Unsettling Science in the Health Care Debate

Settled science rarely is. Except to those with a vested policy interest in the debate. True to form, a recent diatribe by Michael F. Jacobson of the Center for Science in the Public Interest acknowledges none of the widely available data that conflict with his passionate crusade against table salt. However, to a debate that has endured for decades, Jacobson does bring a modern twist:

As legislators struggle to craft a health-care program that covers every American…Congress should direct the Food and Drug Administration and Department of Agriculture to require industry to reduce sodium levels [in food] by half over the next five to 10 years.

Notice that government-provided universal health care is taken for granted. Unsurprisingly, so is the constitutional authority of Congress to dictate market terms to the private sector. If this is really a question of health, why not ask if exposing patients to the cost of their unhealthy lifestyle choices (instead of further obscuring them through legislation and health entitlement bureaucracy) might encourage people to alter such habits voluntarily?

Jacobson never asks because the debate is not about health, it is about control. And freedom is not a public option. He simply pronounces:

There are basically three ways to deal with the money issue [in providing universal health care]. One is to cover fewer people and slash services–defeating the very purpose of the legislation. A second is to bring in more revenues. The third is to trim costs. A smart mix of the second and third could help prevent the first. And doing so could be accomplished partly at the dinner table.

As long as Congress sets the menu.

A fourth way, apparently not considered by Jacobson, would be to reform the employer-based health care system and allow true market competition to provide individuals with affordable coverage that meets their needs. Then informed consumers making personal cost-benefit analyses can take an active role in their own treatment.

Of course, these days it seems that informed citizens taking an active role in anything is precisely what the government does not want.

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