Trans Fat Prohibitionist to Head CDC

Today President Obama appointed Thomas Frieden, New York City's crusading health commissioner, as head of the Centers for Disease Control and Prevention. Frieden, an infectious disease specialist who is known mainly as an enthusiastic advocate of New York's strict smoking ban, heavy cigarette taxes, trans fat ban, and mandatory calorie counts on restaurant menu boards, embodies the CDC's shift from illnesses caused by microbes to illnesses caused by lifestyle choices. "Dr. Frieden is an expert in preparedness and response to health emergencies," Obama said today, "and has been at the forefront of the fight against heart disease, cancer and obesity, infectious diseases such as tuberculosis and AIDS, and in the establishment of electronic health records." Some of these things are not like the others. When it comes to justifying the use of force, there is a crucial difference between health risks imposed by others (such as bioterrorists or TB carriers) and health risks that people voluntarily assume (by smoking or overeating, for example). In the former case, even those who believe that government should be limited to protecting individual rights can see a strong argument for intervention; in the latter case, intervention can be justified only on paternalistic or collectivist grounds. Frieden either does not recognize or does not care about this distinction. Consider this anecdote recounted by The New York Times:

Dr. Alfred Sommer, emeritus dean of the Johns Hopkins Bloomberg School of Public Health, who was on the team that recommended Dr. Frieden as New York's health chief in 2002, recalled interviewing him shortly after the Sept. 11 attacks. Dr. Frieden had flown to New York from India, where he was living and working on tuberculosis control.

Before he left India, he was asked about his top priority, Dr. Sommer said. "Oh, well, that's easy, Al," Dr. Sommer recalled him replying. "Tobacco. Tobacco is killing more people, and that's my top priority."

"Tom, I don't disagree that tobacco is a real scourge, but have you heard of 9/11?" Dr. Sommer said he countered.

"Of course I know about that, but bioterrorists are not going to kill more New Yorkers than tobacco is," Dr. Frieden said.

For contemporary public health officials, it's all about the numbers. The aim is to minimize total morbidity and mortality, whatever their cause. This calculus leaves no room for freedom of choice.

More on Frieden here. In "An Epidemic of Meddling," a 2007 Reason article, I explored the totalitarian logic of public health, a major theme of For Your Own Good, my book on the anti-smoking movement. 

Comments

[FrBunny]

I hope his kidneys fail.

[JB]

Someone should start following him around and videotape what he eats.

[Ska]

Very scary to see this guy up on the national stage.

I can't wait until we're eating protein enriched gruel 3 times a day, for healthy balanced diet.

[Episiarch]

He probably takes Vicodin like they're pez.

As an aside, it's absurd that House takes Vicodin and not Norco. The amount of acetaminophen that he consumes by taking Vicodin as opposed to another, reduced acetaminophen brand would give him liver toxicity in no time.

[Anonymous]

Food Nazis? In my CDC?

[Pro Libertate]

Shouldn't the CDC be focusing on bacteria and viruses? And maybe a fungus or two?

The whole point of the CDC is to track and help coordinate responses to epidemics, right? Yeah, the idiots talk about an obesity epidemic, but it's not like people get fat when someone sneezes at them. It's also not like the medical community or the media promote fatness, either.

[The Angry Optimist]

Uh, Epi, correct me if I'm wrong, but Norco is 325mg acetaminophen and Vikes are 500...that much of a difference?

[Kyle Jordan]

This entry, Gillespie's, and Welch's are fucking up my weekend. I expect to come to Reason on Monday mornings and be depressed but usually Fridays are a bit lighter. Damn. Oh well, it's nothing a bucket of fried chicken won't fix.

[Episiarch]

Norco is 325mg APAP to 10mg hydro, whereas Vicodin ES (which is what House takes) are 750mg APAP to 7.5mg hydro. It's 3 times the APAP for the equivalent hydro. Way too much for his liver.

[!]

JB,

Someone should start following him around and videotape what he eats.

Somehow I think any 'stalker' law on the books would be enlisted to stop that.

[JW]

Shouldn't the CDC be focusing on bacteria and viruses? And maybe a fungus or two?

Or, you know, maybe MRSA or some other man-made scourge that could do us in one day. But, where's the fun in that? That's what lab technicians are for, not Olympic gods like Frieden.

This is just further evidence of just how incredibly wealthy we are as a people. We can now afford to ignore infectious diseases and, with a nasty Victorian streak, focus on unpopular or unsavory personal habits.

All of the big problems have been solved. Now it's time to fritter away at the edges and redefine mission statements to justify their existence. Up next: SWAT teams to enforce CDC mandates.

[FrBunny]

it's absurd that House takes Vicodin and not Norco

Since he's actually taking them (ostensibly) for pain management, the APAP would be important. I'm still pretty sure you're right that he'd be way dead by now though.

[JW]

For a president who promised to not get bogged down in ideological politics, Obama is going out of his way to make sure that every critical post in his administration is filled with nanny-state extremists.

[Pro Libertate]

Next time I need pharmacological advice, I'm going to Episiarch.

Apropos of nothing, when I was in Cabo a few years ago, I went to a Mexican pharmacy. Everything was OTC, as far as I could tell, because there were hundreds of what we'd call prescription medications just sitting out on the counter. Whoa.

[FrBunny]

In Mexico, C-II through C-IV substances are still prescription-only, which is most of the fun stuff. Non-controlled meds are OTC.

[Episiarch]

Since he's actually taking them (ostensibly) for pain management, the APAP would be important.

Not really. The synergistic effects of the APAP with the opiates are weak at best. They put the APAP in there to "stop abuse", which is an amazingly sick thing to do--they've designed it to essentially poison you if you take too much Vicodin.

In reality, House would be taking Oxycontin, and a shitload of it because he'd be heavily tolerant at this point. I knew people who were taking 80mg of Oxy per day, up from initial amounts of 10 or 20.

[FrBunny]

Next time I need pharmacological advice, I'm going to Episiarch.

Seconded.

[Paul]

Let's say for a minute, that we ban tobacco, and no one smokes. Fatty foods are taxed, salt reduced by Federal fiat. Everyone wears 5 point harnesses in their electric vehicles, helmets on their hybrid scooters.

Something will still be "the biggest killer" in this country. What will be the response from people like this?

[Citizen Nothing]

"What will be the response from people like this?"

Ban 5-point harnesses and replace them with the much safer 6-point harnesses.

[Citizen Nothing]

And only union-made hybrid-scooter helmets.

[JW]

What will be the response from people like this?

Ban hybrid scooters. Those things are death machines!

[Bronwyn]

Ban all motorized vehicles and make everyone walk.

With a 3mph speed limit.

[Citizen Nothing]

Bubble-boy bubbles for everyone!

[Citizen Nothing]

But not those unsafe, non-union bubbles.

[Episiarch]

I'll do NutraSweet's job since he's away and recommend With Folded Hands in this case.

What will be the response from people like this?

This isn't a slippery-slope. This is a bottomless pit.

These people see humanity as a danger to itself, so they are determined to remove all harmful tools -- social organization, weapons, food, hands.

[Citizen Nothing]

Dateline, 2021:
The U.S. government today announced it would spend $300 billion researching ways to increase the safety of bubble-boy bubbles, which today are the leading cause of death for Americans.

[Citizen Nothing]

Thanks, Epi. Nice recommendation.

[!]

Is it odd that Naga and SugarFree are both absent today?

[Citizen Nothing]

I've never seen them in the same room...

[WWJGD]

MSNBC, 2021
We still sorely trail behind the Europeans who have reduced the official illness and injury rate to 0% by shoveling all their citizens into furnaces.

[prolefeed]

As an aside, it's absurd that House takes Vicodin and not Norco. The amount of acetaminophen that he consumes by taking Vicodin as opposed to another, reduced acetaminophen brand would give him liver toxicity in no time.

I think the writers on the show felt they had to have House use a drug that most viewers would have heard of, a rare but arguably necessary dumbing down of an otherwise extremely smart show.

[James Anderson Merritt]

"Frieden ... embodies the CDC's shift from illnesses caused by microbes to illnesses caused by lifestyle choices."

So can a name change be far behind? "If you liked us as the CDC, Centers for Disease Control, you'll LOVE us as the CLC, Centers for Lifestyle Control!" /jazz-hands.

[The Angry Optimist]

In reality, House would be taking Oxycontin

Well, in reality, he'd be on smack or methadone, but they did that plot point already, so alas...

[Tonio]

All of the big problems have been solved. Now it's time to fritter away at the edges and redefine mission statements to justify their existence. Up next: SWAT teams to enforce CDC mandates.

JW wins the thread.

[The Bad-Idea Fairy]

Given that lifestyle choices are the number 1 killer, and that this costs the taxpayer millions every year, why don't we subsidize gym memberships?

[Paul]

CDC Memo:

When blogging on Hit & Run, it is recommended that these gloves be used for hand safety.

[Paul]

Up next: SWAT teams to enforce CDC mandates.

Except the 5th circuit fucked that up. No SWAT teams for regulatory searches.

[The Bad-Idea Fairy]

I propose a bill that shuts down businesses between the hours of 3PM and 4PM, for the purposes of an "Employee Exercise Hour". Graveyard shift businesses will have the same requirements, only it will be from 3AM - 4AM.

[!]

No SWAT teams for regulatory searches.

Then a new name is in order.

[The Angry Optimist]

Not to rain on your parade, Paul, but the no SWAT use extends only to those jurisdictions under the Fifth Circuit. And god help us all if there's a circuit split on the issue.

[LarryA]

Given that lifestyle choices are the number 1 killer, and that this costs the taxpayer millions every year, why don't we subsidize gym memberships?

Once again, it isn't the folks who make lousy lifestyle choices, get sick, and die that cost the big bucks. It's the folks who stay healthy, so they spend 40 years on Medicare and Medicaid ends up paying bundles for ten years in a long term care facility between the age of 95 and 105.

If you really want to cut health care costs, pass out free non-filter cigarettes in junior high school. (Note I'm not advocating we actually do such.)

[William]

What's next? Appointing the head of MADD as highway safety czar?

[!]

What's next? Appointing the head of MADD as highway safety czar?

That was last, but he was not pure enough for the Obama White Castle.

[J sub D]

What's next? Appointing the head of MADD as highway safety czar?

That was last, but he was not pure enough for the Obama White Green Castle.

Service provided at no charge.

[Buffalo Bill]

Oh Say Can You Smell?

"You know--" said Eliot, "Kilgore Trout once wrote a whole book about a country that was devoted to fighting odors. That was the national purpose. There wasn't any disease, and there wasn't any crime, and there wasn't any war, so they went after odors."
. . .

"This country," said Eliot, "had tremendous research projects devoted to fighting odors. They were supported by individual contributions given to mothers who marched on Sundays from door to door. The ideal of the research was to find a specific chemical deodorant for every odor. But then the hero, who was also the country's dictator, made a wonderful scientific breakthrough, even though he wasn't a scientist, and they didn't need the projects any more. He went right to the root of the problem."

"Uh huh," said the Senator. He couldn't stand stories by Kilgore Trout, was embarassed by his son. "He found one chemical that would eliminate all odors?"

"No. As I say, the hero was dictator, and he simply eliminated noses."
(page 156) God Bless You Mr Rosewater

[Mango Punch]

Pro Liberate, you might be surprised that someone sneezing on you suposedly does cause obesity

[The Angry Optimist]

Mango - WTF??! I mean, is that shit made up? I was hoping for an early April Fool's Day joke, but no luck.

[libertarianjim]

...And you'll work harder
With a gun in your back
For a bowl of rice a day...

[Wicks Cherrycoke]

Liberal Democrats like Barack Obama give me high blood pressure. Can we outlaw them too?

[Carol]

Jacob Sullum refuses to criticize the health fascists' scientific fraud, of deliberately using studies based on nothing but lifestyle questionnaires which ignore the role of infections, in order to falsely blame smoking and lifestyle, etc.

That line about "CDC's shift from illnesses caused by microbes to illnesses caused by lifestyle choices" ENDORSES our enemies' scientific fraud.

People like him are actually worse than useless, because the only thing they accomplish is to help our enemies pretend they present both sides of the issue, when they do not.

[Citizen Nothing]

MMMMMM.
O-Kay...
(backs slowly away from the monitor...)

[Anonymous]

Jacob Sullum refuses to criticize the health fascists' scientific fraud, of deliberately using studies based on nothing but lifestyle questionnaires which ignore the role of infections, in order to falsely blame smoking and lifestyle, etc.

That's a completely valid thing to criticize. However, if the had no authority, all it would amount to is customers leaving them.

Not to downplay how bad these departments are doing their jobs, but they shouldn't be departments of the government at all.

[TrickyVic]

"""That line about "CDC's shift from illnesses caused by microbes to illnesses caused by lifestyle choices" ENDORSES our enemies' scientific fraud."""

Enemies? What does Al Qeada have to do with this?

[Carol]

By "enemies," I mean the American Cancer Society et al. and its mass media propaganda organs. All of this is happening because they lied and lied and lied and lied, and never told the truth even once. And then for the so-called "criticism," they give us an ignoramus whining about "nannyism." It's all a systematic campaign of fraud and deceit.

[I Digress]

There is usually little benefit in using doses of codeine phosphate above 60 mg per dose. Higher doses may lead to agitation and eu/dysphoria

eu/dysphoria

eu! eu! eu!

[alan]

I think the writers on the show felt they had to have House use a drug that most viewers would have heard of, a rare but arguably necessary dumbing down of an otherwise extremely smart show.

The existence of Thirteen has dumbed it down. I've said before, I thought her character was meant to be a shot at the truly stupid, Grey's Anatomy, but unfortunately, that is not the case.

The chick who plays Thirteen should be playing House's favorite stripper at his favorite strip joint, and be no where near a patient's diagnostic review.

However, Linda Edelstein, I like her bedside manner, boo-iiin-gg!!!

[skr]

Thank you libertarianjim

That made me smile. Jello really started me on the lib road.

[Carol]

Here's what the "pro-freedom" crowd told the anti-smokers:

It's "freedom versus public health (but there's nothing wrong with the science).
It's nannyism! (but there's nothing wrong with the science).
It's bad for business! (but there's nothing wrong with the science).
It's a slippery slope (but there's nothing wrong with the science).
It violates property rights (but there's nothing wrong with the science).

Public health is the justification for numerous laws and regulations. But unlike legitimate regulations, smoking bans are based upon deliberate and flagrant fraud. By refusing to expose the anti-smokers' deliberate and flagrant fraud, the despicable traitors who pretended to be "for freedom" ensured that the balance was wrongly tilted in favor of the anti-smokers. And THAT is how the anti-smokers won their smoking ban fights!
And now, because the cringing, cowardly "pro-freedom" traitors let the anti-smokers get away with their scientific fraud, the rest of the health fascists now feel even more arrogant about launching a blitzkrieg against all the rest of our personal liberties.
Those "pro-freedom" phonies should all be drowned in a bucket full of spit!

[Robert]

the CDC's shift from illnesses caused by microbes to illnesses caused by lifestyle choices

...is an example of the sort of thing I'm seeing all over the place in gov't policy, past & present, that I call "dragging the pivot foot". A policy is accepted on one ground, and then society (the referee) forgets that was the pivot foot, fooled into thinking the other foot was. Do it enough times, and you've walked the ball into completely different territory. You just have to do it slowly enough that enough people forget the original basis for the policy.

[Drew]

I live in New York City. Since restaurants in the past used trans fatty acids in their food to cut costs, their food then tastes exactly the same as it would otherwise but would put your health at risk to a much higher degree. Residents of lower-income neighborhoods are the ones most at risk, as they have less access to healthy foods and are more saturated with fast food joints-- you can think of it as putting poison in your food to save money, and it's impossible to know who is or isn't serving it. Everyone has benefitted from the ban here. To call it an assault on freedom sounds much more like rigid ideology than common sense.

[Carol]

"the CDC's shift from illnesses caused by microbes to illnesses caused by lifestyle choices"

It's deliberate, knowing scientific fraud. They deliberately use defective studies, which are based on nothing but lifestyle questionnaires, and ignore the role of infections, in order to manufacture a fraudulent pretext to tyrannize over our personal lives. The Harvard School of Public Health and the American Cancer Society are guilty of creating and perpetrating this fraud. And Congress refuses to do anything, in large part because nobody protests it. And, when phony defenders of freedom like Jacob Sullum refuse to question it, they're helping the health fascists get away with it.

[KD]

Drew said: To call it an assault on freedom sounds much more like rigid ideology than common sense.

I see your point, however, no one is forcing anyone to eat fast food. If one desires to avoid trans fats, one doesn't have to eat out at restaurants. There's no fundamental right to eat at a restaurant, so there's no need to regulate the types of fats they can serve.

Plus then it goes back to the whole, 'I said nothing but then they came for me' thing. If that ball gets rolling of banning trans fats, who knows what the government will deem worthy of banning next? Maybe your favorite food will be deemed unhealthy and, instead of just taxing it, they'll ban it. It's just a bad idea in general to ban things if it's easy for people to avoid them, should people desire to.