I’m struggling with the exaggeration of calling mineralization as “mass medication”. Would you refer to remineralization of anything out of e.g. a desalination plant “mass medication”?
Here, if fluoride is added to water for the purpose of preventing tooth decay, then that is rather plainly a medical intervention, as the purpose is to prevent tooth decay.
Whether it is harmful or not (I have seen a Harvard study that claims to find negative effects on intelligence scores), it is a rather odd and arbitrary medical intervention. Tooth decay? Even if we accept that tooth decay deserves this degree of attention, we no longer live under conditions that motivated the original fluoridation of water when dentistry and brushing of teeth with fluoride toothpaste was not as common.
I simply fail to see justification for such a broad and heavy-handed intervention, or the cost of such an intervention.
Drinking water is a completely different story. You can't survive more than a few days without it, and it is being pumped straight into our homes. Bottled water is literally orders of magnitude more expensive, so it cannot be used as a suitable alternative for drinking - let alone for activities like showering and washing dishes. If the water contains fluoride, a significant portion of the population cannot make the choice to consume unadulterated water instead. They are forced to drink it.
This is starting to sound real silly.
Correct. You already get most of your salt intake from salt-containing foods. In most cases there is zero need to add salt to your food. You can get a 3lbs box of kosher salt for less than $4. Assuming the maximum recommended daily salt intake of 6g, if you get half of that via added salt, that's less than $0.01 / day.
Alternatives are widely available at no significant burden, so it is not mass medication.
> Or is it mass medication in the grains case because the FDA requires folic acid to be added?
Debatable because grain-free diets are possible. But I would indeed consider this a form of mass medication because it is mandatory to add it. In fact, for a long time my country explicitly forbade adding it to grains! These days it is allowed here, but of course optional.
My position is incredibly simple, actually: don't require adding random stuff to food which doesn't need to be there! It is my body, the government doesn't get to decide what I do with it. It is irrelevant whether that is helpful (like fluoridated water and folic acid almost certainly are) or harmful, they should not have that power in the first place.
I don't think you can construe fluoridation as supplementation, especially given that it is not really needed, especially under current circumstances. There are also mixed studies about the health effects of consuming fluoride (I mentioned intelligence studies, but fluorosis of the bones also comes to mind). Also, you must factor in the gravity of the health concern and the efficacy of the treatment. Fluoride doesn't seem to be justified in this regard. Iodine, and even vitamin D, I would argue, are much more justifiable, and as I wrote above, more avoidable.
I would say the principle we should be working from is that such intervention must be justifiable and proportionately so. You're in a bad place if your basic argument for something is "It's not harmful". That's not a reason to institute something. The burden of justification is on those who institute things.