From Jacob Sullum’s fantastic “An Epidemic of Meddling,” May 2007 Reason (subscribers only):
What do these four “public health” problems—smoking, playing violent video games, overeating, and gambling [framed as such by, respectively, Henry Waxman, Hillary Clinton, Surgeon General Richard Carmona, and Thom White Wolf Fassett (general secretary of the United Methodist General Board of Church and Society(] have in common? They’re all things that some people enjoy and other people condemn, attributing to them various bad effects. Sometimes these effects are medical, but they may also be psychological, behavioral, social, or financial. Calling the habits that supposedly lead to these consequences “public health” problems, “epidemics” that need to be controlled, equates choice with diseases, disguises moralizing as science, and casts meddling as medicine. It elevates a collectivist calculus of social welfare above the interests of individuals, who become subject to increasingly intrusive interventions aimed at making them as healthy as they can be, without regard to their own preferences.
This is precisely and elegantly put—as well as pointedly inclusive: nannystatists tend to be progressive statists, the kind of secular moralists whose influence has grown in the wake of cultural Oprahfication; in fact they are, you might say, the bastard children of Ralph Nader’s consumer concern and alarmist hyperbole fetchingly dressed in the slick, sexy garb of modern marketing campaigns.
But such “traditional” nannystatists are not alone, as Sullum’s list makes clear—which is why I am often just as critical of social conservatives who try to legislate their particular morality as I am the progressive nannystatists. Note, though, that legislating is, for me, the key: because I have no philosophical problem with the free-market gambits of social conservatives, such as boycotts or public condemnations of, say, The Dixie Chicks—though I may not agree with the content of the form.
And as Cathy Young very adroitly pointed out not too long ago, libertarians themselves are often guilty of promoting that which they ostensibly and ideologically claim to abhor.
The point being that we all must be constantly on guard if we are to balance individual liberty—the basis of our republic—with our own moral prescriptions, lest the prescriptions become a form of socialism.
Making this particularly thorny for the classical liberal or conservative is his adherence to process. That is, laws held to be Constitutionally sound and duly passed by the legislature become part of the social contract—even when we consider those laws silly or intrusive. Which is why many of us wind up legal conservatives—pushing for judges who we hope will respect the Constitution, which we believe does a fine job, when interpreted with fidelity, of promoting and protecting individual freedoms.
But back to Sullum:
This tendency to call every perceived problem affecting more than two people an “epidemic” obscures a crucial distinction. The classic targets of public health were risks imposed on people against their will, communicable diseases being the paradigmatic example. The more recent targets of public health are risks that people voluntarily assume, such as those associated with smoking, drinking, eating junk food, exercising too little, watching TV too much, playing poker, owning a gun, driving a car without wearing a seat belt, or riding a bicycle without wearing a helmet. The difference is the one John Stuart Mill urged in his 1859 book On Liberty: “The sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any of their number is self-protection…The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.” Mill’s “harming principle” is obviously important to libertarians, but public health practitioners also should keep it in mind if they do not want to be seen as moralistic busybodies constantly seeking to expand the reach of government.
Under Mill’s principle, there is a strong case for government intervention to prevent the spread of a deadly microbe, extending even to such highly coercive measures as forcible quarantine or legally mandated medication. The case for intervention to prevent people from placing bets, eating ice cream, or playing Grand Theft Auto is much weaker. It requires demonstrating that such activities harm not only the people engaged in them but other people as well. And although Mill was imprecise on thise point in On Liberty, harm to others has to be understood as a necessary but not sufficient condition for government intervention. To justify the use of force, the alleged harm has to be of the sort that the government has a duty to prevent—that is, the sort that violates people’s rights.
The mechanism Sullum describes—running matters of choice through the filter of moralism and hyperbole and producing, as an end result, an “epidemic” or a crisis of “public health”—is particularly dangerous, as I’ve recently discussed, when the government assumes the role of healthcare provider.
Because under such conditions, the very people who are redefining choices in terms of disease will ultimately be responsible for controlling the costs of treatment, and for determining what is and is not covered by “universal healthcare.”
Which makes bans on soda and salt-and-vinegar potato chips (non-baked)—if not the advent of mandatory jumping jacks—that much more likely.
And the last thing I want to do is find myself standing in a field one day, shirtless and smeared with greasepaint, screaming “you can take away my Oreos Doublestuff, but you can never take…MY FREEDOM!”
Especially if I’m wearing a kilt.
…the guided linguistic slippage from “medicine” to “health maintenance” to “health care” to “healthcare” will have been an underexamined lever of that assumption.
I think we ought to try to get everyone in Congress liable to vote on the issue to sign a pledge to use only the health care afforded to the average American citizen under any national plan, and not to go outside of it.
I get that habit from Pynchon, BoZ.
Most of the time it’s on purpose, too. Here? I’m not telling.
This doesn’t even account for the Global Warmist meddling:
You’ll be wearing a helmet and 5-point harness in your electric car with a 35mph governor on it; a breathalyzer interlock installed; airbags in the front you can’t turn off; gps position system with speed, maintenance and g-force data that calls the police if you violate any set-points; cellphones and smoking while driving banned.
It’s worth remembering as well that there is an entire industry of advocates and academics that exists solely to perpetuate ever more expansive lenses of public health. Keep scrolling here for a taste. What is evident here I think is that even a robust national public health framework will do nothing to mitigate parallel state and local nannyism.
My god, what’s next?
Preemptive wars by our nanny state government against wielders of imaginary WMD?
*shudder*
The obligatory “ignore the Alphole” inserted here.
Citizen – begin exercising and losing weight or you will have to pay the “fat tax”.
Citizen – you’re exhaling too much CO2 due to your exercise, you have to pay the “carbon tax”.
What a glorious future we have before us!
Behold! The Future!
“For he doth feed upon imaginary coup.” [Sir Isaac Newton]
This isn’t really a new thing is it?
I don’t think so. America’s always had a bit of a Puritanical streak. These are the same old folks that gave us temperance societies, witch hunts, etc. The religion used to be some form of Protestantism, but now the religion is progressivism, environmentalism, or whatever other word the believers use to describe their devotion to otherwise Godless Communism or socialism.
Banning Bread and Circuses is the new Bread and Circuses.
I think the release of Anthrax has a public health crisis dimension to it. Whereas, say, your not strapping on your bike helmet before you pedal home from the playground is your business, alphie.
Unless, of course, a government funded ambulance has to cart your broken-headed self off to a government funded hospital to get you patched up?
As a United Methodist, I writhe in shame at the nonsense of our alleged governing bod(ies). Of course, mine was the Grandfather who was loudly invited over for a beer at his neighbors in Holstein, Iowa back in the day…man, took a while for that scandal to go away.
The best of all worlds would allow for insurers and employers to pass the burden/cost to the people that partake of an activity, rather than have it all lined up for us ripe suck taxpayers to foot (or to be banned by our betters). Sigh.
Individual responsibility – what a concept.
I can see the bumperstickers now:
Alphole says;
And he’s quite right. Which is reason enough to avoid gummint health care whenever possible. Kelo, public good, nothing is safe. All your body are mine.
“Health” is the secular religion … Secularists having deemed Judeo-Christian tenets as “old-fashioned”. Nihilism holds there is not good/evil, right/wrong and modern secularists/”progreesives”, as apt to temptations of power, frame things as “healthy/unhealthy”
Thus we get “progressives” sneering at even hinting that certain ideologies can be immoral/evil (ie Islamism) but will demand and pass the most draconian laws against smoking (banning it in all outdoor public spaces or in private cars) because it is an article of faith that even the whiff of second/third/fourth hand smoke is unhealthy.
Most social conservatives I know recognize the line between what morality is the realm of government and what is not. Sometimes they would draw the line differently than social liberals, but at least they are honest in speaking clearly that it is morality they are talking about legislating.
All law is based on morality … the debate is truly about whose morality and how much of it is within the proper province of government. IE adultery is immoral, but it is not, nor should be, a matter of criminal statutes.
America would be a better place if only we could all learn to just let the children of Libertarians bleed to death after an accident instead of squandering government resourses to save their lives?
In addition, on the macro level, national defense is one of undisputed proper roles of government. At the local level, a good police force has proactive programs to identify and eliminate criminal threats before they mature, so it goes at the national level via defense programs.
Proggs see patriotism and national interest as “unhealthy” and “old-fashioned”…but that’s what makes them evoluntionary dead-ends.
Ah, Thomas Pynchon. Great artist, lousy philosopher, like so many of the Postwarriors.
Commander0
My eldest daughter is a paramedic. It is a good month when her company can collect 40% of their billings.
It is not the government that makes up their losses…it is the individuals who DO pay their bills (direct or through insurance) that make up the difference via higher fees.
Ditto ER’s.
So Major John is correct. Individual responsibility would have those that play, pay.
But when everyone assumes that some faceless guy hundreds of miles away will pick up the tab, why even start to try and be responsible?
Then I wonder if wouldn’t be better to go away with a bang, rather than live like that.
Alphie provides a rare moment of honesty as to the real motive of liberals and universal health care.
Once we have the gov’t paying the bill for medical costs, what is off limits in terms of legislating?
Arguably, every single thing a person does or does not do affect his/her health in some way, or could pose a danger that could cause injury.
thus, if the gov’t is paying for all health care, than it become perfectly appropriate for the gov’t to tell us all what we can and can’t do, can and can’t eat, can and can’t own, etc.
It also would require a massive tax increase across the board. Plus, as health care cost is a massive portion of our economy, it would, in practice, cede control of the economy to gov’t.
So, not only would the tyranical left gain almost absolute control over every aspect of our lives, it would also control the economy more thoroughly than even soviet russia.
The Progg’s very own Sharia.
I gotta stifle a giggle, oops, sorry, a heckle, every time someone who sees nothing wrong with forcing all Americans to pay into their $600 billion a year “kill the people who scare me” fund calls me a lefty.
Ah, Thomas Pynchon.
Just thought I’d try that on. Anyone buying it?
The progressive that advocates the nanny state is by nature not a risk taker. Reducing their risk at the expense of everyone’s personal freedom seems like a good trade off to them with the added benefit that personal freedoms as a concept also seem risky to people who are afraid to exercise them.
These are the same old folks that gave us temperance societies, witch hunts, etc.
Let’s not forget that the temperance movement was primarily feminist in nature. They weren’t trying to stop people from having fun; they were trying to stop men from going to the bar straight from work, getting loaded, then going home and beating their wife and kids senseless.
Prohibition may have been repealed, but to some extent the pattern of abuse was broken.
That said, it’s hard to balance what hurts only me on the one hand and what hurts society on the other. Absenteeism affects one’s fellow workers who have to pick up the slack, early death from bad health practices send people’s dependents into the welfare office, etc.
Will the insurance companies be able to successfully sort out those claims that result from our bad behavior from those that result from dumb luck?
If you get lung cancer and you never smoked, do they not raise your insurance, whereas they’ll raise the rates on one who did?
I’m single; some say that has a detrimental effect on health. Do I pay more just because no one has made me an offer I can’t refuse?
I gotta stifle a giggle, oops, sorry, a heckle, every time someone who sees nothing wrong with forcing all Americans to pay into their $600 billion a year “kill the people who scare me†fund calls me a lefty.
I’m sure you’re really a righty or even a moderate instead of a lefty.
Question: Why are those on the left scared to admit it? Why do they run away from being called a “liberal” or even “progressive” and instead try to pretend they are “independent” or “moderate”.
I’ve never been ashamed of admitting I am a righty or a conservative. Why the shame in your political ideology alphie? Why the reluctance to admit it?
After all, whether you agree with the war or the current foreign policy or not, it is hard to argue that national defense / national security / foreign policy is quite clearly the proper province of government, which any conservative would agree with whether or not they agree with the particular policy being pursued.
Health care and regulations about what people can eat are not so clearly the proper role of government.
Thus, it is easy to support the war and still be conservative and see that those who call for ever more government intrusion into our lives and control over the economy is “statist” which is “leftist.”
So, I’m not so sure why you are giggling over the term. I’m more than happy to call you a liberal or a progressive or a socialist or whatever term you want, as long as you don’t try to sell me on your being an “independent” or “moderate” or “true conservative”.
I hate those people who cry “you can’t pigeonhole me” with your terms. I think for myself.
Yet, every utterance they make is the party line from the far left.
I wonder where our strict Constitutionalist emmadine has run off to? She could maybe explain some things to alphie.
Please, somebody save me before I eat trans-fats again!
I think what has happened here is the old bait and switch. While we were all busy watching Snady Burglar destroy history by destroying historic documents, I think Hillary, Bloomberg, and the other nanny-ists snuck into the archives and made off with the Constitution.
Burglar can confess all he wants (“ooo – I soiled myself”), but the trans-fats BS gives it all away. I’m sure it was just an oversight that the founding fathers forgot to include trans-fats in the second amendment when they banned personnal fire arms.
Pe5rsonally, I have never met a trans-fat that I didn’t love.
GB,
If you check into a hotel while the Orkin man deals with the cockroaches that have have infested your home, it doesn’t mean that you’ve moved.
Darleen says:
Yes I know this, they aren’t “gummint” ambulances and Mr John is also correct that those who play should pay. We should do our best to AVOID the alpo solution of “gummint” health care. Because with decisions like Kelo backing up a notion of overriding public good we are all going to be incredibly scrutinized and have our peccadilloes dissected and held up for “gummint” approval. I prefer to keep mine just as they are, semi-private and utterly loathsome.
The collective loves health care but not at the expense of earth care.
In the near future they will require every home in America to use mercury-laden light bulbs to save earth from catastrophe human-induced destruction.
The Oprahfication of a Nation.
That’s interesting, but it seems as if successful expansions of public health concerns often rely on second-order pathologies.
abortion
teen pregnancy
climate change
energy inefficiency
obesity
trans-fats
gun violence
domestic violence
animal rights
factory farms
I don’t know what my point is other than to say that this sort of thing seems to metastasize promiscuously, and that the second-order issue may or may not be a genuine concern of those advocating on the first-order issue.
The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.
H. L. Mencken
I just hope that my government health care program will include treatment for hairy palms and penis elbow.
Why isn’t everyone ignoring the idiot? He tried to hijack this thread.
Hell, considering the topic of this thread, his hijacking attempt was blatant and clumsy. It should get his ass banned, IMHO.
Do not touch that straight line—you do know where it’s been.
“A screaming comes across the sky.”
Too bad it wasn’t our troll.
Dear Great Banana, Commander0,
I submit this for your perusal.
Regards,
BRD
Just trying to help out the irony impared, Robert.
Decrying the nanny state while at the same time advocating that the governemnt should send an army of Mary Poppins to the Middle East to protect us from the scary non-believers is not a rational position.
Just thought you guys should know.
B Moe,
Doesn’t matter. No getting through to someone who claims confusion, repeatedly asks for clarification, and repeatedly responds to it with the original nonsense as if the response were never made.
Are you saying that some nanny staters are swadddling us in unconstitutional cotton balls, JPT?
Not true.
I believe the nanny staters who throw dirty hippy cancer patients tryng to ease their pain with demon weed into jail cite the commerce clause of the constitution as their justification.
I was poking fun at emmadine, JPT< I suspect that a strictly literal interpretation is a situational affliction for her.
What is that whimpering, by the way? Did someone leave the puppy out?
Somebody should have put the puppy out. It’s left a smelly present.
Ya, I knew that. I was poking fun at emmadine’s calculated obtuseness myself.
Eat a salad every couple of days. Last I checked veggies are available at the corner grocery and even McDonald’s has them.
Play some tennis.
Walk.
Don’t smoke.
Get a flu shot.
Odds are at that point you can tell Henry Waxman to pack sand.
Why do I have to wait that long to tell Rep. Waxman to go pound sand? Can I please do so now?!?
Major, when I lived in his district, I would write a letter to Waxman telling him to go pound sand every time I saw the arrogant twit’s name in the paper.
But the postage costs nearly drove me to bankruptcy.
On another note … Moby is still here?
alphie –
Are you okay, man? You feel alright?
Robin,
If you mailed him everytime a kleig light went on or a reporter opened a notebook…wow, no wonder you had to stop. That guy finds cameras and reporters almost as fast as Jesse Jackson or Charles Shumer!
Great Banana, you scare me… did you read my mind?
So very true… scary true….
Great banana, you read my mind.
That’s like so true.. scary true.
the government taking us all over through the health care system….
why didn’t I think of that..
note to self: buy health care stock.
I seem to recall blasting Scalia’s commerce clause decision, praising Thomas, and coming out in favor of medical marijuana.
So alphie has me confused with someone else.
Are you two-timing me, alphie?
Jeff, you know by now that being alphie means never saying you’re sorry.
I guess he means that if you are for government spending in a clearly governmental function – such as defense / national security, than you must be for all nanny state regulations and spending or you are a hypocrite.
The substance of the different policies is meaningless you see, if you are for the federal gov’t doing something in one area, such as having a military and using it for national defense, then you must be for the gov’t taking over health care and regulating what we can and can’t eat. Makes perfect sense I suppose.
or something. Not sure. But he giggles a lot and that seems to prove his point or something.
And, a lefty decrying the overreach of the Court’s commerce clause jurisprudence is almost too funny. Pot meet kettle. (For the record, I think the federal gov’t should allow states to regulate marijuana as they see fit.) But, it was clear liberal precedent that led to the Court’s decision, so liberals should not be so quick to blame conservatives on this one.
He Who Must Not Be Named scares me.
Is there some fund I could pay into?
There is a funny consistency that occurs with people on the left and the right–one that is also incredibly, logically, incongruous. And that is the constant refrain that the government abuses its power, authority, and responsibilities. Whether it is the issue of privacy, security, speech, property right, et. al., there is no shortage of criticism–and not all of it unreasonable.
The incongruity occurs when the same parties advocate for more power, authority, and responsibility be given to the government–in this case, universal health care as the balm to salve the so-called epidemics or diseases so identified–without the recognition of the already extant short fall in performance by that government, or the long history of unintended consequences that are a natural result of government legislation.
The political left espouses little trust in government to restrain its use of its existing power, yet is regularly inclined to advocate for ever more government authority over all walks of life.
And conversely, the political right, which espouses small government–restraint, indeed–yet has demonstrated great difficulty in actually governing on that basis. It’s as if when handed the reins of state, they automatically turn into the party of the government, rather than superintend to their base instincts of restraint.
I think it makes one want to vote for gridlock. If the past 100 days is Nancy Pelosi’s (and the Democrat’s) best game, I say let’s have another hundred days of no accomplishment. They didn’t really screw up anything.
Cheers.
It is actually a result of trying to medicalise the results of criminal conduct. It really took off when the CDC tried to medicalise gun violence in the 90s, by referring to it as a public health problem in order to justify restricting gun ownership in the inner city, as opposed to dealing with the underlying criminal conduct.
Witness the bans on “saturday night special” handguns, which were merely cheaper model handguns that poor people, usually minorities, could afford for self defense. Typical lefty racism in action.