Monday, January 08, 2007

Whither Personal Responsibility?

David White has an interesting post today on the conservative Frontpage website that deals with cigarettes and twinkies. The piece, originally published in The American, a magazine published by the American Enterprise Institute, questions how far the public health community will go to regulate peoples' lives in the name of health.

The article points out that when the cigarette companies began to fight against confiscatory taxes, they posed the question of whether this would lead to the taxing of fatty snacks. At the time, in the mid-nineties, this assertion was treated with ridicule but, as we have seen, it was prophetic. It has led, in the author's words, to the creation of "the regime of compulsory nutrition."

The trans fat bans (what the author calls part of a general belief "in government-knows-best social engineering"): and the menu labeling propositions are part of this push towards compelling people to be healthy-or else. It reminds us of Rousseau's dictum that sometimes you need to "force people to be free." White's money quote: "People are stupid, the theory goes, and easily manipulated into consuming whatever's on the menu at Jim-Bob's local barbeque. Therefore the government has the responsibility to discourage-or even prohibit-unhealthy behavior."

All of this is ,justified of course by the level of public expenditure for health care-a $90 billion a year cost (half Medicaid and half Medicare) attributed to the diseases associated with obesity. But this cost is only borne if the government picks up the bill. So that the circumscription of our personal freedom is directly tied to the increases in the country's beneficiary class.

This is, however, a terrible slippery slope since, "So many behaviors affect health care that eventually, in the interest of cutting costs, the government will seek to micromanage each individuals personal decisions. No longer will one be able to eat junk food, have unprotected sex, sleep less than six hours a night, or skip flossing."

As White says, why not mandate exercise? And before you laugh this off remember the guffaws that accompanied the suggestion of a "twinkie tax." There is a real danger here that people will, using this ideological perspective, elevate a reified concept of "health" and juxtapose it against the less important ideal of individual liberty. If so, there is no end to the danger that this approach could lead us into.