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Public health is on the ballot this Election Day

The election I am going to watch today is in San Francisco. On the ballot there is Proposition E, an initiative to add a 2-cent tax for every once of sugary beverage. Choose Health SF, a group supporting the tax, estimates it would raise $54 million, which would go towards, get this: “funding active recreation and nutrition programs in San Francisco public schools, parks, and recreation centers; food access initiatives, drinking fountain and water bottle filling stations; and dental health services.”

The other side effect of this tax would be a decrease in consumption of sugary beverages. Some estimates say by up to 31%. That’s a lot fewer calories being ingested, and hence, a lot more public health.

I know taxes are a polarizing topic.

Credit: HighMark Foundation
Credit: High Mark Foundation

But obesity is different. It is serious. Our fatness is killing us, literally.

Some argue such beverage taxes are regressive, eg, they hurt the poor more than the rich. To that I respond, obesity is hurting the poor more than the rich. Obesity in America is regressive.

I don’t get sugary beverages. The massive doses of sugar in these artificially-colored drinks causes spikes in insulin. Insulin then promotes fat storage and arterial disease. The NPR Salt blog recently ran a story about labeling high-calorie drinks by how much exercise it would take to neutralize the sugar. A 110-lb adolescent, for instance, would need to run 50 minutes to burn off a typical 250-calorie soft drink.

I see obese patients every day. I see their heart disease and atrial fibrillation. They tell me about their joint problems, their immobility and often about their complications from diabetes. What fatness does to the human body is nothing less than sad. Do fat men (or boys) actually know their fat cells are churning out estrogen, which has the effect of transforming them into women?

Racing bikes on the weekend provides a striking contrast. Cyclists, especially young ones, are beautiful to watch. I often think to myself: this is how a human body should be. Then I go to work on Monday and see the ravages of excess calories and immobility. Sad.

Of course I realize taxation is politically charged. Millions of dollars are lining up on both sides of the issue. Big corporations are behaving just as you would expect in a capitalist system–they are protecting their self-interest. Soda companies aren’t charged with public health; their job is to make money. This is normal. It’s our system.

We let government set rules about driving, alcohol, car seats and education. We do so for the greater good, to protect the children and the less fortunate.

I write in favor of this tax as a witness from the front lines of public health. It’s really bad here. The people need help.


8 replies on “Public health is on the ballot this Election Day”


Do you really truly believe that any tax revenues the govt receives if this tax passes will actually be earmarked for what they say
Will it end up in the general treasury to be spent by the politicians special interests on other political issues?

People do not need a spanking from a govt they trust less and less every day. They need leadership from communities and health professionals to teach, teach and teach some more about the health dangers of sugary beverages.

Problem with govt taxes based on health issues is that we often later find out we were wrong on the issue.

One European country had a butter tax as they were fearful of fat. Sorry but studies about natural fats causing harm are extremely weak.

I will end with saying that all govt bills/propositions are started with special interests in mind. You generally have to figure out who truly gains and loses $$ with each outcome to see who is behind it.

Good points. Thx for writing. A couple of things: 1) I’ll invoke the Charles Barkley rule–I may be wrong but I doubt it: I don’t think future research will ever show that any dose of Big Red promotes health. 2) Does it matter who wins if the greater good is served, eg, people consume fewer empty calories.

I usually roll my eyes when doctors start talking about nutrition. I became an adult in the 80’s and look where nutrition has gone since then. I am aware that it was the food industry and the government and not doctors who set those nutrition guidelines. But it was doctors who were doing the preaching. I have to agree with Dr. John with this one. No one is going to be hurt by consuming less sugar.

I have a real problem with taxes on some product that are detected to “fix a problem” that product causes.

It sends a mixed message.

Does the community was recreation programs and school nutrition programs OR does it want to decrease the use of sugar drinks.

And the drinks are not the only cause of obesity. And the tax would not affect diet drinks which apparently are just as bad.

Well it’s official. I kind of suspected you were a hardcore liberal and this post confirms it.

You’re crazy if you think 2 cents is going to discourage anyone from consuming less sugary drinks. Mark my words, it won’t happen. You’d have to double the price of these drinks to even begin discouraging their use…which I’m sure you’d be in favor of.

Why is it liberals always think government knows better? The majority of our problems today start in the home – with two parent households leading the charge. That is also where they will be solved – NOT by government.

But if you really believe it’s the government’s role to babysit its citizens and play the role of mom and dad, and if you think obesity hits the poor more than the rich, then why not change the welfare rules. You can no longer use your food stamps on junk foods. That would do more good than a stupid 2 cent tax.


( )
The Economic Way of Thinking about Politics
12/03/07 – Russell Roberts at Econlib
=== ===
[edited] Politicians find it hard to do the right thing, like the rest of us. They claim to have principles, but they often find a way to justify their self-interest when their principles clash with what is expedient. They are sure to explain that it was all for the children, or the environment, or the good of society.

Bruce Yandle uses bootleggers and Baptists to explain what happens when a good cause collides with special interests. The Baptists rejoice when the city council bans liquor sales on Sundays; it is wrong to drink on the Lord’s day. The bootleggers also rejoice; it increases the demand for their services.

The Baptists give the politicians cover for doing what the bootleggers want. No politician says we should ban liquor sales on Sunday in order to enrich the bootleggers who support his campaign. The politician holds up one hand to heaven and talk about his devotion to morality. With the other hand, he collects campaign contributions, bribes, from the bootleggers.

Yandle says that virtually every well-intentioned regulation has bootleggers along for the ride, special interests who profit from the idealism of the activists and altruists.
=== ===

As for new taxes, note the long list of interests who will get the tax money, but obesity will not be affected. We don’t know why childhood obesity has increased or how to greatly reduce it. Obesity is only a label to justify another sin tax to support politicians and the companies they start to collect the new tax money.

Ulcers used to be blamed on spices and chocolate. The cause is now known to be genetic differences and infection by H.pylori. Obesity will eventually be understood, and it won’t be the availability of sugary drinks.

In the meantime, tax who you can. The people are dumb, you are smart, and telling people what to do is fun, especially when backed by power.

Today is a day of politics. As a write this with Obama on the radio in the background discussing how republicans and democrats can possibly work together and get something done, I am wondering what if our political system functioned like the medical decision is SUPPOSE to. What if they too utilized evidence based facts to support their claims and legislation. What if it was a system where it is not either a democratic idea or republican idea and instead just a good idea, based on research. Retrospective political research is available for analysis all over. Got a controversial issue like legalization of marijuana, look at Colorado, there is much to be learned from it, whether good or bad for the nation. It would be so nice if we had some prospective political research. What if the political system allowed for experimentation with facts? Take the fact that obesity is linked to sugary drinks. Why not perform a study in any city U.S. to see if taxation leads to reduction in it’s consumption. It certainly seems plausible. Point is we need to try something new. Arguments over Obamacare are likely to surface again soon given the changed political landscape. My argument is healthcare is not fixable without fixing ‘health’. We have been taking wrecked cars to the body shop and an alarming rate in this country. Fact is Obesity is not cheap, yet a 2 cent tax on an ounce of soda is. Why not try it, somewhere?

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