Shall we have a Nanny State or an Unrestrained Corporate Empire?

As Michael Bloomberg leaves the mayoralty his health legacy is bitterly contested. During his three terms in office he sought to remake the city, shaping decisions on diet, tobacco, physical activity, and firearms (see Table). Many of his policies have served as models nationally (and even internationally) such as posting calories (adopted in the Affordable Care Act), the trans fat ban (proposed by the FDA), and smoke-free public places (now in most major cities). Over 20 food companies adopted his voluntary salt-reduction guidelines. But, Bloomberg’s policies have also drawn the ire of vocal critics and sometimes the rebuke of judges.

Two controversial moves came just as he was leaving office—a portion limit on sugary drinks and a tobacco purchase age of 21 years (the highest in the nation). The courts struck down the portion limit, but the case is now on appeal to New York’s highest court. And critics expressed amazement that an 18 year-old can drink alcohol, drive a car, and enlist in the military, but now cannot buy cigarettes in New York City. (See my essay in the Hastings Center Report http://www.thehastingscenter.org/Publications/HCR/Detail.aspx?id=6536).

The public broadly accepts the exercise of infectious disease control powers, for example, to stop the spread tuberculosis, SARS, or novel influenzas. But they often bristle at the “new” public health, aimed at the growing obesity epidemic—causing diabetes, cancer, and heart disease. Critics frame their arguments in intellectual terms, claiming that chronic disease policies are unproven scientifically, inconsistently applied, unfair to minorities, and undemocratic. I want to dispel these intellectual arguments, and then get to what is really bothering a vocal segment of the public—the belief that government has absolutely no justification for reaching into the lives of adults, who are perfectly capable of making choices for themselves.

. . .

http://blog.constitutioncenter.org/2013/12/bloombergs-nanny-state-refuting-opposition-to-the-new-public-health/