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Posts Tagged ‘health’

I have written enough in the past about Canada’s (usually successful) attempts to muzzle free speech and monitor thought crimes and enforce some kind of bizarre right to not get your feelings hurt.

But this latest proposed law takes policing your head to an entirely different level. I understand that the proposal has been spurred by Natasha Richardson’s tragic death, but that’s what makes it all the more scary; that so many people’s natural reaction to a tragedy is to clamor for more government regulation.

Considering the fact that ski helmets are fairly useless at speeds higher than 20 mph (an impact leads to a fatal collision of the brain with the inside of the skull, something no helmet can prevent), I wonder if they will next make a rule that declares Newton’s laws of motion illegal.

(Also read: On motorcycle helmet laws and freedom)

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Ashutosh points me to this fine article by Atul Gawande on healthcare reform in the US. While the overall viewpoint of the author is pragmatic liberal, the emphasis is definitely on the pragmatic — indeed, his insistence on the value of building upon existing institutions rather than attempting a drastic overhaul gives the piece a slightly Burkean conservative flavor. In any case, it is an article worth checking out, even if you, like me, don’t agree with much of what he says.

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I missed this post by Andrew Sullivan from a while back.

One reason I’m a conservative is the British National Health Service. Until you have lived under socialism, it sounds like a great idea. It isn’t misery – although watching my parents go through the system lately has been nerve-wracking – but there is a basic assumption. The government collective decides everything. You, the individual patient, and you, the individual doctor, are the least of their concerns. I prefer freedom and the market to rationalism and the collective. That’s why I live here.

Andrew, of course, is a British citizen, who was born and raised there but has been living in the US for a long time now, so his perspective is certainly worthwhile.

Now I’ll be the first to admit that this is mere anecdotal evidence which does not prove anything. Andrew Sullivan’s healthcare experience has been better in the US; there are obviously British citizens who prefer their system. However as long as we keep the anecdotal nature of this statistic in mind, there is nothing to lose by considering it. Indeed, I get the idea that a lot of dyed-in-the-wool liberals who have lived in the US all their life automatically assume that everyone who has lived in single payer prefers it. Quotes like these may at least help them open their minds to the truth.

For the truth is much deeper than that little quote by a popular blogger. Yes, the US healthcare system sucks in many ways. However any system of government mandated healthcare has fundamental drawbacks. Excessive regulation adversely affects medical research and the quality of healthcare provided. It encourages the passage of nanny-state laws designed to compel people to stay healthy. Even the claimed reduction in costs does not necessarily happen in all cases; see this article on the Massachusetts mandate. Above all there is a moral issue — a government mandate involves coercive takings and elimination of choice.

My personal preference leans towards “freedom and the market”, as Sullivan puts it. If the government has to be involved it should do so in the following ways:

1) Change the nature of regulation to light, smart ones designed to reduce costs (those associated with litigation, inefficient record keeping, bureaucratization, compliance with unnecessary rules), increase transparency/information disclosure and foster competition.

2) Replace Medicare etc. with a system of vouchers that can be spent on any health provider.

3) Retain one catastrophic government run health insurance system with a high deductible that would cover everyone in case of emergencies and other catastrophes and deal with the free-rider problem in those situations; eliminate all other government insurance schemes.

These measures are influenced by Milton Friedman’s views, espoused among other places in this article.

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We bring you, courtesy the great guys at CCF, the following awesome analysis:

Also read: Your health is my business. And please do not point out that what works for Olympic athletes will turn an average person into a hippo.

(Hat Tip: Reason Hit and Run)

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I found this article on Obama and voter preferences funny yet strangely depressing.

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This guy needs to loosen up. Someone get him a stiff drink!

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There are many good arguments libertarians put forward against the idea of mandating universal health insurance (either through single payer or a Massachusetts style measure).

It is morally wrong to coerce some people to disproportionately pay for others’ costs or to tell someone who decides to take his chance that he cannot do it.

A mandate would almost surely be accompanied by excessive regulation which would adversely affect medical research and the quality of healthcare provided.

It will encourage the passage of nanny-state laws designed to compel people to stay healthy.

Despite these flaws, it was assumed that such a measure would at least reduce medical costs and thus make life better for a lot of people. However it now appears that even this economic rationale does not hold good.

Of course, the linked article of course only looks only at the Massachusetts model but it seems extremely likely that the same problems will arise in any similar scheme.

So what’s the best solution? I don’t have a completely satisfactory answer; check out, however, Milton Friedman’s short essay on the topic.

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From the SF gate report:

Mayor Gavin Newsom has proposed prohibiting tobacco sales in pharmacies, including Walgreens and Rite Aid. The city’s public health chief said the proposal is modeled after rules in eight provinces in Canada but has not been tried anywhere in the United States.

Supervisor Chris Daly has proposed legislation that would vastly limit areas where people can smoke.

Gone would be smoking in all businesses and bars, which now make an exception for owner-operated ones.

Gone too would be lighting up in taxicabs and rental cars, city-owned vehicles, farmers’ markets, common areas of apartment buildings, tourist hotels, tobacco shops, charity bingo games, unenclosed dining areas, waiting areas such as lines at an ATM or movie theater, and anywhere within 20 feet of entrances to private, nonresidential buildings.

Mitch Katz, director of the Department of Public Health, said he strongly supports both measures – even if they are angering business owners who say it’s one more example of San Francisco City Hall overstepping its bounds.

“Tobacco remains the No. 1 cause of preventable death in the U.S. – period,” he said. “It’s government’s responsibility to protect people from obvious risks.”

To paraphrase a comment at the Reason blog, whose responsibility is it then to protect people from tyranny?

Indeed, it’s scary listening to these public-health fanatics. By their logic, speed limits should be lowered to 10 mph, burgers and cokes banned and motorcycles outlawed. Gambling and extreme sports ought to be banished from the face of the earth. And did I forget to mention unprotected sex?

Its a simple enough principle but some don’t get it. Costs and benefits are different for different people. An act that one person views as self-destructive is completely worth the risk to another.

As Jacob Sullum eloquently put it:

Maximizing health is not the same as maximizing happiness. The public health mission to minimize morbidity and mortality leaves no room for the possibility that someone might accept a shorter life span, or an increased risk of disease or injury, in exchange for more pleasure or less discomfort. Motorcyclists, rock climbers, and sky divers make that sort of decision all the time, and not all of them are ignorant of the relevant injury and fatality statistics. With lifestyle choices that pose longer-term risks, such as smoking and overeating, the dangers may be easier to ignore, but it is still possible for someone with a certain set of tastes and preferences to say, “Let me enjoy myself now; I’ll take my chances.” The assumption that such tradeoffs are unacceptable is the unspoken moral premise of public health. When the surgeon general declares that “every American needs to eat healthy food in healthy portions and be physically active every day,” where does that leave a guy who prefers to be fat if it means he can eat what he likes and relax in his spare time instead of looking for ways to burn calories?

It’s true that, as the anti-smoking activist William Cahan pointed out on a CNN talk show several years ago, “People who are making decisions for themselves don’t always come up with the right answer.” They don’t necessarily make tradeoffs between health and other values in an informed or carefully considered manner. Sometimes they regret their decisions. But they know their own tastes and preferences, and they have access to myriad pieces of local information about the relevant costs and benefits that no government regulator can possibly know. They will not always make good decisions, but on balance they will make better decisions, as measured by their own subsequent evaluations, than any third party deciding for them. Leaving aside the question of who is better positioned to decide whether a given pleasure is worth the risk associated with it, there is an inherent value to freedom: When it comes to how people feel about their lives, they may well prefer to make their own bad choices rather than have better ones imposed on them.

Now the smoking ban of course goes beyond nanny-statism. It is also about protecting other people from the risks of second-hand smoke. That’s a laudable intention and as a libertarian I have no quarrels with the underlying principle. But my point is this — how does preventing the sale of cigarettes from certain shops or preventing their use in private bars designated for smoking serve this goal? People who enter such a bar or restaurant usually do with the intention to smoke — those who do not can always choose not to enter.

And whats this about banning smoking in rental cars? Second-hand scent? WTF?

Ultimately, we must recognise these type of bans for what they are — an act of those who are pompous enough to believe others’ well-being is their business and deluded enough to think they are in a better position to make these value judgements than the individual involved. The result is a further expansion of government power in an era when the threat to civil liberties and personal freedom from such intrusions gets bigger every day.

And just so that no one ascribes imaginary motives — I have never smoked, do not ever intend to and hate the smell of second-hand smoke as much as any regular guy. (I do however believe in respecting others’ choices.)

(Hat-tip: Reason Hit and Run)

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One of the dangers of publicly funded healthcare is that it increases the likelihood of the government micromanaging your health and other private affairs. Jacob Sullum wrote an excellent article in Reason last year about the totalitarian implications of public health. The Japanese government is the latest to prove him right.

Under a national law that came into effect two months ago, companies and local governments must now measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups. That represents more than 56 million waistlines, or about 44 percent of the entire population.  

Those exceeding government limits – 33.5 inches for men and 35.4 inches for women – and having a weight-related ailment will be given dieting guidance if after three months they do not lose weight. If necessary, those people will be steered toward further re-education after six more months.  

Here is the link to the above article.

And while you are at it, do read Sullum’s article from last year. It is full of truths that are obvious but often not recognized by those in power.

Maximizing health is not the same as maximizing happiness. The public health mission to minimize morbidity and mortality leaves no room for the possibility that someone might accept a shorter life span, or an increased risk of disease or injury, in exchange for more pleasure or less discomfort. Motorcyclists, rock climbers, and sky divers make that sort of decision all the time, and not all of them are ignorant of the relevant injury and fatality statistics. With lifestyle choices that pose longer-term risks, such as smoking and overeating, the dangers may be easier to ignore, but it is still possible for someone with a certain set of tastes and preferences to say, “Let me enjoy myself now; I’ll take my chances.” The assumption that such tradeoffs are unacceptable is the unspoken moral premise of public health. When the surgeon general declares that “every American needs to eat healthy food in healthy portions and be physically active every day,” where does that leave a guy who prefers to be fat if it means he can eat what he likes and relax in his spare time instead of looking for ways to burn calories?

It’s true that, as the anti-smoking activist William Cahan pointed out on a CNN talk show several years ago, “People who are making decisions for themselves don’t always come up with the right answer.” They don’t necessarily make tradeoffs between health and other values in an informed or carefully considered manner. Sometimes they regret their decisions. But they know their own tastes and preferences, and they have access to myriad pieces of local information about the relevant costs and benefits that no government regulator can possibly know. They will not always make good decisions, but on balance they will make better decisions, as measured by their own subsequent evaluations, than any third party deciding for them. Leaving aside the question of who is better positioned to decide whether a given pleasure is worth the risk associated with it, there is an inherent value to freedom: When it comes to how people feel about their lives, they may well prefer to make their own bad choices rather than have better ones imposed on them.

Indeed.

(Link via Reason Hit and Run)

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In that the addictions produced by both are similar.

I can see the health police salivating at the prospect of using this as a reason to regulate or ban junk food (though to me, it looks like yet another argument for drug legalization).

However, as the author of the linked article says:

Because if we really do crave junk food the way addicts crave drugs, good luck prying those cheeseburgers from our hands.

I am not so sure. The capacity of some people to enforce their standards of correctness on others never ceases to amaze me.

(Link via Andrew Sullivan)

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This is rather old news but I got to know if it only today. Elizabeth Whelan writes in National Review –

Earlier this year in New York City, a public-heath regulation went into effect that set a new and very troublesome precedent, one that insinuates government agencies into personal medical matters.
In mid-January, the city began legally requiring laboratories that do medical testing to report to the Health Department the results of blood-sugar tests for city residents with diabetes — along with the names, ages, and contact information on those patients.
City officials are not only analyzing these data to assess patterns and changes in diabetes prevalence in the city, but are planning “interventions.” Simply put, diabetics will soon receive letters and phone calls from city officials offering advice and counsel on how to effectively deal with their medical condition. If you wish to keep your medical data confidential, you cannot.

And this may just be the beginning. As the writer notes, the next stage of intervention “may be a harshly punitive one, with fines and other restrictions on those who fail to heed the health warnings. The message will be: Live a healthy life or the government will punish you.”

This is one of those occasions when my words can simply not convey the outrage I presently feel, so I will not say anything more.

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Dad loses 30 pounds, climbs Mt. Kilimanjaro with daughter. Nothing extraordinary in there, but I think it’s a good read.

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