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Op-Ed

Obama healthcare: Government, heal thyself

The $100 million for 'community transformation grants' allocated under President Obama's healthcare plan will fund projects that have little evidence behind them.

June 03, 2011|By Jeff Stier and Henry I. Miller

Even at a time of high-profile budget cutting, the Obama administration is spending not just on the essentials of governance but also on social engineering to promote its liberal inclinations.

One example is the Department of Health and Human Services announcement in May of the availability of $100 million for "community transformation grants," a program created by "Obamacare."

The Centers for Disease Control and Prevention will administer the program, and grants will be funneled to local government agencies and nonprofit organizations, which are required to use evidence-based strategies and ensure that their activities have broad population impact and help address health disparities. Projects that could qualify include the promotion of blood pressure and cholesterol screenings, increased access to healthful food options, including the elimination of food deserts (areas where it is supposedly difficult to buy healthful foods), and efforts to improve school nutrition and bring more healthful foods to corner markets in urban areas.

The new grants "will empower communities with resources, information and flexibility to help make their residents healthier," according to Secretary of Health and Human Services Kathleen Sebelius. And this presumptive improved health will result in — wait for it — savings in federal healthcare expenditures because of less chronic disease caused by tobacco use, obesity, poor diet and lack of physical activity.

These are worthy goals, but we would argue that this wishful-thinking, ideological approach to achieving them is especially dubious at a time of budgetary belt-tightening.

An examination of how the CDC has doled out funds under a similar program shows that funding decisions are based more on ideology and intuition than evidence. This program, Communities Putting Prevention to Work, or CPPW, also funded by Obamacare and administered by the CDC, comes from a pot of $500 million this year, increasing to $2 billion by 2015 and thereafter, and funded in perpetuity until Congress decides to drive a stake through its heart. The CPPW ostensibly requires "evidence-based strategies" to fight tobacco use and obesity.

However, most of these CDC-administered social engineering programs are not based on evidence. In fact, in some cases, the evidence shows that the projects don't work. For others, there simply isn't evidence that they are effective because the interventions haven't been studied, making these extremely expensive experiments at best.

Here are some examples of how the funds in the CPPW program are being used:

•$15.8 million to Pima County, Ariz., for ensuring that "residents have improved access to affordable, healthy, locally produced food through the fostering of private and community gardens, composting cooperatives, farmers markets and food cooperatives." But there is no evidence that such efforts change eating habits. Given that, using federal funds for community gardens and composting is the agricultural equivalent of congressional earmarks such as the infamous "bridge to nowhere" in Alaska.

•$15 million to Philadelphia to "make healthy foods more available and affordable by dramatically expanding the number of farmers markets in low-income neighborhoods and by creating 1,000 healthy corner stores that sell fresh produce and water. Unhealthy foods will be removed from school stores and fundraisers, and a citywide pedestrian and bike plan will be completed." Whatever they call it, this is a federal welfare program. And like other federal welfare programs, it will be prone to rampant corruption, abuse and fraud. We will see more pedestrian paths where people don't walk and bike lanes where people don't bike.

•$6.1 million to Boston for anti-tobacco campaigns. A portion of these funds is going to an anti-scientific, bizarre and secretive campaign to ban the use of e-cigarettes where cigarette smoking is banned. E-cigarettes are tobacco-free, smoke-free devices that use vaporized nicotine to replicate the experience of smoking cigarettes. There is no evidence to suggest that e-cigarettes are any more dangerous than the nicotine gum or patches that the FDA has deemed safe and effective. A ban would create a gratuitous obstacle for people who are trying to quit smoking cigarettes. And if that isn't troubling enough, the Boston Public Health Commission, which received the grant, and the CDC have repeatedly refused to disclose any scientific basis or rationale for the ban. So much for transparency and responsible governance.

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