Monday’s Mtg: How far should the government go to encourage healthy lifestyles?

The more I think about this one the more complicated it gets. OTOH, a lot of what the government does to prevent and treat what are called non-communicable diseases (like cancer, diabetes, anorexia, Alzheimer’s, and hypertension) is widely supported by most Americans. The public loves govt funding basic research on chronic diseases, Medicare and Obamacare subsidies, and govt-enforced safe food and water.

But, when Americans perceive that other people’s illnesses are due to poor lifestyle choices things get controversial. How far should, for example, regulation and taxpayer-supported health insurance go in protecting people from their own bad choices?

It’s not just a moral judgment, either. As the first article below points out, it is hard to attribute many chronic conditions to specific behaviors. This is true even for health problems they’ve been studying for decades like cancer and diabetes and (it seems to me) is probably even more true for behaviors that public policy is newly targeting, like obesity. How can we know what interventions are cost-effective if we don’t know how a lot of the science works?

Oh, and what constitutes a bad lifestyle “choice” exactly? Not all decisions about what to eat and where to work and live are equally voluntary, especially for children but also in a sense for people too poor to afford healthy choices.

Along with these issues, here are some other basic questions we might consider on Monday. I will be back from my vacation, BTW.

DISCUSSION QUESTIONS –

  1. Rationale: Why should the govt try to prevent/minimize bad lifestyle choices?
    — Why: General public interest? Externalities (effects on other people)? To help the economy? To prevent needless suffering? To fulfill international obligations?
    —  When: Scientific uncertainty.
    — Who: Federal govt v. state/local concern?
  2. Targets: Which behaviors?
    — Smoking/drinking, other drug use and vices.
    — Diet: Obesity/sugar, child nutrition/school lunches, “food deserts” in poor areas.
    — Violence and accidents: Guns, hazards. At work/home.
    — Health care: Insurance, Obamacare carrot and sticks.
  3. Tools: It’s not just regulation.
    — Taxation/subsidies.
    — Information and advocacy.
    — Market regs: Restrictions on buying/selling, food service, product safety regs, etc.
    — Health care.
    — People under govt control: School kids, prisoners, soldiers…
  4. Limits:  How much govt action is too much?
    — Who should decide?
    — Where has govt gone too far or should do more?

SUGGESTED BACKGROUND READING –

NEXT WEEK: Does foreign aid work?

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One response

  1. This is a very interesting topic to me, because I work as an analyst at the USDA Food and Nutrition Service, overseeing research about the Supplemental Nutrition Assistance Program (SNAP), also known as food stamps. A big issue right now is whether the types of food that people can purchase with SNAP should be restricted. Should people be allowed to purchase sodas with their SNAP benefits? State legislatures have been asking for waivers to restrict SNAP purchases for a few years now. In the past, the Obama administration always denied state waiver requests; I expect that the new administration will approve them. Although most of the States requesting these waivers are GOP controlled, plenty of liberals in the health community support some restriction. On the other hand, many business groups (such as supermarkets and food manufactures) are firmly against it.

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