Saturday 10 December 2011

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.


  1. I have been thinking about this for awhile. I think the causation runs the other way: people don't like a group, make moral judgements against them and then lobby for policies which either try to reform or hurt that group.

  2. As long as we socialize the costs of fixing people who break their brains by not wearing a helmet then it will be tempting to impose these sorts of restrictions.

    There are, of course, some additional risk factors associated with wearing a ski helmet. It tends to make one ski a bit faster and indulge in more risk than might otherwise be the case. You could probably argue that wearing a helmet increases the risk one poses to other skiers.

    At the end of the day the solution is pretty simple.

    1. Fix the externalization of healthcare costs at source.
    2. Leave te decisions over helmets to private parties both real and otherwise. There are a number of US resorts who are making helmets mandatory for those who wish to use their facilities. I don't see this as being at all paternalistic; if you wish to ski at my ski field you can wear a brain bucket so that I can lessen my investment in ski patrol and liability insurance.

    300hr/yr ski bum... who likes his helmet for keeping his ears warm.

  3. @Azmytheconomics: I don't think we're disagreeing. But put people on a continuum for whether they give approbation or disapprobation to a group. The hard core on the disapprobating side will start trying to "denormalize" the activity among moderates, partially by making what that group's doing seem like it's imposing costs on other people, partially by minor regulatory changes that work to make the activity less prevalent and more stigmatized. Then harsher regs follow as the group becomes more stigmatized...

    @Chris: Yup. You'd like the Browning 1999 piece in Public Finance Review, "The Myth of Fiscal Externalities". Hit the "Fiscal externalities" tab for related posts here...

  4. @Anon/Chris
    It seems very much a case of people take on the riskier behaviour once they have their skull armour on. Even 15 years ago hardly anyone wore a helmet, I wonder what the trend head injury rate is?

    Perhaps an experiment might be to have slopes of similar terrain be helmet-only and helmet-free. And compare the injury rates over time.
    Personally I don't see the need for a helmet unless you are doing tree runs which are really only applicable at overseas resorts.

    P.S. Have you tried a woolly hat?