Nova Scotia reductio

I'd suggested mandatory ski helmets as the the absurd end of the logic requiring the internalization of costs externalized by the public health system. There was a brief subsequent push for mandatory helmets in New Zealand, but it came to nothing.

But Nova Scotia's going to go there. Here's Chris Selley at the National Post:

Nova Scotia bolted into the lead this week in the epic race among North American jurisdictions to make us slightly safer - barely overtaking King County, Wash., which in June banned swimming and wading in rivers without wearing a life jacket.

Bill 131, tabled Tuesday at the House of Assembly in Halifax, would make it illegal to ski or snowboard without a helmet, effective Nov. 1, 2012. A helmet cuts the risk of head injury by at least 60%, according to a news release from the Nova Scotia Department of Health and Wellness. And Minister Maureen MacDonald assures me there will, indeed, be helmet cops on the slopes. The minimum fine is $250.

Ms. MacDonald offers two justifications for this: brain injuries, and the terrible consequences they often entail; and the money it costs to treat them. According to the province, a "traumatic brain injury" costs roughly $400,000 a year to treat. And since 2000, 11 helmetless skiers and snowboarders have suffered such an injury on the slopes of Nova Scotia. Call it one a year.

Selley starts pushing to see how far Nova Scotia Health Minister Maureen MacDonald will toboggan down that slope:

People who slide quickly down mountains put a huge burden on the public health system, if you're inclined to look at it that way - I'm certainly not, but clearly many Canadians are - and that will still be true when the last dinosaur buys a helmet. Most snow sports injuries aren't head injuries anyway. All four people who died at Canadian ski resorts last season were wearing helmets.

So, aren't we trying to save lives? Aren't we trying to save the healthcare system money?

"This legislation doesn't ban skiing," says Ms. MacDonald, sounding a bit exasperated.

According to her own logic, and in her own words, I have to ask: Why not?

My short answer: social stigma doesn't yet attach to skiers. Politically disfavoured groups that impose costs through the public health system see taxation, regulation, and eventually bans on activity. Tobacco's nearing the end of that slope, alcohol's moving along, and fat people are next at the gate. Bans don't come until participants have been sufficiently stigmatized - anti-smoking ads don't just encourage people to quit smoking, they also do a nice job in painting smokers as antisocial people who hate their kids. Dodgy cost reports painting costs borne by smokers, drinkers, and the obese as costs to the country help fuel demand for greater regulation and taxation.

If every sort of risky activity that potentially imposed cost through the public health system merited tax or regulatory treatment, it is hard to think of any part of private life that would escape attention.