returns to profitability, ie forever.
B & F propose that the the revenue generated by taxing Coke and Pepsi be used to subsidize the purchase of “healthful” foods. What are “healthful” foods? Well assuming you’re getting all the vitamins and minerals needed to prevent deficiencies of the same there is no such thing or everything is. Under these conditions a calorie is a calorie. If you want thinner people they need to take in less calories irrespective of source. Thus don’t limit the tax to soda; tax all food. Make a trip to the supermarket really painful. It’s for our own good. The government needs to make us eat less, even if they have to cram it (taxes) down our throats. Food is too important to be left to the unregulated whims of the public.