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October
2003
Pointing Fingers
in the Dark
The East Coast was hit
by two recent power failures — the
cascading outages in August and the hurricane-induced blackouts
of September. A third East Coast power failure is less noticeable
but more damaging. It is the failure of those in power to put into
practice what they preach.
Take HHS Secretary Tommy Thompson. Please.
“Everywhere I go, I tell people to exercise. And eat right.
And quit smoking. And get the right screenings,” Thompson
said in a recent speech. He might have added, “But you’ll
have to do it yourself.” That is the subtext for an administration
that thinks moralizing alone will do the job and that health is
a personal responsibility, not a shared public one.
The secretary released
a report recently citing examples of huge companies that have
suddenly realized that healthy employees are
profitable. He lauds the voluntary steps they took — adopting
some ergonomic rules, promoting smoking-cessation programs and
asthma management and providing healthier office snacks.
For some reason though,
what’s good for business — and
these large Republican campaign contributors can afford modest
investment in prevention — isn’t so great for Americans
in general. While Thompson talks the talk, the administration has
overturned ergonomics regulations, won’t raise taxes on cigarettes,
ignores the rising urban asthma rates when considering revisions
to the Clean Air Act and insists against all evidence that condom
distribution promotes promiscuity.
HHS concedes, almost
as an afterthought, that social and physical environments do
influence health and that government does have
a role to play in improving health. So why do Thompson and the
rest sing only the one note of “personal responsibility?” It’s
cheaper, both financially and ideologically.
Thompson’s tribute
to seven companies for their prevention efforts is the essence
of a private-industry approach to public
health.
The utility industry
is acting on its own, too, but you can bet it will get a lot
more government help than health promotion does.
The power grid, like some aspects of health practice, is a 19th
century technology that has not been upgraded because it is expensive
for each, or any, participant to repair on its own. The industry
now realizes it must first build a coalition of private investors,
consumers and government to improve reliability. “Unless
we do something to incentivize people … they won’t
do it,” says Republican Rep. Billy Tauzin, using code for “government
handout.”
Plenty of technical fixes could help consumers conserve energy
and help utilities manage flow. And there are plenty of fixes that
would help produce healthier behaviors. But because there is no
profit or campaign contribution for doing so, the Tommy Thompsons
will bluster on, pointing fingers at couch potatoes instead of
helping them up before their lights go out for good.
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