Thursday, November 15, 2007

Government Health: Intervention, Restrictions, and Penalties

What do Massachusetts and Great Britain have in common? Mandated health coverage.

Today is the last day that citizens of the State of Massachusetts may buy health insurance or risk penalties on their State income tax.

The BBC News from Britain reports that the Nuffield Council on Bioethics proposes that the government do more to protect the people from themselves and their choices:

The government should intervene more with public health measures Government ministers should shrug off media accusations that they are running a nanny state and introduce tougher public health measures, experts say.

The Nuffield Council on Bioethics said the time had come to consider a whole host of interventions in the UK after the introduction of a smoking ban.

Its proposes raising alcohol prices, restricting pub opening hours and better food labelling to fight obesity.

The government said it was taking steps to protect public health.

The report by the panel of experts, which include scientists, lawyers and philosophers, said there was a balance to be struck between individual freedom and wider public protection.

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"But the government has a duty to look after the health of everyone and sometimes that means guiding or restricting our choices." (emphasis mine, BBN)


Of course, the UK doesn't have our Declaration of Independence, with its insistence that each of us is endowed with the inalienable right to life, liberty and pursuit of happiness and that the government receives its power from the consent of the governed. Massachusetts ought to know better.

However, I'm afraid that the bioethicists and bureaucrats go to the same schools.

While I appreciate that the Massachusetts plan calls for each person or family to buy individual health insurance if they don't have it through their employer, and I recognize that people would be healthier if they follow the recommendations of the UK bioethicists, I would prefer a tax deduction for compliance, rather than a penalty. Rewards seem to work better than punishments for behavior that other people decide is "for your own good."

The statement from Lord John Krebs about restrictions for the common good, however, is the most worrisome. Remember that some in the public health community believe that in times of crisis, the community interests must trump those of individuals due to the scarcity of resource and public funding of relief and rescue. (Never mind that the courts are paid for by community funds, also have limited resources and yet, no one would dare suggest suspension of individual rights in criminal cases.)

2 comments:

Suricou Raven said...

I happen to like the public-places smoking ban. Its the first time ive been able to go into a pub without choking on the air.

LifeEthics.org said...

And the property owners and other patrons have no rights?

The point was the ethicists' encouragement of the use of restrictions for all, regardless of private property or private wishes, with penalties that make the property owner buy signs and enforce the laws or face fines and/or be shut down.

My definitely non-smoking husband was more than irritated when we had to buy signs and post them on the wall in his stores and my office, although no one had ever lit up in either in our little town.

What about when the pubs are told to shut down earlier and restrict the alcohol use of the patrons according to some health guideline? Or when the overweight are refused service so the restaurant or pub or candy store owner won't face similar fines?

How will the "healthy motion buildings" be achieved except by removing elevators and escalators?