Protecting Health With the Power of the Market
Much of this is a paraphrase of the "Environment and the Economy-A Special Report" Science 260:1883-1896, 6/25/93.
To paraphrase then President-elect Clinton in a December '92 speech regarding the environment "our future depends on maintaining sustainable health and in doing that we can create economic opportunity."
Looking at our distant past in it's natural form can guide us as we look at the development of Preventive Medicine for our future. Real Preventive Medicine as a "green idea" can go hand in hand with greenbacks. Real Preventive Medicine will open new markets and at the same time benefit employers-employees-the nation as a whole by directly reducing the environmental and personal impact of disease and indirectly creating high profits in those industries which prevent disease. Changes will be necessary.
The benefits of these shifting political sands can be for everyone once we get past the debate of whose position is morally superior, accomplishing real reduction in diseases (paraphrasing Daniel J. Dudek, Senior economist for the Environmental Defense Fund). Paraphrasing John Shanahan of the Heritage Foundation "by harnessing the power of the markets, we will be able to minimize disease, and maximize protection in a way that will not place undue burdens on the nation's economic growth. It's a win-win situation."
This is a no nonsense fact about capitalism: Markets respond to price signals. We must now face the true costs of disease and enact policies that adjust prices so that they more accurately reflect all the costs associated with allowing a particular disease to be created, rather than prevented.
By concessions to various industries which promote low fiber, high fat-high sweet-high salt foods we are forcing society to bare the cost of repairing and treating human pollution and diminish the productive value of the public. Indirect cost externalities must no longer remain external to the price and must now be included within a more correct and accurate accounting technique known as the "internalizing approach."
As no one is saying do not log-fish-mine-defend Persian Gulf shipping lanes, which at $15 billion per year is a $23.50 per barrel "externality" on imported oil, because of significant and previously unaccounted price externalities. So, now, should it be said that correct use of the "internalizing approach" must be applied to smoking-drinking alcohol-using stimulants-eating high fat and sweet foods, all of which substances do generate diseases, and should not be given the same par value as those naturally high fiber, low fat and sweet foods and behaviors which prevent or reduce disease.
H. Robert Silverstein, MD
Hartford, CT