First Imaginary Conversation between President-Elect Barack
Obama and His Newly Appointed Surgeon General, John
Date of 1st
Meeting: November 30th, 2008
Barack Obama invites us to share our vision:
to him and include this letter.
(copy and paste
the interview below into the submission form on
Obama: Welcome to the job. I want to be clear that I
have appointed you because I need someone who has new ideas
that will inspire change. My one fear is that Congress will
not confirm your appointment because many of the members
represent interests of the food and drug industries—and you
are well known to be a strong critic of both.
McDougall: I voted for you because I believe you are,
foremost, interested in the welfare of people, not only
Americans, but everybody. Being intelligent, articulate, and
appearing unafraid also helped sway my vote.
The US Department of Health and Human Services says, “The
Surgeon General serves as America's chief health educator by
providing Americans the best scientific information
available on how to improve their health and reduce the risk
of illness and injury.” With two notable exceptions, which I
will talk to you about later, the Surgeon General’s office
has failed the American public. I am a general doctor; you
should expect my interests to be solely focused on the
welfare of people, not industry.
Obama: You will be perfect; the Surgeon General
functions as the nation’s family doctor. I fully realize
restoring health to America is fundamental to our success in
all areas, including the economy and the two wars we are
fighting. So where do we begin?
McDougall: The urgency to fix the broken health of
this nation is as great as solving the housing and economic
crises that you are facing. More than 80% of our health
problems are from our food choices. After the age of 30, in
our country, almost everyone is overweight, on medications
and/or has risk factors, like high cholesterol and high
blood pressure, which predict premature disability and
death. You have been asked to lead a nation of sick people,
which compounds the difficulty of solving every one of your
Fortunately, there is one single big solution that will
revitalize our citizens, cut food and health care costs, and
reduce environmental pollution, overnight:
reestablishing the natural human diet. If you will
reflect for a moment on your life experiences you will
quickly understand what I am talking about.
You lived for 4 years in Jakarta, Indonesia (1967 to 1971)
and in 1988 you spent 5 weeks in Kenya. Do you remember the
diets of these people?
Obama: Rice was the staple food in the Indonesian
diet. In Kenya they eat a ground corn flour mixed with water
called ugali. They also eat lots of green vegetables, beans,
breads, rice, and a little meat and milk.
McDougall: I realize you were only a young boy then,
but when you lived in Indonesia 98 percent of the calories
people ate came from plant-food sources. Even today, the
Kenyans ingest about 77% of their total daily calories from
carbohydrates, primarily from starches.
The importance of starch as the natural human diet is
resurging. Corn, beans, and squash—the three sisters of
American Indian agriculture—will appear on the nation’s one
dollar coin next year. The United Nations has declared 2008
the International Year of the Potato in order to address
global concerns, including hunger, poverty, and threats to
All large populations of trim, healthy
people, throughout written human history, have
obtained the bulk of their calories from grains, tubers, and
legumes. You have read history books about this and have
witnessed this effect first hand in your extensive travels.
Mr. Obama: Here
Is a Partial List of Historical Examples of
Barley – Middle
East for 11,000 years
Corn – Central and
South America for 7,000 years
Americas, Asia, and Europe for 6,000 years
Millet – Africa
for 6,000 years
Oats – Middle East
for 11,000 years
Potatoes – South
America (Andes) for 13,000 years
Sorghum – East
Africa for 6,000 years
Sweet Potato –
South America and Caribbean for 5,000 years
Rice – Asia for
more than 10,000 years
Rye – Asia for
Wheat – Near East
for 10,000 years
Obama: I remember; everyone was trim, healthy, and
hard working in Indonesia. The same for Kenya, in fact
their runners are legendary for their performance,
endurance, and their unique ability to recover from
strenuous exercise. Today they dominate long distance
McDougall: Over the past century there has been
escalating abandonment of a starch-based diet in favor of
one centered around low-carbohydrate meat and dairy foods.
Each and every time a population has made this change an
epidemic of obesity, heart disease, diabetes, and
cancer has followed.
You just finished 2 years of campaigning across America.
You must have noticed the condition of people, particularly
those of African decent. About four out of five
African-American women are overweight or obese. One-third of
blacks in America have hypertension accompanied by stroke,
heart attack, and kidney failure. Black men have the highest
rate of prostate cancer in the world. Asian Americans,
often in one generation, have also become Americanized in
their diet and appearance.
must learn to get the bulk of their calories from starches.
Notice I did not say every patriotic American has to become
a vegetarian or vegan—I am not pushing a religion, just a
single big change in eating.
Obama: You are talking about a revolution. I have
promised our nation change on a historic scale. But, this
McDougall: Twice before, Surgeons General have put
people’s health before industrial profits. Luther Terry, MD,
who was appointed by President Kennedy, served as Surgeon
General from 1961 to 1965. Under his leadership, in 1964 the
first Surgeon General's Report on Smoking and Health
was released. Look what has happened over the past 4
decades. In the late sixties, when I was a medical student,
I saw doctors smoking while examining patients. Today,
smoking cigarettes is a social disgrace.
similar change in our society should have followed
on Nutrition and Health
issued under C. Everett Koop, MD in 1988. Unfortunately,
this report didn’t have the desired effects; over the past 2
obesity in America has risen from 10% to over 30% of our
The ultimate insult: McDonald’s and Burger King sell their
products in hospitals. We are now two decades behind; we
need a health revolution backed by our President.
Have you considered the effects on the meat, dairy, and
processed food industries?
I have about as much sympathy for the people in these
industries as I do for those selling tobacco. I have also
considered the effect on the medical businesses. If this
movement works as planned cardiologists and bypass surgeons
will be temporarily standing in unemployment lines along
with autoworkers. However, under your leadership millions
of new jobs will be created and the country will move
forward. In order to carry out your dream for a green energy
economy Americans must be competitively fit—we can no longer
add $1500 to the price of each automobile to pay for the
healthcare of the employees. The benefits to individuals
will be immediate; food costs will decrease from $14 a day
to $3 a day per person on a starch-based diet.
As appointed (but unconfirmed) Surgeon General can you
provide me with some specific steps to take?
Identify the livestock and processed food industries as the
major cause of death and disability in the
This will be more difficult than it was for tobacco because
in the case of smoking in 1964, half of the population were
non-smokers and could see the insanity. Right now more than
99.9% of Americans cannot see past their own dinner
plates—they have no idea there is a problem with their food
choices. The education hurdles will be great, but not
asking for $217 million annually for this budget. By no
coincidence this figure represents the
amount the dairy and beef
industry spend annually—$175 million and $42 million,
respectively—shamelessly promoting their products through
our school systems, dietitians, doctors, the USDA,
scientific journals, and every available form of media. You
may be asking how are we going to pay for this?
a tax on health-damaging foods. Cigarette taxes added
by individual states are as high as $2.58 per pack. Since
there is too little time to wait for individual states to
act, this legislation will immediately be brought to
Congress, and become a federal tax. This tax will achieve
two social objectives: to reduce the number of citizens
making themselves sick and to raise government revenue.
Annually, 28 billion pounds of beef and 9 billion pounds of
cheese are consumed in the US. Taxed at $1 per pound, this
tax will leave a lot of money left over for other worthwhile
programs. How about dedicating $10 billion to
rehabilitation live-in programs, modeled after the highly
successful McDougall Program, for people with type-2
diabetes, heart disease, inflammatory arthritis, multiple
sclerosis, GERD, IBS, obesity and other diseases caused by
meat- and dairy-centered diets?
Place Product Warning Labels. Just like those on
tobacco products. Here are two examples:
Change to a starch-based diet for all government funded
programs. Three very needy groups come to mind: our
military, schools, and food assistance programs. Among our
fighting forces 61% are overweight—it is unsafe to send
these men and women into battle in such poor condition.
Diet-induced childhood obesity and illness will be
considered abuse, especially after adults know better.
Subsidizing foods that make people fat and sick doubly harms
underprivileged Americans. In the near future food stamps
and other assistance programs will not provide for the
purchase of tobacco, alcohol, meat, dairy, or highly
processed “junk” foods.
Educate doctors and dietitians about diet and how to take
people off medications. The effects of food on health
and disease, a subject almost entirely ignored in medical
schools, need to be taught. The food industry will be
highly regulated when they finance research and banned
entirely from educating dietitians. Relicensing exams will
require all professionals to take courses in diet therapy
and how to reduce and discontinue medications once used to
treat diseases of over-nutrition.
Require all hospitals to serve healthful foods. In my
parents’ day, free samples of cigarettes were distributed to
patients, and I can remember hospital gift shops selling
cigarettes. Right now every hospital in the country serves
to their patients the very foods that brought them there in
the first place. No longer will we miss the “teaching
moments” that happen when people have a heart attack or a
diabetic crisis. All fast-food restaurants will be banned
Allow lawsuits to go forward against food industries.
The Personal Responsibility in Food Consumption Act, also
known as the “Cheeseburger Bill,” was twice passed by the
House of Representatives, but fortunately not yet confirmed
by the Senate. The aim of this bill is to protect producers
and retailers of foods from being sued by customers who have
become obese and sick by eating their products. This
legislation is being pursued by congressional
representatives supporting the interests of industry;
because of similar suits brought in the 1990s against
Obama: This is an ambitious plan. I like it.
McDougall: With the failing economy people may be
forced to change to a starch-based diet, or starve.
However, a planned transition will be less painful, more
likely to succeed, and a key ingredient in saving America.
America can no longer afford to be sick. We must get this
fixed now; we do not have a generation to wait. As your
Surgeon General, I will be the nation’s family doctor.
Let’s plan another meeting soon.
Mr. Obama: Here
are three Congressional actions needed for me to
do my job:
First, the US
Public Health Service (USPHS) must be converted
into a fully independent agency that reports
directly to the President, like the U.S.
Environmental Protection Agency does now.
Surgeon General, as the head of the USPHS, must
be a lifetime appointment, like federal judges
Third, the Surgeon
General must take over from Department of
Agriculture (an organization representing the
interests of the food industries) the
responsibility of establishing and disseminating
dietary advice to Americans.