Monday, July 06, 2009

Silly recommendations are very bad for our health

Should the Government give tax breaks for gym memberships?  Sponsor therapy sessions for smokers?  Limit the number of bottleshops in each suburb?

The Federal Government's Preventative Health Taskforce has spent the past year coming up with creative little ideas to help Australians kick their alcohol, tobacco and fatty food habits.  On Tuesday, the taskforce delivered its recommendations to Canberra.  But they've been dripping out their proposals to the media for a few weeks.

Indeed, the taskforce seems to have adopted a tactic new to policy debate:  if you propose enough bad ideas in a short enough space of time, it's impossible to rebut them all.

One of the least convincing ideas is the one that has got the most attention:  subsidised gym membership and fitness equipment to tackle obesity.

Yes, gyms can be expensive.  But come the raw prawn, National Preventative Health Taskforce.  Gwyneth Paltrow may spend $900 a month to go to a "workout studio", according to the British Telegraph, but most gym memberships are the cost of an average mobile phone plan.

Maybe we are all craven, stingy fatties, but if we are, then it'd be a good bet that we're lazy too.  A few small tax breaks or a small government-sponsored reduction in the price of a gym membership is not exactly a compelling motivator to cast aside the pizza boxes and pump weights.

One of the more prominent anti-smoking proposals of the taskforce is to scrub cigarette packs of all brand identification -- logos, colours, everything -- as if stencilled gold foil pasted onto a cardboard box is all it takes to eliminate an individual's willpower.  Are there really that many people who want to quit smoking, but keep being drawn back by the shiny wrapping, like a nicotine-addled magpie?

No doubt the taskforce hopes to replace the labels with "YOU MIGHT AS WELL BE DEAD ALREADY" in a nice bold typeface on one side of the pack, and on the other side a picture of a confused and sad Bruce Willis.  And you get a mandatory slap on the face with each packet purchased.

We're a lot further down the nanny state's slippery slope than anybody could have predicted a few decades ago.  When restrictions on tobacco were first seriously implemented, those who opposed the measures asked whether fatty food could be the next target.  That concern was, of course, dismissed as silly and a little bit shrill.  Well, it's government policy now.

There's a big chasm between the medical world and the world of public policy.

Public health activists demonstrate their odd detachment from the mainstream world of politics when they start talking about our "obesogenic" environment -- a term used by reputable groups such as VicHealth and the Australian Heart Foundation to describe a society which apparently makes obesity nearly inevitable.

Like those post-Marxist philosophers who study the "essential violence" of peaceful capitalism, these public health academics now seek to expose the essential fatness of 21st century Australia.  Indeed, many health scholars have moved so far out of the realm of medicine that they seem to be developing a branch of sociology based solely on trans fats.

They may have good intentions.  Nobody wants Australia to be needlessly unhealthy.  But these medicos with ambitious regulatory proposals rarely consider some critical questions.  Will there be unintended consequences?  (Such as drinkers changing from alcopops to hard spirits since the tax was increased.)  And where is the evidence that it'll even work -- will the specific policy being recommended actually fix the problem?

There is an almost unanimous agreement among public health lobbyists and the commentariat that the Government should ban junk food advertising to children.  But the Royal Journal of Medicine argues there is "no good evidence that advertising has a substantial influence on children's food consumption".

Our peak communications regulator, the Australian Communications and Media Authority, which has repeatedly looked at the issue over the past decade, agrees.  Nevertheless, we still get vacuous claims about "pester-power" -- claims which seem to be driven by the belief that only the government can stop kids nagging their parents.

Mark Twain was concerned that giving the government the power to "meddle with the private affairs of cities or citizens" risked people losing their "independence of thought and action".  Today, it seems that for many in the public health establishment, this loss of independent thought and action is not so much a warning as an assumption.


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