The New England Journal of Medicine has published, today, a few leading articles on the subject of child obesity, especially its implications for heart disease and the costs thereof to society. For more on childhood obesity, see my previous post.
The Journal pontificates on the subject and calls for action:

Unfortunately, the U.S. government has thus far invested only a fraction of a cent in research for every dollar that obesity costs society. And although broad consensus exists regarding the dietary and lifestyle habits needed to prevent and treat childhood obesity, we lack anything resembling a comprehensive strategy for encouraging children to eat a healthful diet and engage in physical activity. Such a strategy would include legislation that regulates junk-food advertising, provides adequate funding for decent lunches and regular physical activities at school, restructures the farm-subsidies program to favor nutrient-dense rather than calorie-dense produce, and mandates insurance coverage for preventing and treating pediatric obesity.

In other words, what it is saying is that the responsibility for some kids becoming fat should be shared by all of society, and that no kid should be exposed freely to a Macdonald’s burger or French fries. Not even an ad of the same.

It is, therefore, suggesting that tax money be spent on providing nutritious lunches in schools, and providing gyms and playgrounds for the kids. In addition, it is advocating insurance for all kids. The question I have for the learned journal is: Who is going to pay for it? And why?
Can one dare ask the high-and-mighty Journal, “What gives you the right to assume that State-funded care is all that is possible to tackle healthcare issues? As far as the issue of taxing people for these services, may I ask: By what right?”
What gives an obese kid (or anyone else, for that matter) the right to be a recipient of a part of my hard-earned money, unless I choose to do so?

The Journal assumes a Socialist position on healthcare rather casually.

Elsewhere in the same issue, it thunders on the cough preparations for children (that have been scientifically proven to be useless) and calls for banning them or, at the least, banning the ads. In other words, if your child has a persistent cough, and you want him or her to just take a bit of cough syrup and sleep it off, you don’t have the right. They have the right to stop you. You, the user, can do nothing. You see, you don’t have the brains to know which is good for your kid, or which ad to believe and which one to dismiss as crap. The Government will do this thinking for you.

To get back to the issue of child obesity, the most important things are for each of us to choose consciously what we need to do: watch less television, avoid junk food, and play or work out every day, for example. I accept that all this is easily said, but not done. The responsibility and the outcome squarely rests on the individual, his parent and his doctor.

The NEJM would have none of this. It would want everyone to be deprived of their choices (ads and junk food) just so that some of society would benefit. It is a moot point if any of these interventions will ever work on a large scale in society.
It gets shrill as it raises its political voice:

But why should Mr. and Ms. G.’s efforts to protect their children from life-threatening illness be undermined by massive marketing campaigns from the manufacturers of junk food? Why are their children subjected to the temptation of such food in the school cafeteria and vending machines? Why don’t they have the opportunity to exercise their bodies during the school day? And why must Mr. and Ms. G. fight with their insurance company for reimbursement to cover the costs of their children’s care at the OWL clinic?

Hello, did we hear right? We are all subjected to temptation. I want to be subjected to temptation: do I have a right or not? The NEJM says no, because temptation is bad for kids, at least some kids.

Isn’t a defence against rape to the effect that “she tempted me, it wasn’t my fault!”? So where is the concept of free will here? Where is the parental or school responsibility for the health of the children? Who, gentlemen, are going to pay for those ‘opportunities’ that you demand?

Every modern health problem seems to inspire Statist solutions, irrespective of the fact that State control in anything has not worked anywhere as well as capitalist solutions. Unfortunately, people living in First World countries and occupying prestigious chairs in the NEJM have not (possibly) seen the ground reality of Socialism in healthcare. They need look no further than India.

I wish to ask one final question to the Editors of the NEJM: Is the NEJM a leftist journal mag?

9 responses to “IS THE NEJM A LEFTIST MAG?

  1. It’s no big secret that the US government’s been spending its taxpayers’ dollars inappropriately. Just try asking George to put aside some Iraq money for childhood obesity. Try asking all the normal-weight people in Congress, for that matter!

    About the cough syrup: I agree, it’s getting quite ridiculous. Every time someone buys pseudoephedrine, their license is scanned and the quantity purchased is recorded in a national database (and restricted by federal law). Now you have to be 18 to buy dextromethorphan.

    Don’t get me started on the recent recall of infants’ and childrens’ cold remedies. (The dosage on the back was correct, but parents were killing their children because they can’t read.)

  2. This is a tough one for me, Rambodoc, because I’m no longer certain where I stand on the concept of free will — especially when it comes to today’s sophisticated marketing. And even more especially when it comes to marketing to kids.

  3. Farming the government is one of the best business models in the USA. I wonder how many unemployed nutritionists, sports instructors, medical insurance companies, farmers (how could you forget to boldface farm subsidies, doc?), not to forget the unelectable liberal politicians, contributed to this article in NEJM.

    The only way to stop our tax dollars disappearing into the twin black holes of war and welfare is to pass a constitutional amendment to reduce taxes to zero. As a side benefit, it will also reduce private campaign expenditure to a minimum!

  4. Always liked this quote from Rene Dubos:
    “In the words of a wise physician, it is part of the doctor’s function to make it possible for his patients to go on doing the pleasant things that are bad for them – smoking too much, eating too much, drinking too much – without killing themselves any sooner than is necessary.”

  5. TRF:
    Thanks. I should mention here that I am unable to comment in your (excellent) blog because of technical reasons.
    Paul: the fact that you no longer certain about where you stand on free will is itself a demonstration of the free will.
    Bancheese: thanks.
    Aos: Welcome to the blog. Very witty quote!

  6. Just a few quick thoughts, Doc: free will is a valued concept, but I think the exception is public health. We would be horrified if there were a measles outbreak. The Centers for Disease Control would descend and assure gaps in immunisations filled. They are working on the childhood obesity issue as well, but that one is far more complex.
    Still, it is a budding public health issue – our practitioners are already seeing things you described: things not historically seen often in children: joint pains, diabetes, etc.
    A generation raised on super size portions and junk food — well, it makes it harder to put that genie back in the bottle. We have made some efforts at health fairs and the like, one person at a time….one of my fave tactics is showing a bowl of sugar – the content in ONE can of soda.
    Communities also need to be restructed so that ‘mercans can live, work, school, shop, go to clinics all within walking distance.
    The fight for obesity will not work because it has to be a lifestyle. Chomping at the bit to add more, but gotta run. Thanks!

  7. Jackie, in the midst of all this, bariatric surgeons and the companies making stuff for them are having a great time!

  8. Doc, the nanny state you fear, with regulation of ads may not be the right tactic, but please let me report from the field: we are FAT society!
    And it disproportionately affects the poor. I don’t know if regulating advertising is the right thing to do… but the NEJM is hardly a leftist rag. This is a serious public health issue. The poorest – who receive Medicaid, Medicare, etc (govt health insurance) —well, either way you gonna pay (you, meaning taxpayer).
    So whatever prevention and educational tactics we can use, will help the greater good. I assure you, funding for obesity education and prevention will pay off for the average taxpayer far more than the investment.
    We have gone backwards in this country (USA), from one where healthy (or at least less yummy) foods were served in schools, and where advertising and junk food marketing was off limits. You had to participate in physical education. Not anymore.
    Somewhere this stopped, and sodas/fast food became so cheap, it is easier to feed your children more and more for less and less cost.
    If obesity were infectious/contagious, we would be all over it. It pains me to see children with type 2 diabetes, hypertension, and other afflictions of obesity.
    It is a serious public health issue, and not easily addressed in your typical 15 or 30 minute physician encounter or well child check.
    We conduct health fairs, and the like, but there is little money for nonprofits to enable tools, handouts to give to attendees.
    Either way, we will pay. Even the more educated and well-off parents struggle, athough their children tend to be of normal weight.
    I don’t know what the line is, but this is a public health problem that will balloon, and will cost us dearly in the long run.

  9. Thanks for the comment, Jackie!

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