Wednesday 23 September 2009

Slate on paternalism

Slate has been on fire of late against paternalism.

Jacob Weisberg: First they came for the Marlboros:
The underlying left-right divide is not about whether government has the right to promote private virtue but, rather, about what kind of virtue it should promote. Republicans demand paternalistic policies that uphold morality or social order. In Indiana, where I recently spent my vacation, you can pick up fireworks or a handgun anywhere, but good luck buying a six-pack on Sunday. Democrats, by contrast, deploy paternalism for health and safety reasons, yielding a different set of absurdities. In California, pot is on the verge of becoming more permissible than cigarettes. Both left and right take pleasure in mildly persecuting those who fail to meet their civic ideals.
Dan Engber: Abolish the Fat Tax!
Obese people have shorter life spans. Since the elderly are by far the costliest patients, it's possible that early deaths save taxpayers money in the long run. In fact, fatal diseases almost always return net-cost savings to public health care. Smoking, which causes a host of particularly deadly conditions, turns out to be especially cheap—which is to say, government attempts to curb nicotine addiction have actually cost the United States money. (Niggling mental disorders and musculoskeletal diseases tend to be more expensive.)

Jeff Merron, "Workus Interruptus", on the stupidity of most "costs to society" measures:
Often, though not invariably, "costs to the U.S. economy" are self-serving sums concocted by lobbyists, companies, and advocacy and trade groups in order to grab attention. Basex, for example, is a consulting company that—you guessed it—would love to help you cut down on all those pesky interruptions, for a fee.
William Saletan, "Then they came for the Fresca"
My real interest is in the authors' third basis for regulation: market failure that
results from time-inconsistent preferences (i.e., decisions that provide short-term gratification but long-term harm). This problem is exacerbated in the case of children and adolescents, who place a higher value on present satisfaction while more heavily discounting future consequences.
Wow. This isn't socialism. It's sheer paternalism. It applies even if you cover every cent of your medical expenses. You buy and drink soda because you want the "short-term gratification." Later, you regret this purchase because of its "long-term harm." This, according to the authors, is a market failure that justifies taxation to alter your behavior, totally apart from its impact on public health costs.

This is what worries me about the crackdown on death sticks and edible crap. There's no end to its ambitions. We'd better start applying some brakes.

One decent argument against the socialization of health care in the United States is that the arguments for health paternalism would then become more appealing to the kinds of folks who'd otherwise not give two hoots about your dietary habits. Once you socialize the downside costs, pressures for regulation of risk-taking behaviour become pretty strong.

It would be great to run a study looking at whether the extent of government involvement in health care correlates with the extent of nanny-state health regulations across a panel of countries. I'm sure I can get data on government health care expenditures. Any pointers on an index of "health nanny statism"?


  1. Is there any evidence for this:

    "Since the elderly are by far the costliest patients, it's possible that early deaths save taxpayers money in the long run. In fact, fatal diseases almost always return net-cost savings to public health care."

    Chronic fatal diseases would seem to be costly regardless of age of death...

  2. There certainly is evidence for health care cost being higher for the elderly: ie the first relevant google hit:

    Are you confusing type of illness with type of patient.

  3. @Cam: Smoking is certainly a net saver for the fisc, mostly because of the taxes collected. Even the anti-tobacco groups admit that collected taxes far outweigh health care costs.

    This isn't an argument in favour of disease-promotion; rather, that the fiscal externality argument for paternalistic intervention ought be viewed with skepticism.

  4. Owen: No I am just asking for evidence for the assertion that fatal diseases "almost always" return net-cost savings. I am not disputing that the elderly are the most expensive...

    Eric: I certainly view that argument with skepticism, however there are lots of claims flying about on public net-costs of certain lifestyles and I just haven't seen much eveidence one way or another...

  5. @Cam: It is definitely true that smokers return more in tobacco taxes than the cost they impose on the health system. I'm pretty sure that alcohol imposes less cost on the public health system than drinkers pay in excise taxes (in NZ), or at least that's my best read after slogging through and correcting the BERL report.

    As for other stuff -- be very careful because the majority of reports horribly conflate private costs of activity with the cost imposed on the fisc.