Do We Really Need a Surgeon General?

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President Clinton has nominated Dr. David Satcher, currently head of the Centers for Disease Control, to be the next surgeon general. By all accounts, Dr. Satcher is an amiable and uncontroversial nominee. After the firestorm surrounding the nomination of Henry Foster and the tumultuous tenure of Joycelyn Elders, one can be forgiven for heaving a sigh of relief and asking “Why not?”

But a better question would be, “Do we really need a surgeon general at all?” As a matter of fact, has anyone even noticed that we haven’t had one for the past two years?

When you get right down to it, the surgeon general really doesn’t do very much. The office was originally established in the 19th century to ensure medical care for the Navy. For years surgeon generals labored in quiet obscurity, until C. Everett Koop dragged the old Navy‐​style uniforms out of mothballs and discovered television.

Nowadays, the surgeon general is little more than the “national nanny,” nagging us to stop smoking, lose weight, exercise more and never go out without a condom. I’ve been flipping through my copy of the Constitution, and I can’t find the authorization for the federal government to take taxpayers’ money to establish an office to tell us how we should live our lives.

There are plenty of private groups that are fully capable of instructing us on how to be healthy, wealthy and wise without the government’s getting involved. The American Lung Association can tell us not to smoke. Alcoholics Anonymous can preach sobriety. The American Medical Association can lecture couch potatoes on the benefits of losing weight and exercising more. Planned Parenthood and the Family Research Council can fight it out over when and how we should have sex.

Moreover, the government’s involvement turns health questions into political questions. Both left and right want access to a government‐​funded microphone. Today, the Clinton administration wants to lecture us on safe sex. Tomorrow, a different administration may want to lecture us on abstinence. I don’t want to be forced to pay for either lecture.

It’s not that I don’t believe these are important issues. I would love to see healthier Americans. But the government has enough problems trying to deliver the mail. Being the nanny for 260 million Americans seems a little beyond its ability.

If constitutional considerations are not enough to eliminate the Office of the Surgeon General, perhaps budgetary ones are. Congress is searching for ways to cut spending and balance the budget. That office is relatively inexpensive as federal bureaucracies go — roughly $1 million per year. But a million here, a million there, and pretty soon you’re talking about real money.

The surgeon general does oversee the Public Health Service. But we have a Department of Health and Human Services that is supposed to be running the government’s health care programs. Why not let HHS take over any useful functions of the Public Health Service and dump the rest, including the surgeon general?

We’ve done just fine without a surgeon general. Let’s keep it that way — and enjoy the peace and quiet.

Michael D. Tanner

Michael Tanner is director of health and welfare studies at the Cato Institute.