The United States Constitution is no public health handbook, though recent health reforms suggest otherwise. Attending to the 50 million uninsured, we invoked Article 1, Section 8, Clause 3—the commerce clause—which affirms Congress’ power to regulate interstate commerce. Matters of health reform efficacy and cost-effectiveness, as a result, were muted by debates over governmental reach. Cries for sacred rights and freedoms, buoyed up by misguided fears of having broccoli stuffed down our gullets, grew loudest. Now, as New York Mayor Michael Bloomberg’s notorious soda ban faces official scrutiny, dissenters are rehearsing their Fifth Amendment rights—which ostensibly secure life, liberty, and property, but in this case, many hope, prohibit government from shrinking our Slurpee. This is our body on politics; freedom will be preserved at all costs.
And even if those costs add up. Every year, $168 billion is spent on obesity-related treatments. Will New York heed that price of freedom?
When the ban was proposed, New Yorkers were undecided about what it meant for their freedom. Asked whether or not the ban constituted “nanny government,” 43% said it did, while 43% said it did not. Today, there is no question that freedom—not health—is the issue at stake. At the Million Big Gulp March, a recent protest against the ban, a City Council member voiced concern for the “principles on which our country was founded.” The soft-drink industry, in response, now hopes to harness public outcry in an effort to bolster such re-framing of the issue.
Coca-Cola and other soda companies are insisting that we avert our gaze of our collective bulge. “This is about protecting our freedom of choice,” the latest advertisement cried. Such efforts may rally citizens to the July 24 public hearing, when the Board of Health will consider the ban. Howard Wolfson, a deputy mayor, scoffed at attempts to sway public consensus. Health experts, he affirmed, “will be influenced by science, and not any PR campaign.” So one would hope; but the politicization of health is an insidious affliction.
Already the conversation has departed from fact. Nearly 1/5 of U.S. medical expenditures are spent treating obesity, a modern epidemic spurred, no doubt, by slurping more sweet fizz than the human stomach is capable of bagging. Treating an obese person ($2,826, annually) costs 50% more than treating a non-obese person ($1,840). The implications, which the soda industry eschews, extend beyond free choice: more medical care means less working hours, costing employers $6.4 billion annually in lost productivity, dragging down hiring and wages in an era of fiscal constraint. Even the healthy obese run a tab, burning $4 billion more gasoline, thus reinforcing dependence on volatile, foreign oil.
Soda industry clamor is helping re-frame the ban as a matter not of fatness, but freedom. The Constitution is again being invoked for our health. If freedom really is at stake, we must question whether life, liberty, and the pursuit of happiness are endowed unconditionally—whether free choices incurring a grave societal cost are worth fighting for.