Megan McArdle presents a provocative point that challenges one of the central assumptions of the growing ranks of self-righteous “healthy lifestyle” enforcers. Specifically, McArdle questions whether at least some of the focus on “obesity” as a threat to the health care system confuses correlation with causality. She also highlights the way in which the condemnation of obesity takes a dangerously moralistic tone that becomes linked to public policy through the invocation of health care costs under a government-controlled health care system:

Megan: Over the last five years or so, I’ve noticed that public health efforts about obesity are not just amping up the volume, but exploring increasingly coercive methods to induce weight loss: taxes on junk food, lawsuits against fast food companies (which are basically a tax on junk food), and so forth. Does that match your analysis?

Paul: It’s the classic pattern of moral panics. As public concern about the damage being done to the fabric of society by the folk devils increases, increasingly intense demands are made on public officials to “do something” about the crisis, usually by eliminating the folk devils.

That of course is the strategy for this crisis. If fat people are the problem, then the solution is to get rid of them, by making them thin people. The most amazing aspect of this whole thing, for me, has always been the imperviouusness of policy makers, and even more so people who consider themselves serious academics and scientists, to the overwhelming evidence that there’s no way to do this.

The point is not merely word-play. As the government’s role in managing health care seems likely to grow, so also will grow the power of those government bureaucrats who believe that the government’s investment of dollars into individual health care gives the government the right to mandate lifestyle choices. Is it really inconceivable that the government will not use the threat of withdrawing health care insurance as a coercive tool to force people to attend mandatory exercise sessions at the gym? Given the demonization and discrimination that is already extended towards pretty much anyone who is deemed “fat” in comparison to near-skeletal ideals, this doesn’t seem completely paranoid. And the last decade of jihad against smokers can be seen as a cautionary tale for what kind of self-righteously coercive attitude newly empowered government health care bureaucrats might embrace with regards to obesity. And the result will be no likely increase in health, but a lot of increase in the power of bureaucrats to reach deeply into individual lives and control them in accordance with the bureaucrat’s personal ideas about what is a “good lifestyle”.

Does anyone really think that the same people who want to make texting while driving a federal crime would flinch from criminalizing doughnuts?

Democrats make a lot of complaint about Republicans wanting to force government into the bedroom, but I don’t see how their forcing government into the kitchens and rec rooms is much better.