A Stitch in Haste

New York is preparing to hunt down the latest public health threat — diabetics:

Conceived after a sharp rise in diabetes deaths over the past 20 years, the plan would require medical labs to report to the city the results of a certain type of test that indicates how well individual patients are controlling their diabetes.

"There will be some people who will say, 'What business of the government is it to know that my diabetes is not in control?'" said Dr. Thomas R. Frieden, the city's health commissioner.

The answer, he said, is that diabetes costs an estimated $5 billion a year to treat in New York and was the fourth leading cause of death in the city in 2003, killing 1,891.

Here we go again. What a sublime, almost artistic way to erode privacy rights — the reciprocal of the hypocrisy of sin taxes. With tobacco and similar taxes the government takes people's money to control them (i.e., they say they tax it to stop it, but of course they know they can't stop it so then it becomes "we tax it to finance the cost of dealing with it").

But with totalitarian healthcare, now the government gives money (or benefits) to control people. He who pays the piper controls the medical records apparently ("Well, since the government pays for diabetes treatment, it should have the power to minimize those costs, regardless of any privacy considerations..."). The fact that the healthcare benefits that the government provides come from the very same taxpayers who receive those benefits (in the aggregate, of course) simply reduces the state to a meddling middleman, a costly extra layer of bureaucracy and interference in private decisions and private lives.

As I blogged previously:

The government creates the moral hazard in the first place, then turns around and decries it — all the while escalating the tax-and-regulate, tax-and-subsidize, tax-and-ban, tax-and-control spiral and all the while defending the practice with Orwellian economic double-talk.

The fact that the government taxes us against our will is not a valid justification to seize, almost as if by Kelo-style eminent domain, our privacy rights just to save some money that should have been our money from the start.

The fact that diabetes is neither communicable nor the result of any moral or behavioral failure (like a sexually transmitted disease), makes the proposal all the more outrageous.

The proposal should be voted down, and challenged in court if enacted.

UPDATE #1: Welcome Catallarchy readers! Please have a look around; I hope you'll consider subscribing or blogrolling me.

UPDATE #2: Meanwhile, the city has also started a mandatory vaccination registry for schoolchildren. This may by less obnoxious than the diabetes hit list (the goal of the vaccination registry is to aid pediatricians, not health department or school bureaucrats), but still — the increasing tendency to require, by law, the accumulation by a bureaucracy of private health records is always ominous regardless of the circumstances or purported macroeconomic or adminstrative benefits.

Back in July I blogged about an atrocious plan by New York City's hack bureaucrats to require medical labs to submit blood test results to the city to track what has apparently become the latest public health crisis — diabetes.

Never mind that the sole past justification for tracking people, against their will, via their health records, was the threat of transmission — especially sexually transmitted diseases and double-especially AIDS. You can't catch diabetes from another person, so that excuse to violate privacy rights falls flat on its face in this situation.

So now we have a new justification: diabetes is "expensive." The city spends a lot on public health care related to diabetes. So the city has a "right," we are told, to track diabetics — who have committed no crime and pose no threat to anyone or anything except the city budget.

The program was quietly initiated on January 15. Which means that people are starting to find out about it. And which also means that the apologists are hard at work:

Maintaining medical privacy has become more and more expensive, both to individuals and to the public. The emerging question is whether medical privacy is a basic right or something more akin to a privilege for which those who want it should pay, rather than shifting the cost to others.

If this is the question that is "emerging," then the debate is "submerging" into a muck of illogical and un-American gobbledygook.

So now, we are told, it's not a question of physical or medical externalities, but of supposed "fiscal externalities" -- why should I be expected to pay for your medical privacy?

But this anti-privacy sophistry is built upon a contradiction. I'm not paying for your privacy and you're not paying for mine. We're all paying, through Medicare and other taxes, for our own medical privacy, and for everything else. Some pay more, granted, and some pay less. Some are net recipients of public health dollars, some are net contributors. But in the end, everybody pays for everything in our increasingly socialistic health care state, and it is therfore not legitimate for health care bureaucrats to start cherry-picking flows of funds by seeing only "diabetes money" or "obesity money" or "second-hand smoke money" or any other particular public health issue. There's just one giant ocean of taxpayer money that comes from millions of sources and goes to millions of uses.

And if that leviathan is somehow unfair or inefficient or expensive, then the answer is to rein it in, not to give it more tentacles.

And of course, if the government has a right to your blood sugar levels, can mandatory reporting of cholesterol levels be far behind? After all, statins are expensive too.

In a time when it seems as if we lose another bit of privacy with each passing day, do we really need to be embracing absurdities such as "medical privacy is too expensive"?

Privacy is a bargain at any price.

Having nothing better to do with the city's budget — like, for instance, lowering taxes — Mayor Blooperberg and his chief health fascist, Thomas Frieden, are now declaring war on baby formula:

The city Health Department is spending more than $2 million in city-run hospitals to encourage moms to breast-feed.
...
"That means getting formula out of the nursery. It means putting the baby on the breast immediately after birth. It means that every person who interacts with that mother and child is supportive and encouraging of breast-feeding[," said Frieden.]

Two million dollars per year? They couldn't just send an email to maternity ward staff? "Hey, be sure to remind them about breast feeding."

It gets worse:

Baby-formula companies have long plied hospitals with goody bags for new parents, filled with free samples and bottles. But that will come to an end[;] public hospitals will now give new parents freebies like ice packs to keep pumped breast milk fresh.

So "greedy" capitalist firms are giving away free stuff (and free baby formula is hardly equivalent to, e.g., free cigarettes), for the city to distribute to poor families — and the city will now refuse to take or distribute it? Madness. Sheer madness.

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And don't get me started on property-rights-infringing "right to breast feed" laws. Your right to breast feed ends where my property line begins.

It's bad enough when nanny staters, such as New York City health commissioner Thomas "Trans Fat" Frieden, take it upon themselves to restrict personal autonomy in the name of curtailing the costs of socialized medicine (or, worse, simply for the sake of the "public good").

But it's far worse when they conscript doctors to do their thuggery for them:

Increasingly, doctors are being called on to serve a policing role by screening their patients for society's ills. Laws have long required health professionals to report injuries from weapons and child abuse, but in recent years doctors have been asked to extend that reach to other areas.

Six states require physicians to report patients who may be unfit to drive, such as seniors hindered by illness. And although unsuccessful after public outcry, federal lawmakers tried to get doctors to notify authorities if they treated illegal immigrants.

Strange, I always thought the function of a health care professional was to provide health care, not police patrols. Going to the doctor — or the school nurse or the dentist or the optometrist or the pharmacist or ... — should be for my benefit, not the government's. A hospital is not a customs checkpoint or central booking.

If the state wants to keep incompetent drivers off the road, then it should simply require recurring driving tests as a prerequisite for license renewals, especially among high-risk groups such as the elderly. And definitely leave the hunt (witch hunt?) for illegal immigrants to law enforcement.

Government agents have no right holding my well-being — or my doctor — hostage for no other reason than to make their jobs easier.

(Via Kevin, M.D.)

"Thank God for democracy!"
--George Bliss, pedicab industry spokesperson

To elaborate: Mr. Bliss' rather bizarre and utterly myopic reaction is to the news that New York City mayor Michael Bloomberg has decided to veto a bill restricting the aforementioned pedicabs to 325. The bill, nominally the work of the hotel and theater industries, was certainly more eagerly sought by the taxi industry, and of course the current pedicab owners -- who, presto!, would suddenly have become a government-imposed cartel. Ain't "capitalism" grand?

Meanwhile, it was precisely "democracy" (i.e., unbridled majoritarianism) that created the pedicab conundrum in the first place. The bill restricting pedicabs was quite "democratic" -- as will be the legislative override of Bloomberg's veto that is generally presumed to take place.

Thank who for what?

Why should these private entrepreneurs, who generate no bona fide negative externalities and who are apparently providing a service that people are willing to pay for, be subject to a legislative ban? By what theory, other than rent-seeking and mob-rule, does a city council arrogate to itself such power? How is giving fewer people fewer options acting in "the public interest"?

When it comes to limitless regulatory control over the economy and entrepreneurship, it's not "Thank God!" but rather "God help us!"

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Bloomberg, who took a break from imposing smoking bans and trans fat bans and baby formula bans, and from pushing for stadiums and Olympics and tagging diabetics, issued the following statement:

If the public wants more pedicabs, why shouldn't the public be allowed to have more pedicabs?" he asked. "If the public doesn't want 'em, nobody's going to drive 'em because they can't make a living. So let the free marketplace decide.

How can someone be so utterly schizophrenic on matters of economic liberty?