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January 02, 2006



Re: "Civil libertarians bitch and moan about smoking bans, but they work. And for those of us non-smokers, they make going out a much more pleasant experience. Public health is getting more attention, especially in relation to preventable illness and its effects on rising health care costs."

Nice language Kate. Regarding public health, civil liberties, and healthcare costs, what do you make of New York's new public health initiative to track diabetes patients by compiling a data base detailing info about citizens with the condition? (1)

According to the AP, "the policy breaks new ground because it involves the collection of information about people who have a disease that is neither contagious nor caused by an environmental toxin."

The health commissioner sites the number of lives the program could save, and saving lives is great, but that doesn't justify it as a "public" issue. Clearly the rationale is driven by cost concerns-which, under current payment structures, are largely public-not infection concerns.

Remember that obesity, as the public health machine has made us poignantly aware, is a major cause of diabetes and that lifestyle choice plays an important role in maintaining weight.

Therefore, if it would help contain costs, should public health officials also compile data on the lifestyle choices that contribute to weight and thus obesity, by tracking resteraunt purchases in the city and perhaps cross checking them for calorie content? What about other costly but non-communicative health conditions? Cervical cancer comes to mind. Would you object to a government database detailing the personal information of women with cervical cancer? And if not what's the difference?

I believe public health officials should consider how some policies affect civil liberties, but I might just be %@*!$ing again.



Excuse me, but where did I give opinion about obesity or New York's program to track diabetes? All I mentioned is smoking bans. And smoking bans work.

Should civil liberties be considered in instituting policy? Absolutely. But as far as smoking bans are concerned, they make public environments a lot more comfortable for the majority of the population (who does not smoke) while reducing the number of smokers, and thereby reducing health costs.

I've never advocated for following people's eating habits or punishing obese people.

So yes, you can bitch all you want, but you're making a straw man.


If you think issues of civil liberty in public health are important then address them and their supporters as if you take both seriously.

Leaving out profanity would be a good step toward substantive discussion.


Man, fuck that shit.


Hi Ezra.


I do take the issues (and their supporters) seriously, I just don't appreciate your spurious accusations which aren't relevant to what I said in my post.


Hey Tom -- how's it hangin?


Re: "I just don't appreciate your spurious accusations which aren't relevant to what I said in my post."

Kate, I was responding to what you wrote here...

"Public health is getting more attention, especially in relation to preventable illness and its effects on rising health care costs."

The cost concern argument you make is the one used by supporters of the NY diabetes program: diabetes must be tracked because it is a costly, preventable disease. And according to the AP article I site, this has "raised privacy concerns in some quarters."

Since you use a civil liberties discussion ("...Civil libertarians b%*ch and moan about smoking bans") to segue into the the role of public health in cost contaiment, I thought it was relevant to discuss a new public health cost-containment program with civil liberty implications.

But I'm not accusing you. I know you don't believe in punishing obese people. The comment was a "slippery slope" argument, not a spurious straw man parade-though that would be a fun addition to Thanksgiving day parades :).


You know Kate, the more I think about it, the more I like the idea: let's write an NIH grant proposal together for funding of the inaugural, annual "Spurious-Health-Policy-Straw-Man Parade." I am positive that many, of all political pursuasions, from within the public health discipline will be able to contribute. Ezra can help us if he wants, but only if he behaves.


That's the best idea I've heard in a long time.

I think we should actually try and get the FDA to give us $$ because this seems more down their alley.

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