by Terence Corcoran
In an editorial in the latest edition of the Canadian Medical Association Journal, Dr. David Lau of the University of Ottawa issued a "Call for action: preventing and managing the expansive and expensive obesity epidemic." Two other articles in the journal painted a bleak picture of obesity's toll on Canadians. One claimed obesity costs the Canadian health-care system as much as $2-billion a year.

The media jumped. CBC television's The National -- which has yet to come across a health scare that wasn't worth repeating -- whipped out film of grossly overweight people and stuck Dr. Whatzizname, its health specialist, in front of a camera to transmit the news that fat people are a burden on society and that they'd better thin down. One of the authors of the journal articles, epidemiologist Laird Birmingham of the University of British Columbia, appeared on news shows and granted interviews. Obesity, he said, may actually cost the health-care system $4-billion a year.

The story was swallowed whole by a media establishment that likes nothing better than an opportunity to righteously hector citizens. The only flag was the possibility that it might be politically incorrect to single out such a visible and vulnerable sector of society. "Once again, we're victimizing fat people," said Helena Spring, president of the Canadian Association of Size Acceptance.

And she's right, except it's much worse. In the field of public health care, we're all victims. The CMA's special issue on the "obesity epidemic" is another grotesque in the escalating and immoral assault by health fascists on all Canadians. In the name of public health care, there is ultimately nothing that cannot in some way become the target of health police who will try to tell people how to live their lives.

All of this is reminiscent of the war on smoking. Similar health-cost studies have been produced on the impact of tobacco use. The only difference between tobacco and food is that the alleged cost of health effects from tobacco appears to be lower than the cost of obesity. The Canadian Centre on Substance Abuse estimated a couple of years ago that the direct health-care costs of tobacco use were $2.7-billion a year. According to the obesity study, the cost of being fat could be greater.

Coming soon from a bureaucracy near you may be a ban on beef consumption and mandatory labels on french fries and Doritos. Or maybe they'll try to regulate the fat content of food. If fat people are such a burden on society, then it's logical to begin thinking of forcing the overweight to go to fat farms where their diets will be strictly controlled. Look at the savings! Or how about special taxes on fatty foods, T-bone steaks and Oreo cookies?

This may sound extreme, but any of the above would fit into Dr. Lau's prescription. "The challenges as we approach the new millennium will be to understand how obesity develops, and to design strategies targeting undesirable societal, cultural and other environmental influences." He proposes "universal or public health prevention directed at the entire population, selective prevention . . . and targeted prevention" to reduce obesity's burden on society.

There is no regulation, intervention or control that cannot be justified in the name of public health or in the cause of reducing health-care costs. In a nationalized or centrally managed health-care system, people who are unwell or who live what might be unhealthy lives become a problem. They are a liability, a cost, a potential drain on the system.

The obesity reports take us to the ethical core of mandatory health care. In a normal market for health-care services, in which patients relate to doctors, those wanting service create a financial opportunity for those providing it. To doctors, clinics, and hospitals who can make people well and deal with illness, the person who is sick is a potential source of revenue. If a doctor or a clinic sees the patient as a source of revenue, the motivation is to increase service and provide more facilities.

Managed health care turns the system upside down. In a managed system, the patient becomes a liability. People who are sick become a menacing cost, an unwelcome consumer of precious resources. Is this an ethical structure? Is it right to turn people who need health care into unwanted citizens, to put them on waiting lists and to attempt to control their lives because they might become a charge to the system?

The CMA journal's obesity studies are grounded in this dark, unethical model. Like smokers, people who are fat are a looming threat to society, as is everyone who is or who ever will be sick. It's a rotten moral foundation for health care