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NAME: Paul Gross POSITION: Director ORGANISATION: Institute of Health Economics and Technology Assessment SUBMISSION1: The Task Force has issued a discussion paper that overlaps in part with the deliberations of the House of Representatives Standing Committee on Health and Ageing in its ongoing inquiry into obesity in Australia, and with the deliberations of the Senate Standing Committee on Community Affairs on so-called junk food advertising (whose report has issued). My concern is solely with gaps in the Task Force's overview of the obesity problem. In evidence tended to both parliamentary inquiries and in the first two solutions "reshape and protect" solutions of the Task Force, there is an undercurrent of enthusiasm for regulatory route and taxes (often called 'sin taxes') to balance out the perceived effects of the unfettered marketplace that allows advertising to children of particular types of energy-rich foods. First, the Task Force should acknowledge that there is no empirical evidence to support the use of regulations and taxes as preferred tools against obesity. Obesity "control" is nothing like tobacco control despite poorly argued attempts to label it so. If the Task Force proposes any regulatory and tax policies, it should spell out the costs and benefits of these routes to thinness. Second, the Task Force's "reshape and protect" imperatives are not balanced by equivalent discussion of the need to - (1) reinforce the role of personal responsibility in obesity prevention; or (2) propose incentives that help individuals make healthier choices in energy intake and energy expenditure, the two arms of the energy balance that affect weight gain. Third, while the discussion paper is appropriately written at the lay level of understanding, the final report of the Task Force must eschew generalities and identify working examples of effective programs for prevention of weight gain that engage the household in healthier decisions. Fourth, with the experience of those benchmarks and with Task Force cost estimates, a comprehensive obesity control strategy could be given a kick-start in the May 2009 Budget, and the 2020 horizon of the Task Force for obesity outcomes is inappropriate. Overall, I look to the Task Force to avoid what are now called eminence-based solutions to obesity, viz., proposals that do not accord with available evidence. The gaps between eminence- based and evidence-based policy analyses, painfully obvious in testimony to two recent Parliamentary inquiries and in parts of the Task Force discussion paper, confuse politicians and thus impede the implementation of comprehensive solutions to obesity that are already underway in many nations, including a reinforcement of personal responsibility in trait formation and as part of social solidarity. I am not opposed to government regulation of society when the measured benefits exceed the measured costs. As demonstrated in recent financial fiascos involving sub-prime mortgages and financial derivatives, the absence of effective (or any) government regulation has been devastating for the international economy. Regulation of cigarette advertising and higher taxes on tobacco were both valid policies in my view when the tobacco companies steadfastly ignored rising community concern, the demonstrably high costs of tobacco-induced diseases, and their own internal advice that cigarette addiction occurs at early ages when adolescents are vulnerable. Alcohol taxes are problematic. In obesity prevention, the law may be needed to achieve behavioural change when all else fails. My contention is that "all else" has not been given a run yet in Australia, and individual liberty and personal responsibility are not strengthened by regulations, bans and taxes. Advocacy of the precautionary principle to promote such paths is the last resort of eminence-based policy- and the Task Force should instead tell the nation why benchmark reformers like Norway, Kaiser Permanente and the US state of Arkansas have introduced comprehensive reforms that have had measurable results (at least the last two) PRIVACY: yes SUBMIT: Submit |
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