Tuesday, June 29, 2010

Diabetes, Obesity, and Government

Obesity and its stepchild, type 2 diabetes, have replaced smoking as the leading health hazards. Yet despite government and public health pleadings to eat less, move more, lose weight, the obesity and diabetes epidemics are on a tear.

Here is how the WSJ Health Blog assesses the situation:

“Editors of the Lancet didn’t mince words when they weighed in on the epidemic of type 2 diabetes — they said the fact that the mostly preventable disease has become so prevalent is “a public health humiliation.”

“Medicine might be winning the battle of glucose control, but it is losing the war against diabetes,” the authors write."

“ ‘Lifestyle interventions’ is another name for efforts to convince people to lose or maintain weight, eat a more healthful diet and get more physical activity. When people do make changes, good things can happen - even a 7% weight loss can produce much as a 58% improvement in the risk of progressing from prediabetes to diabetes.”

“It’s not like the diet and exercise message hasn’t been broadcast loud and clear, especially in the U.S. and other western countries, but public-health entreaties don’t always work. Most adults aren’t supposed to eat more than a teaspoon of salt per day, for example, but a CDC study released yesterday says only 10% of us do that. And other CDC statistics released recently show that in 2009, 29% of Americans were obese. “

Hapless Government

Why is government so hapless in persuading people to change for their own good?

I suspect the answer lies in complexity of human society and its desire for personal freedom.

In his classic The Road to Serfdom (1944), conservative economist Friedrich Hayek wrote that the economy and society are too complicated for centralized government to control and intervene at marketplace or lifestyle levels. That is why the economic stimulus package of February 2009 has failed to raise employment and why the health bill is unlikely to change patients’ lifestyles.

Hayek contended political freedom and economic freedom are inextricably linked. In a centrally planned economy, the state infringes on what we do, what we enjoy, and where we live. When the state has the final say on the economy, we need permission of the state to act, speak and write. Economic control becomes political control.

The problem with political control is that it attracts people who relish running the lives of others. Further, powerful politicians take care of their friends first and the people second.

Americans are suffering from top-down overkill. President Obama has expanded federal control of health care. By doing so, he has left fewer resources for the rest of us to direct through our own decisions. In a a free modern society, we cooperate with others to produce the goods and services we enjoy, all without top-down direction.

This holds true in everything that makes life worthwhile —when we sing and when we dance, when we play and when we pray. Leaving us free to join with others as we see fit—in our work and in our play—is the road to true and lasting prosperity.


Katherine Hobson, “ ‘Type 2 Diabetes Epidemic Called a ‘Public Health Humiliation’” Wall Street Journal Health Blog,, June 25, 2010.

Russ Roberts, "Friedrich Hayek Is Making a Comeback , “ Wall Street Journal, June 28, 2010.


salemnian said...

Excellent piece, succinctly written, says in 200 words or less what the media mavens and philosophers are at a loss to articulate clearly.

I've linked to this from PSP magazine's blog, plasticsurgerypractice dotcom slashblog

Richard L. Reece, MD said...

Thank you for your compliment. Pass it around. I am trying to get more exposure and hits on my blog.

HaynesBE said...

Well put. Thank you for this post.