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public health

Townspeople came out loudly and in force to oppose the proposed Westminster, Mass. ban on all tobacco sales, and that has thrown advocates back a bit [New York Times, MassLive, earlier]:

“They’re just taking away everyday freedoms, little by little,” said Nate Johnson, 32, an egg farmer who also works in an auto body shop, as he stood outside the store last week. “This isn’t about tobacco, it’s about control,” he said.

Right he is. And despite the Times reporter’s lifted eyebrow at the notion that “outside groups” are encouraging town officials to go forward with the ban, it’s worth asking how Westminster, Mass., population 7,400, came to have its very own “tobacco control officer.” Do you imagine the townspeople decided to create such a position with local tax funds? If so, read on.

WestminsterSealFor well over a decade the Massachusetts Municipal Association has run something called the Tobacco Control Technical Assistance Program, assisted by grant money from the state Department of Public Health. It does things like campaign for town-by-town hikes in the tobacco purchase age to 21, and town-by-town bans on tobacco sales in drug stores. It will surprise few that it has been in the thick of the Westminster situation.

This article, written for a friendly audience of public health advocates, frankly describes how the MMA project, with assistance from nonprofit and university groups as well as the state of Massachusetts, worked to break down the reluctance of town health boards to venture into restrictions on tobacco sales (scroll to “Roles of the Massachusetts Tobacco Control Program, Local Boards of Health, and Tobacco Control Advocates”);

Local boards were enticed into hiring tobacco control staff by the DPH’s tobacco control grants. As a participant in the process explained, “[L]ocal boards of health looked at it as ‘oh, it’s a grant. Let’s apply for this grant. So now, what do we have to do, now that we’ve got it?’” … The grants dictated that local boards use those community members they had hired as their staff to assist them in enacting and enforcing tobacco control regulations…

The staff paid for with money from outside the town seem to have seen their job as, in part, lobbying the local officials: “We’ve had to work on each individual board [of health] member to get them to come around,” said one.

The account continues with many revealing details of how the outside advisers managed to orchestrate public hearings to minimize critics’ voice, deflect challenges with “we’ll take that under advisement” rather than actual answers, and in the case of particularly intense opposition, “back off for a couple of months” before returning. “Grant-funded regulatory advocates were able to counter all of [opponents'] arguments and tactics.”

In other words, an extra reason for the townspeople of Westminster to be angry is that they have been paying to lobby themselves. And it’s worth knowing exactly how the game plan works, because similar ones have been rolled out to localities in various states not only on “tobacco control” but on “food policy,” environmental bans and other topics. Grass roots? If so, most carefully cultivated in high places.

Update Nov. 21: board drops plan in face of overwhelming public opposition.

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Needed: a post-Frieden CDC

by Walter Olson on October 24, 2014

cdc_ebola2x

Bloomberg’s nanny-in-chief was never the right choice to lead the Centers for Disease Control, much less with an actual epidemic in sight, argues the New York Sun:

…it was the former mayor of New York City who gave the nation Thomas Frieden, who is one dangerous doctor and is the middle of the catastrophe. … Because of the government’s blunders in the Ebola emergency, people are starting to look a harder look at Bloombergism.

… the CDC budget has soared more than 200% since 2000 to $7 billion. The Centers, moreover, are squandering this lucre (which was seized from the American public via taxes) on regulating motorcycle helmets, video games, and playground equipment, as if any of that has anything to do with diseases. No wonder that when Ebola hits, the CDC seems to be staggering….

Mr. Bloomberg is enormously invested in this through the school of public health at Johns Hopkins. Do Americans want a cabal of left-wing, government doctors in Atlanta engineering our playgrounds, motorcycle helmets, and video games? No one plays a video game or rides a motorcycle for his health….

It is important that the Ebola emergency is starting to get people thinking about the first principles of the Centers for Disease Control.

Read the whole thing. Related: Heather Mac Donald and Steve Malanga, City Journal; Jacob Sullum.

While we’re at it: I’ve got a new post at Cato about the international aspects, including the U.N.’s World Health Organization and Prof. Lawrence Gostin’s article “Healthy Living Needs Global Governance.”

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“It Has A Mission Creep Problem,” argues David Harsanyi, noting that large chunks of the Centers for Disease Control’s budget and attention now go “to temporary health scares and trendy crusades that often go well beyond any mission it should be pursuing.” Glenn Reynolds has more at USA Today on how the agency has far more on its plate than communicable disease these days, “having involved itself in everything from playground safety to smoking in subsidized housing.” (And binge drinking, and obesity, and suburban zoning, and….)

It seems that as government has gotten bigger, and accumulated more and more of its own ancillary responsibilities, it has gotten worse at its primary tasks. It can supervise snacks at elementary schools, but not defend the borders; it can tax people to subsidize others’ health-care plans but not build roads or bridges; and it can go after football team names but can’t seem to deal with the Islamic State terror group.

Earlier on the Centers for Disease Control and on director Thomas Frieden, who of course won fame before his CDC appointment for his activism as NYC Mayor Michael Bloomberg’s health commissioner, crusading against salt, sugar, guns, and so forth. More: Chris Edwards chart at Cato; Nick Gillespie, Reason; Michael Tanner. (& welcome Instapundit/Glenn Reynolds, Craig Newmark/Newmark’s Door readers).

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Paternalism roundup

by Walter Olson on May 19, 2014

  • “Go to Heaven, Bloomberg: The meddling ex-mayor thinks he is on a mission from God.” [Sullum] “De Blasio to resurrect attempt at NYC big soda ban” [Eric Boehm, Watchdog.org]
  • The CDC connection: much of Bloomberg’s crew of public health officials has moved into the Obama administration, and has big plans [Jeff Stier]
  • “The public health approach rejects the idea that there is such a thing as unfettered free will” — here’s Bloomberg paternalism boiled down nicely for you [Larry Gostin, Hastings Center Report via Scott Burris, Bill of Health (regretting "mass delusion of autonomy")]
  • Centers for Disease Control (CDC): if skeptical media call, tell ‘em you’re not around [Zenon Evans]
  • For her own good: “89-Year-Old Kicked Out of HUD Housing for Smoking Cigarettes” [Elizabeth N. Brown]
  • “Longer Pub Hours, Fewer Car Accidents in England and Wales” [James Schneider, Econlib]
  • Sally Satel on the benefits of e-cigarettes [AEI Ideas video] “The FDA Says E-Cigarettes Are Less Harmful Than Smoking” [Jason Koebler, Vice Motherboard]

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Oops: after years of imperious public-health hectoring, government intervention, and even visions of mass tort suits, it seems the science isn’t so settled after all. [Telegraph, NPR, CBC, earlier]

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Farm and food roundup

by Walter Olson on February 18, 2014

Christopher Snowdon on Britain’s hypertrophy of public health [Spiked Online]:

…["Public health"] once meant vaccinations, sanitation and education. It was ‘public’ only in the sense that it protected people from contagious diseases carried by others. Today, it means protecting people from themselves. The word ‘epidemic’ has also been divorced from its meaning – an outbreak of infectious disease – and is instead used to describe endemic behaviour such as drinking, or non-contagious diseases such as cancer, or physical conditions such as obesity which are neither diseases nor activities. This switch from literal meanings to poetic metaphors helps to maintain the conceit that governments have the same rights and responsibility to police the habits of its citizens as they do to ensure that drinking water is uncontaminated. …

Once again, all it took was a change in terminology. A ‘binge-drinker’ had traditionally been someone who went on a session lasting several days. Now it means anyone who consumes more than three drinks in an evening. … Today, if you are gripped by an urge to eradicate some bad habit or other, you no longer have to make a nuisance of yourself knocking door-to-door or waving a placard in some dismal town square. You can instead find yourself a job in the vast network of publicly funded health groups and transform yourself from crank to ‘advocate’. … Although ‘public health’ is still popularly viewed as a wing of the medical profession, its enormous funding and prestige has attracted countless individuals whose lack of medical qualifications is compensated by their thirst for social change.

“Sin” taxes? “Fines for living in a way that displeases a purse-lipped elite.” For persons who are going to live well into old age in any event, the question is not so much “preventing” one eventual cause of death as swapping one for another, perhaps more troublesome cause. And always, always the moralizing:

It can scarcely be coincidence that the main targets of the public-health movement are the same vices of sloth, gluttony, smoking and drinking that have preoccupied moralists, evangelists and puritans since time immemorial. HL Mencken long ago described public health as ‘the corruption of medicine by morality’.

Whole thing here.

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Nanny state roundup

by Walter Olson on July 12, 2013

  • “Sneaky public-health messaging appears to be on the upswing across the country” [Baylen Linnekin, NY Post; earlier here, here, etc.]
  • Scotland: “Parents warned they could face court for lighting up at home in front of kids” [The Sun] And Sweden: “Law professor calls for ban on parents drinking” (in presence of kids) [The Local via @FreeRangeKids]
  • Speaking of tobacco: “Former German Chancellor Stays One Step Ahead of European Nannies, Hoards Cigarettes” [Matthew Feeney on Helmut Schmidt]
  • Speaking of alcohol: ObamaCare slush fund bankrolling anti-booze advocacy in Pennsylvania [Mark Hemingway, earlier]
  • To fix the nation’s weight problem, socially discourage processed foods. Right? Wrong [David Freedman, Atlantic]
  • Mark Steyn on federal regulation requiring emergency bunny plan for magicians [NRO, more, earlier]
  • Run for your life! It’s a falling toilet seat! [Free-Range Kids]

Did you know that the Affordable Care Act creates an enormous, multi-billion-dollar slush fund — in the out years, it will raise $2 billion a year in perpetuity — for the federal government to spend on more or less anything that might “improve health and help restrain the rate of growth” of health-care costs? That the spending can bypass the Congressional appropriations process, and is rife with expenditures for the purposes of lobbying government itself, which is supposed to be an unlawful use of federal funds?

Somehow it didn’t sink in until I read this excellent investigation in Forbes by Stuart Taylor, Jr., the distinguished commentator and journalist now associated with the Brookings Institution. Because almost any cause arguably advances health, the administrators end up with close to unlimited discretion as to how to spend the money, which results in the usual array of goofy-sounding grant activities ranging “from ‘pickleball’ (a racquet sport) in Carteret County, N.C. to Zumba (a dance fitness program), kayaking and kickboxing in Waco, TX.”

It’s tailor-made for log-rolling and rewarding local friends, but the dangers go beyond that. In particular, as outraged Republicans from Fred Upton (R-Mich.) in the House to Susan Collins (R-Me.) in the Senate have been documenting, large sums from the program have been devoted to the purpose of lobbying for the passage of legislation at the local and state level — notwithstanding specific statutory language making that an unlawful way of spending money raised from federal taxpayers.

To quote Taylor:

* In Washington state, the Prevention Alliance, a coalition of health-focused groups, reported in notes of a June 22, 2012 meeting that the funding for its initial work came from a $3.3 million Obamacare grant to the state Department of Health. It listed a tax on sugar-sweetened beverages (SSB), “tobacco taxes,” and increasing “types of outdoor venues where tobacco use is prohibited” as among “the areas of greatest interest and potential for progress.”

* The Sierra Health Foundation, in Sacramento, which received a $500,000 grant. in March 2013, described its plans to “seek local zoning changes to disallow fast food establishments within 1,000 feet of a school and to limit the number of fast food outlets,” along with restrictions on fast food advertising. A $3 million grant to New York City was used to “educate leaders and decision makers about, and promote the effective implementation of. . . a tax to substantially increase the price of beverages containing caloric sweetener.”

* A Cook County, Ill. report says that part of a $16 million grant “educated policymakers on link between SSBs [sugar-sweetened beverages] and obesity, economic impact of an SSB tax, and importance of investing revenue into prevention.” More than $12 million in similar grants went to groups in King County, Wash. to push for changes in “zoning policies to locate fast-food retailers farther from . . . schools.” And Jefferson County, Ala., spent part of a $7 million federal grant promoting the passage of a tobacco excise tax by the state legislature.

These aren’t isolated flukes: they look very much like the normal and planned operation of the program. A $7 million grant to activists in the St. Louis area went in part toward lobbying for the repeal of a state law barring municipal tobacco taxes. The Pennsylvania Department of Health reported on how it used a $1.5 million federal grant: “210 policy makers were contacted . . . 31 ordinances were passed . . . there were 26 community presentations made to local governments .. . and 16 additional ordinances were passed this quarter, for a cumulative total of 47.”

This is outrageous. Congress has enacted and reiterated the ban on lobbying with federal funds because of the obvious unfairness of requiring taxpaying citizens to support political efforts of which they disapprove. Now a combination of the most politicized sector of public health activism (which likes to dictate how people live) and a cross-section of the local political class (which likes to find new ways of raising taxes) is getting massive federal subsidies to pursue such lobbying, often on a scale that can bulldoze disorganized local opposition. If you were wondering why some bad new ideas for local legislation (e.g., zoning to keep fast-food restaurants out of big-city neighborhoods) seem to be everywhere despite a tepid level of voter enthusiasm, now you know. You’re paying for them to be everywhere.

I joined host Ray Dunaway on Hartford’s WTIC this morning to talk about the issue.

P.S. Thanks to commenter gitarcarver for pointing out this April report on the problem by the investigative group Cause of Action. (& David Catron, American Spectator)

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Food roundup

by Walter Olson on May 29, 2013

  • NYT op-ed: let’s pay folks to cook at home, they’ll never figure it out otherwise [Amy Alkon on Kristin Wartman attempt to revive old Wages for Housework campaign with foodie spin] “You don’t have a moral obligation to cook” [Maggie Koerth-Baker]
  • “The Making of the Obesity Epidemic: How Food Activism Led Public Health Astray” [Helen Lee, Breakthrough Institute via Julian Morris] Research suggesting benign effects of slight overweight slammed by public health profs who fear it might complicate desired policy narrative [Nature; more from Trevor Butterworth on Walter Willett vs. Katherine Flegal] Lessons of Denmark’s fat tax [Christopher Snowdon, IEA]
  • Will ‘elf-and-safety spell an end to Gloucestershire’s annual Cooper’s Hill cheese-rolling event? [Telegraph]
  • Bloomberg’s NYC health dept. can’t find restaurateur to operate a cafe in its headquarters, too many rules [NY Post]
  • Curbs on Italian imports relaxed: “The war on salami finally ends” [David Frum]
  • Most senseless cheese ban ever? In the case of Mimolette, it mite be [Hans Bader, earlier]
  • Diversity in apple varieties has plunged in the past century, right? Maybe not [Alex Tabarrok]

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“Health and Human Services Secretary Kathleen Sebelius has gone, hat in hand, to health industry officials, asking them to make large financial donations to help with the effort to implement President Obama’s landmark health-care law, two people familiar with the outreach said.” Congress had earlier turned down a White House funding request for the project, which among other objectives seeks to promote — sorry, “increase awareness of” — the new Affordable Care Act (ACA). Federal law sharply restricts cabinet members’ freedom to fundraise for non-profits while in office, but HHS spokesman Jason Young cited “a special section in the Public Health Service Act [which] allows the secretary to support and encourage others to support nonprofit groups working to provide health information and conduct other public-health activities.” In 2010 the Secretary, who holds wide discretionary power to make life unpleasant for health insurance companies, vowed strict measures against insurers that were undermining the ACA’s popularity by saying they were expecting the law to raise rates. [Sarah Kliff, Washington Post; Michael Cannon, Cato, and follow-up]

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Some eye sleep patterns as the next frontier for government intervention in the name of public health. [Cohen, Prawfsblawg]

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[cross-posted from Cato at Liberty]

I’m at the Commentary magazine blog this morning with a second bite (second gulp?) at the NYC soda ban ruling. This time I look at the separation-of-powers angle, and at the way Judge Milton Tingling, Jr.’s ruling addressed the overgrown ambitions of some in the “public health” community to control more and more of life. Although the decision did not forestall the New York City Council from adopting nanny-state regulations in the future should it see fit, I argue,

…yesterday’s decision should cheer us for other reasons. It holds the Gotham administration accountable for overstepping the separation of powers, an important principle in the safeguarding of liberty. (In a profile of Judge Tingling, the New York Times notes that he’s been skeptical of government claims to power in a number of other cases as well.)

Under separation of powers as generally understood at the time of the Framers, an executive agency cannot enact new legislation on its own, that being a role constitutionally reserved for the legislature. Especially during the Progressive Era and New Deal, these barriers were eroded as administrative agencies claimed a power to issue regulations that looked more and more like traditional legislation, under powers deemed to have been delegated by the legislature. Still, there are some limits, both under the U.S. Constitution and in New York (which under a 1987 case called Boreali v. Axelrod applies its own, quirky standard in evaluating whether a regulation oversteps the separation of powers.) And those limits to delegation were at the heart of the soda case.

The New York City Health Department was asserting a breathtakingly broad definition of its powers, on the grounds that successive city charters give it sweeping authority to address all matters relating to health. Under the interpretation advanced by Bloomberg’s lawyers, this vague charter language would empower the department to issue pretty much whatever diktats it pleases for New Yorkers to obey on any topic somehow related to advancing health….

Looking at cases where the agency’s authority to act had been upheld, the judge noted instances of emergencies, particularly those relating to epidemics of contagious or communicable diseases. … In that legal finding is the germ of a much-needed rebuke to some actors in the public-health movement, who have taken the centuries of moral and practical authority originally built up by their colleagues from the fight against epidemic infectious disease and dubiously sought to apply it to a dozen other health-related questions of life and lifestyle, including not only doughnuts, soft drinks and salty snacks but also such supposed “disease vectors” as gun ownership and overreliance on cars for commuting.

Read the whole thing at Commentary here. Background in yesterday’s post here (& Alex Adrianson, Heritage).

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Caleb Brown interviews me in this new Cato Institute podcast, in which we discuss the futility of Mayor Bloomberg’s effort to turn NYC soda fans into two-fisted drinkers (that is, they’ll need to carry one in each hand); the role of federal grants from the Obama administration; and more broadly, the creepily intrusive ambitions of the New York City Health Department. If the embedded version doesn’t work, you can find it here.

Related: “The issue is freedom, not soft drinks.” [Jonathan Tobin, Commentary]. “Over himself, over his own body and mind, the individual is sovereign,” wrote John Stuart Mill [Patrick Basham, U.S. News] A new study finds restricting people’s junk food choices doesn’t help them lose weight [Reuters] James Lileks offers a helpful picture gallery distinguishing “Poison” from “Not Poison,” and classes a-burger-and-a-Coke in the latter category. Contrariwise, a ban backer at the Daily Beast is happy to contemplate future rules limiting hamburger sizes: “why not? Eight- and ten-ounce burgers are sick things.” And from earldean71: “If history is any guide at least one Atlanta suburb will pass an ordinance requiring giant soda drinks if NYC has a ban.” Earlier here, here, here, here, etc.

More: Watch me on the video version, just up on YouTube:

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The premise is that they are a public health menace since standing water in them might afford a haven for mosquitoes that carry West Nile virus. [Gideon Kanner]

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Meet the meddlers: officials from California to Gotham to London who believe that so long as we remain free to smoke, drink and consume potato chips in the privacy of our home, “government isn’t doing its job.” [Gene Healy, Examiner]

P.S. As readers rightly point out, the post should have noted that the speaker quoted in the headline was referring to the subsidized food stamp program, not the same thing as restricting consumer access to foods generally (though some “food policy” buffs certainly do favor the latter.)

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June 20 roundup

by Walter Olson on June 20, 2011

Politics edition:

  • Mother ship? White House staffers depart for Harvard Law School [Politico]
  • New York: “Lawmakers consider lawyer-friendly med-mal bills,” even as many key legislators moonlight at personal injury firms [Reuters]
  • David Brooks on explosive political potential of Fannie Mae scandal [NYTimes] After Kentucky bar panel’s vote to disbar Chesley, Ohio AG pulls him off Fannie Mae suit [Adler, Frank, Beth Musgrave/Lexington Herald-Leader]
  • Alabama legislature removes Jim Crow language from state constitution — but black lawmakers oppose the idea [Constitutional Daily]
  • AAJ lobbyist Andy Cochran works GOP turf, has convinced trial lawyers to sponsor Christian radio program [Mokhiber, "Seventh Amendment Advocate"]
  • Centers for Disease Control funnels grants to allies for political advocacy on favored public-health causes [Jeff Stier, Daily Caller]
  • Must have mistaken her for a jury: “John Edwards Sought Millions From Heiress” [ABC News] “One thing [worse than Edwards's] conduct is the government’s effort to put him in jail for it.” [Steve Chapman]

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December 4 roundup

by Walter Olson on December 4, 2010

  • Will they get group discounts on lawyers? Groupon vs. MobGob patent brawl [TechCrunch]
  • Why American courts should sometimes recognize Islamic law [series of Eugene Volokh posts]
  • No, it’s not a “public health issue”: “The Case Against Motorcycle Helmet Laws” [Steve Chapman, syndicated/RCP]
  • Failed system of justice on some Indian reservations [McClelland, Mother Jones]
  • Ten years ago: Morgan Lewis & Bockius handed mlb.com domain over to its client Major League Baseball [Ross Davies, SSRN]
  • City of Boston adds insult to injury after employee runs into building [TJIC, Popehat]
  • Citing fans’ drug use, feds seek forfeiture of farm used for Grateful Dead tribute concerts [Greenfield]
  • Johann Sebastian Bach, serial copyright violator [Cavanaugh, Reason]