Writing for the magazine, Reason, Ronald Bailey notes a disturbing development in New York City. Apparently the city’s health commissioner, Tom Frieden, now considers all preventable health problems to be a matter of public health. So instead of focusing solely on communicable diseases, the New York’s Board of Public Health wants to take action against health problems such as diabetes. To aid in this, the city has begun a surveillance program for all diabetics tested in city labs. How will this work? Bailey writes,
Under the new city diabetic surveillance system, the results from all tests for A1c (estimated to be between 1 million and 2 million annually) will go the city’s D.O.H.. The registry will record the full name, date of birth, and address of each person tested and the date each test was performed. Diabetics whose A1c levels are too high will receive a letter and educational materials from the D.O.H. and their physicians will be alerted to their test results. Frieden says that the surveillance information collected will remain confidential and any diabetics who don’t want to hear from the D.O.H. can opt out, but they cannot prevent their test results from being filed in the registry.
So, at least for now, the monitoring will only result in some mild nagging from the city. But what if that doesn’t result in fewer cases of diabetes? Will the city give up the program or try more coercive tactics? I don’t have much confidence that the city will just decide to back off. Government has a tendency to attract busybodies, so it isn’t difficult to imagine the city becoming more pushy about the issue.
Should we start worrying about the government hounding us about how much junk food we eat or how much exercise we are getting? Probably not for the moment. But there are circumstances in which this could become much more of a concern. As Bailey says,
In the past, Americans recognized a distinction between public and personal health. If I smoked, drank too much, supersized regularly or failed to get to the gym, it was my own fault, not Health Commissioner Frieden’s. However, when (and if) government-funded universal health insurance becomes a reality, the distinction between public and personal health will fade away. Then get ready for your prescription for compulsory biweekly aerobics classes.
Some low-fat, sugar-free food for thought.