Hashtag Big Public Health

Those following me on social media may have noticed the hashtag that I have started- #bigpublichealth. Some have asked what does this mean and why have I done it.

Good questions. Below is my explanation.

We are forever hearing about big tobacco, big food, big pharma, big sugar and just to round it out big banks. These terms are used derisively to imply that the size of these amorphous groups is of itself a problem and that due to size, their influence is considerable.

There is some credence to this view. The lobbying power of the pharmaceutical industry is significant, especially on the USA. Allegations have surfaced about the behaviour of the sugar industry in paying researchers. The food industry, of course wants to protect its position. The tobacco industry has negligible power these days.

However, not one of these groups has the express backing of governments. Not one of them is able to dictate policy. None are paid for by the taxpayer.

So which group is funded by government, through taxes, is able to dictate policy, establish guidelines, attack those who question it and never admits when it is wrong?

The answer is public health. Of course, it claims to be small and powerless. This is nonsense. It has government money and power behind it. They get to make rules and policy. And when it is wrong, there is no accountability.

As a doctor I am legally responsible for everything I do and can be sued if I make an error. In fact, I can be complained about to the regulator anonymously for simply getting out of bed in the morning.

If I give faulty advice I am liable.

What about public health? Is it liable and accountable for faulty advice? Let’s examine three examples.

The most egregious is the low-fat dietary guidelines introduced in the early 1980’s with no scientific basis and which have coincided (some would say lead to) the increased rates of type two diabetes and obesity we see today. The jury is in and we have received faulty advice. We should not be avoiding eggs, red meat and full fat foods. The problem is sugars and processed grains. The PURE study is the best example of where real science has trumped ideology but there are many others.

Yet have we seen an apology? Have we seen a change in approach?

Quite the opposite. The EAT-Lancet report release in January doubles down on this “advice” and calls for people to consume 7g of beef and pork , 29g of chicken and about ¼ egg per day. It calls for rationing if the public wont“play along”.

We have also seen attempts to silence those who question the edicts of big public health. Witness the cases of Gary Fettke and Tim Noakes. Those interested in the history should read this excellent piece by Belinda Fettke.

International figures show that where vaping is supported as tobacco harm reduction, smoking rates amongst adults are declining and youth smoking is also in decline. Yet public health in Australia continues to stick its fingers in its ears and go la la  la la la. A colleague has wondered if a clock should be set up to count every time a smoker dies in Australia due to the antipathy to vaping.

Latest research shows vaping to be twice as successful as all other forms of nicotine replacement therapy.

Is there any accountability? Is there even a requirement to examine real world data?

You can form your own conclusions.

Lastly is our approach to drugs and alcohol. Prohibition does not work and never has. If the aim of drug policy is to stop use, it isn’t working. Much like alcohol prohibition in 1920’s USA (those with Netflix should watch Making of the Mob) it has enabled organised crime to flourish and profit. It also has set the perfect scene for corruption. Plus, it fills jails with people who have committed no crime against another person.

When it comes to handling alcohol, we can learn much from the Europeans.

Not all of you will agree with me on the third example which is absolutely OK.

The influence of tainted guidelines in various medical conditions has also been exposed but nothing has been done. Up to 84% of those sitting on panels have financial conflicts of interest in the USA.  In Australia that figure is at least 65%. Nothing to see here- move along.

The damage done by the low fat dietary guidelines which have been followed by the public (as witnessed by food sales) is massive. Simply look at the increased rates of obesity and type two diabetes compared to the 1970’s. The cost of opposition to vaping is being paid for by smokers who can’t quit.

It is time that the faceless people who inhabit the ivory towers of #bigpublichealth were held accountable for what they do.

For those inclined to do so, I welcome your use of the hashtag – maybe we can go viral. And maybe we can bring about accountability and change for the better.

Dr Joe Kosterich

Dr Joe Kosterich

Dr Joe Kosterich M.B.B.S (WA) 1985 is a doctor, speaker, author, media presenter and health industry consultant. Dr Joe writes for numerous medical and mainstream publications and is a regular on radio and television.He is often called to give opinions in medico legal cases and is an adjunct professor (teaching) at UWA. He is supporting clinical editor of Medical Forum Magazine and advisor to Reed Medical Conferences. Dr Joe is Medical Advisor to Medicinal Cannabis company Little Green Pharma, and also sits on the board of Australian Tobacco Harm Reduction Association. Previously he held senior positions in the Australian Medical Association and sat on numerous industry and government boards. He continues to see patients as a GP each week.
Dr Joe Kosterich

3 Comments on "Hashtag Big Public Health"

  1. Andrew Russell | 15/02/2019 at 1:27 pm | Reply

    A great piece that points out the many errors and deceptions of the Public Health crowd.

    There’s also an important fact; Public Health types are universally ideologically biased in favor of progressivism and against (classical) liberalism, pretty much on principle. Its a bureaucracy that appeals to the power-hungry and the well-intentioned-tyrant. It is more than capable of being both Baptist and Bootlegger.

    They aren’t merely wrong, they aren’t merely vulnerable to regulatory capture. They’re a built-in anti-freedom lobby group.

  2. Lesley Ward | 15/02/2019 at 7:17 pm | Reply

    There is no doubt that the health depts. of Australia like USA are compromised and ‘owned’ by big Pharma influence.
    The Vaccination ‘industry’ is an absolute example of this. But like Monsanto and the truth of their pesticides causing cancer despite destroying careers of innocent scientists and Drs who “DARED” to bring this to the public’s attention, they have finally been brought to Court. The vaccination industry (supported 100% by Aust Health Dept officials) is now having the spotlight turned on their nefarious lack of ‘accountability’ and blatant underhand actions (similar to Monsanto) to destroy all those who draw attention to the dangers and disastrous repercussions to public health and especially our children. It is time Health officials who propagate and control everything relevant to health and safety were personally made responsible for the failings of their actions. Just then some honesty and public safety might be foremost on the agenda.

  3. Chris Ilsley | 17/02/2019 at 12:46 am | Reply

    Great article Joe. I was pleased to be part of the discussion when the idea of #bigpublichealth was first mooted.

    It is the arrogance and dogmatic expectation of compliance without question or inquiry from #bigpublichealth I find most infuriating and patronising.

    Alcohol is perhaps the best example. No alcohol until you are 18 is the epitome of stupidity and bloody mindedness as well as being obviously flawed. Does one need a science degree and peer reviewed study to understand if we don’t educate children to use alcohol responsibly, young 18 plus friends will commencing the night of their 18th birthday?

    Again, in the absence of a science degree, I suggest Wally and Lumpy yelling skol, skol, skol is hardly conducive to responsible alcohol education or consumption. Using #bigpublichealth logic, we simply throw the car keys at our 17 year olds and, without prior instruction, say: “Here, now you can drive”.

    Vaping is another classic example. It appears #bigpublichealth disapproves because it played no part in the original concept. Evidence points to strong health benefits for smokers who find quitting difficult, even when smokers become regular vapers. The #bigpublichealth approach would rather people contract smoking related illnesses than use the less harmful vaping option.

    It’s almost like the kid taking his bat and ball and going home because his friends refused to capitulate when he demanded to be first batter.

    #bigpublichealth and food is a joke. Starting with the Body Mass Index (BMI), absolutely worthless in the modern context. Dwayne (The Rock) Johnson and Vin Diesel are morbidly obese according to the BMI.

    Body Mass Index origins go back to 19th century Belgium and statistician Adolphe Quetelet. BMI was used to determine the extent and location of famine and malnutrition. Clusters of people with BMI’s substantially lower than average pointed toward famine or malnutrition within specific groups or localities.

    The BMI was not specifically indicative of health per se, irrespective of the malnourished logically encountering health issues.

    The BMI simply highlighted body size within different demographics and socio economic groups relative to average. It helped the government identify specific locations and people in need of food relative to the general population.

    It was not until 1972 the BMI found new life using size as a measure of health. It is quite possible to find individuals classified morbidly obese under the BMI in fine health, whilst those within alleged healthy ranges are unhealthy.

    As a measure of health, the BMI is all but useless. It is being used in a way its creator never intended and does not factor why or how a body is its current size. A big, mega fit, footballer may be obese according to the BMI.

    Don’t tell #bigpublichealth.

    Finally and most significantly, everything from #bigpublichealth is assumed 100% correct in ‘Moses from the mountain with stone tablets’ fashion. Classic example is the campaign spearheaded by Andrew Forrest opposing vaping whilst advocating raising the legal smoking age to 21.

    I hope somebody read your comments with respect to prohibition.

    Forrest is simply parroting the words of #bigpublichealth because he undoubtedly accepts the and repeats the matra without question. Another example of #bigpublichealth said, so must it be.

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