“So long as government subsidizes healthcare costs, regulations to discourage obesity are society’s self-protection, not nosy paternalism”

June 17th, 2012

Rick Hills argues that Bloomberg’s sodaban is not some form of statism or paternalism, but is justified:

As Mark (14:7) tells us, the poor we will always have with us, and, in the libertarian paradise envisioned by the Cato Institute and Philip Klein, there will be those who cannot afford insurance at the market-priced premium offered by insurers. We will either provide insurance to them at society’s expense, or we will treat them after the fact in emergency rooms, right? Or do these people really think that we as a society will simply allow the imprudently obese, who refuse to purchase insurance at the market-specified premium, to keel over gasping on the sidewalk while we gingerly step over their twitching bodies? . . .


This confirms my fear that “Once “lowering health care costs” is a legitimate governmental purposes, every regulation on individuals can be justified.”

Event his is too much for Orin!

Rick, your argument is that objections to the soda bans are “silly” because “[s]o long as government subsidizes healthcare costs, regulations to discourage obesity are society’s self-protection, not nosy paternalism.” There are three obvious responses. You recognize and respond to the first, that many of the people who find the soda bans silly also object to at least some of the ways in which the government subsidizes healthcare costs. But there are two other arguments. First, there is not a clear fit between health care costs and this particular anti-soda ban. Second, even if there is some health care cost saving from the ban, there are a lot of important values at stake beyond mere cost. You might say that in your view the cost question must govern, and all other ways to look at the problem are “silly,” but you don’t say why you believe that.

Ilya Somin chimes in–and of course, as a lousy Bostonian, he calls it “soda pop.” No, it is just soda. Soda. Not pop.

In addition, it’s worth noting that Rick’s logic would justify a lot more than Bloomberg’s soda pop “tax.” It just as easily proves the need for a ban on any behavior that increases one’s chance of getting sick and needing health care. So long as there are government subsidies for health care, anyone who has a suboptimal diet, doesn’t exercise enough, or takes any other risks with their health is potentially “slurp[ing] dollars out of their fellow citizens’ wallets.” A soda restriction is unlikely to solve that problem by itself, or even come close to it. The soda-drinkers could just gorge on pizza and cheeseburgers instead. The only way to deal with the problem of obesity externalities through paternalistic regulation is to have a comprehensive diet and exercise code that all citizens must follow or else pay a fine. Much better to cut back on health care subsidies than to go down that route.

Update: More from Somin. Note how he constructs a similar slippery-slope type argument like with the ACA case:

As I explained in my previous post on this subject, paternalistic policies are not going be able to prevent obesity merely by restricting sodas or some other specific food or drink. People who like sugary or fatty foods will simply gorge on something else. The only potentially effective paternalistic solution is comprehensive regulation of people’s diets and possibly exercise as well.

I would oppose the soda regulation and others like it even if they did improve health. Individuals should be able to decide for themselves to what extent they are willing to accept health risks in order to satisfy other preferences. I get less than the optimal amount of exercise in part because I spend a lot of time reading and writing. As a result, I am less healthy than I might be otherwise. But that is a tradeoff I should be able to make in a free society. The same goes for people who are willing to accept health risks for other reasons – including because they want to continue eating the types of food they enjoy.

Nothing short of complete regulation will help the problem, the argument goes, so we should do nothing. This, I think is a tad too slippery.