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Who is the leader of the Sugar Police in NYC?


20 December 2005

Who is the leader of the Sugar Police in NYC?

NYC Department of Health requires clinical laboratories to report A1C (levels of blood sugar for diabetes) test results.
Who has been leading the sugar police in New York City (all boroughs)? It is Thomas R. Frieden, MD, MPH, Commissioner of the New York City Department of Health and Mental Hygiene since January 2002.(NYC DoH is one of the world's oldest and largest public health agencies, the Department has a budget of $1.5 billion and a staff of 6,000.)

Frieden implemented the smoking ban in the Manhattan, and has now decided that diabetes self-management is his next big cause for the welfare of public health. His work ethic and philosophies about public health are indeed honourable. But this new odd outreach programme for diabetes seems way off-the-charts for how far Constitutional boundaries are being pushed. Is this about finding the undiagnosed? Sort of, but it is also about checking on people with diabetes to see how their blood glucose control is being maintained. What is most disturbing is that Friedman doesn't feel that patient consent is necessary! C'mon - what has happened to the the radical, rebellious American voice. Does diabetes exclude you from putting up a fight for your rights! It is not as if the Department of Health is paying for your healthcare in return for the information. That would be a different story altogether!

Is this an infrigement on patient rights? Probably. What is the logic behind this? The following power point presentation states the reasons in 10+ slides: 1.) epidemic proportions of diabetes; 2.) annual cost to the City = 8.3 billion and 3.) public healthcare interventions will lessen the severity of the two former - population and cost.

Why doesn't the programme have a name? I find this strange! Why didn't Frieden's staff write a normal run-of-the-mill Press Release for public information. The New York Times story seems to be one of a handful of (non)official news sources of information. I spent an hour on the Department of Health's website and found nothing officially written about the Board's approval of the "programme" (which occured one week ago). I think there are a lot of questions that no one is asking. Is this new policy in keeping with Amendment XIV in the Constitution? It is so easy to allow healthcare to be the one area for the State (here the State of New York) to demand private information from it citizens. What's next? Was there or is there an AIDS programme like this? Even the American Diabetes Association is keeping quiet.

There is opposition:
Those opposed to the plan, including the Association of American Physicians and Surgeons, the National Lawyers Guild and the National Libertarian Party, express concern that the registry could lead to higher insurance premiums for patients or denial of life, health or car insurance coverage.
See story by Henry Goldman, Bloomberg News "New York City to Register, Monitor 500,000 Diabetics (Update2)"

The way I see it, this is a Constitutional issue that needs to be addressed by the United States Supreme Court.


Anonymous wilson said...

I don't know why everyone is getting so worked up here. According to the Ppoint presentation at least, the A1C info will NOT be shared with anyone else even WITH the patients permisssion. It's a statistical exercise only. And the only "freedom" I see being abused here is the freedom of type 2 fatties (for they are always at least 9/10 of all diabetics) to not take some degree of responsibility for their condition.

11:08 AM  
Blogger the beautiful diabetic said...

Hi Elizabeth! Thanks for your comments on my blog! I do appreciate it! Interesting entry with the sugar police! I read an interesting statistic the other day and was quite shocked by it: If you put all the diabetics in the world in one country, you would have the 8th largest nation in the world. It is staggering. And although I don't agree with the first posters term of 'type 2 fatties', (I am a type 2 and I am not a 'fattie') I do think something drastic needs to be done! NOt sure what it is though! As soon as I can figure out how to link blogs from my sight, I will link you from mine! Thanks!

6:31 PM  
Blogger Megan said...

I don't think NY should be doing this for severeal reasons. My main concerns are that government people are not held to the same privacy standards as healthcare professionals.

Also, any other disease and it is your own business, and your responsibility to take care of it. Why should diabetes be any different? I see alterior motives here: Medicare is a county sponsered program. It's plan and simple. The NYC counties do not want to be paying for diabetes complications.

As far as not being tied to an indvidual, it is. How else would they know which diabetics to bug?

This should definitely be opt in, not opt out.

Finally, the results of this will stretch into people not being able to get insurance, jobs, and health care if you are on the "naughty list."

I hope to see this shot down very soon.

5:50 AM  
Anonymous Lara said...

ADA not keeping quiet. They have always been in favor of "opt-in" diabetes registries. In the case of the NY plan, the ADA's stance is noted here:

BTW, Elizabeth, I enjoy your blog!

T1 31 years
Not a New Yorker

5:32 PM  
Blogger Scott said...

I completely agree with your post here that this is a complete invasion of a patient's right to keep their medical information private -- between them and their doctor's, and NYC's assurances that they will not share the data seems more like wishful thinking considering the high-profile cases of data security violations that have occurred recently (Bank of America, Lexis-Nexus, etc.).

Your readers may wish to know that the legal basis for this plan is very questionable, so if this makes it to a court of law, NYC may have a hard time defending the decision not to provide informed patient consent (or at the very least, notice). I have created a website with more information on this topic, which is still a work-in-progress, but can be found at I hope your readers will check it out!

7:19 PM  

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