While the nation is focused on the controversies surrounding the Affordable Health Care Act, which are many and large, the government’s health establishment has separately and quietly pursued a course change in the area of diet and obesity, and the benefits will be real to a large number of Americans.
Those who might decry the actions as furtherance of a “nanny state” are missing a larger point. A fundamental objective of government is to promote the general health and welfare of the populace, and the Food and Drug Administration’s move to ban the use of trans fat in various food products will meet that objective square on.
The FDA estimates the ban will prevent 20,000 heart attacks and 7,000 deaths each year. Physicians and public health advocates have been encouraging such a move for years, and it’s hard to see how its implementation can be opposed on any rational level.
The same can be said for an effort commissioned by the National Institutes of Health to adjust perspectives on how best to treat patients with high cholesterol. The project resulted in a recommendation that doctors prescribe anti-cholesterol drugs, called statins, to a wider base of patients, based on a patient’s individual risk of heart attack or stroke, not simply on their cholesterol level at any given time.
The recommendations proffer a change of focus that is subtle but significant. They will encourage doctors to treat high cholesterol as a means to an end – the prevention of heart attack and stroke – which will result in more people being encouraged to use statins. Prescriptions would be based on overall risk of stroke or heart attack, which include parameters beyond cholesterol levels alone – which in many high-risk patients may be considered only borderline.
The change is “long overdue,” according to Dr. Jeffrey Anderson, a Utah cardiologist who is chairman of the task force of the American Heart Association and College of Cardiology whose work led to the recommendations. He said the group has set a goal to reduce heart disease and stroke by 20 percent by the year 2020.
The FDA’s ban on trans fat will also have a substantial impact on cardiovascular disease. The food industry has slowly been ratcheting back the use of trans fats, and some states already have banned their use in restaurant foods.
These parallel efforts at promoting public health represent the proper blend of science and policy. In the realm of health care, the government is more effective when it acts to address problems uncovered by research than when it seeks to proactively throw a blanket over an array of concerns that may be considered problems only by those of a particular ideological bent.
Given the slow and deliberate way the government has worked on this and other matters (the FDA has not attempted to ban the sale of cigarettes for example), there is little reason to believe, as some are saying, that trans fats are the first step toward banning sugar and other popular food ingredients.
While we continue to debate the proper role of government in the health insurance market place, there should be no debate over policies that reduce the overall cost of health care by making food healthier and doctors smarter.
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