It used to be that when the Federal government wanted to encourage states and cities to adhere to certain policies, they'd offer grants with strings attached. Highway funds, for example, are available only if states enforce federally mandated blood alcohol levels, as well as a drinking age of twenty-one.
Today, however, all pretenses are out the window, and the Obama administration is taking taxpayer money and sending it directly to local governments and non-profits to lobby on behalf of nanny-state policies.
In response to last year's stimulus act, the Department of Health and Human Services (HHS) created the benign-sounding "Communities Putting Prevention to Work" initiative. It would be more aptly described as $372 million to pay activist groups to support Obama health policies at the local level.
The grants announced last month (March 19) include $5.9 million to reduce obesity in Minneapolis, Minn. -- a laudable goal, but the fund will pay not only for improved park safety but "youth access to transportation," among other programs only indirectly linked to health.
Under the guise of putting Americans back to work, the Boston Public Health Commission would receive $12.5 million to, among other things, encourage people to grow vegetables in their neighborhoods. As a backyard gardener, I'm all for growing tomatoes and cucumbers, but it is not a serious way to battle the bulge -- especially with Boston's short growing season.
Antismoking campaigns can save lives and reduce healthcare costs. Hundreds of well-funded anti-tobacco groups are operating at the federal and local levels. Millions of anti-tobacco dollars go to states annually via the Master Settlement Agreement with tobacco companies. But many of the programs HHS is now funding are neither science-based nor effective.
Consider the $16.2 million en route to the County of Los Angeles Department of Public Health for "a multifaceted educational campaign and encouraging comprehensive smoke-free outdoor air polices." Sounds pleasant, but outdoor smoke is not a serious source of exposure to secondhand smoke. Outdoor secondhand smoke is a quality of life issue, not a public health matter.
Grants to New York City offer numerous examples of misplaced government health spending.
The Fund for Public Health in New York, a non-profit created by the city's over-zealous Department of Health, will send $15.6 million to programs we know don't work very well, such as giveaways of nicotine gum and the patch, which are terribly ineffective smoking cessation methods.
The president himself has, so to speak, quit many times using such nicotine replacement therapy. If it doesn't work for the President, why does he think it will work for stressed out New Yorkers?
Instead, the City should fund alternative approaches such as smokeless tobacco, known as "snus," as a means of harm reduction. Because it is the burning and inhaling of tobacco that is harmful -- rather than the nicotine -- snus is a far less harmful alternative to cigarettes. And e-cigarettes are an increasingly popular way of getting nicotine without any tobacco at all.
The federal government should be encouraging research in this area, with an eye towards giving smokers more effective tools to quit. But the federal government, states, and cities are trying to ban e-cigarette use even in public places.
The government is funding approaches that are marginally effective at best. The result may be smokers yoyoing on and off cigarettes because they are being given patches, which rarely help smokers quit for good.
If the past is any example, today's bad ideas will lead to more interventions along the same lines. New York City's activist health department has, with flimsy evidence, banned trans-fats, banned cup-cakes from bake sales in schools, and now wants to tell chefs how much salt they can use in restaurants.
All this activism takes money. The city has to spend millions on ad campaigns to support its unpopular programs. $15.5 million in federal funds are earmarked to fight obesity but will be used to "set policies," i.e., to lobby for things like a measures reducing consumption of "overly salted foods." Yet salt is not a cause of obesity. Nor are trans fats. Restaurants denied use of trans fats by the City simply switched to other saturated fats -- like butter.
All these are cases where, as so often happens, government is better at spending money in ways that lead not to improvements in citizens' lives but simply to more government. Instead of stimulating health, government tends merely to stimulate itself.