A public responsibility?

When we have a public health system, and when folks worry about costs others impose through the health system, all kinds of private behaviours have external effects. Will Wilkinson rightly chastises Mark Bittman's food nannyism:

Before getting to the problems with Mr Bittman's price-fixing plan, let's ask why this might be thought a legitimate function of government? Mr Bittman says:

[P]ublic health is the role of the government, and our diet is right up there with any other public responsibility you can name, from water treatment to mass transit.

"Our diet"? Interesting. Try this: Our pattern of sexual conduct is a public responsibility. Or: Our convictions are a public responsibility. Right up there with dog-catching, even! After all, one can come down with a killing disease rogering the wrong lad or lass. Moreover, wick-dipping is the leading cause of new citizens, many of whom will turn out to be a net drain on the public purse. Can we afford to continue allowing just anyone to inseminate just anyone? To ask this question is almost to answer it. And how about our convictions?! If folks get their heads full up with wrong notions, they might want to invade Yemen, vote Republican, draw to an inside straight, or eat a Twinkie, to the detriment of us all.

Wilkinson is right to use the reductio. But that can be dangerous; not long after I used mandatory ski helmets as reductio, I started seeing proposals entreating that mandatory helmets would save lives. When I wrote in the NZ Med Journal about the logical end of seeing public health costs as being basis for policy - bringing one's sex life from the private to the public realm - earnest healthists replied that they've happily prescribed subsidised condoms. Setting up signposts about what's logically implied by positions might well be taken as suggestions of where to go next....