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July 01, 2012 11:54 AM Better Ways to Promote Public Health

By Ryan Cooper

Where I part ways with a substantial fraction of the liberal intelligentsia is when it comes to paternalism. Tim Noah had perhaps the perfect distillation of this, talking about Mayor Bloomberg’s soda ban:

What about when the nanny state instructs us to behave in accordance with its views of morality? I disagree with conservative aspirations to install the nanny state in my bedroom, but I wouldn’t necessarily begrudge the state its power to play moral cop elsewhere. I approve of the government prohibition against the selling of organs, and I would never want the government to stop discouraging illicit drug use and prostitution (though I might quibble with its methods). These prohibitions all constitute the government helping to define the nation’s collective values, which is entirely legitimate.

I was ragging on Will Wilkinson earlier, but I think he had the better of this argument:

I take it that Mr Noah disagrees with conservative moral paternalism not because it is paternalistic, but because it is based on a false picture of moral welfare, and is therefore unlikely actually to do us good. Having noted this disagreement, Mr Noah should have paused. If there is widespread disagreement about the human good, about what counts as a benefit or a harm, then paternalistic policies, even when they work as intended, inevitably restrict the liberty of some citizens in the service of conceptions of the good they reject. How is a paternalistic measure justified to us if we reasonably reject the idea of welfare on which it is based? If Mr Noah wants to say, “Well, that’s okay, because it does make you better off according to the true theory of the good”, we’ll want to know by what authority his conception of the good, and not ours, is established as the public standard for justified coercion. “Because I’m right and you’re wrong” is a vacuous, universal reply…
It’s worth remembering that liberalism is, at its roots, a philosophy of mutual disarmament in the face of intractable disagreement, and that its most fundamental principle is the presumption of liberty. According to J.S. Mill, “the burden of proof is supposed to be with those who are against liberty; who contend for any restriction or prohibition… The a priori assumption is in favour of freedom…” I’m afraid Mr Noah’s casual embrace of “baby authoritarianism” illustrates just how thoroughly the technocratic paternalism of American progressivism extinguished the liberal instincts of the left.

In short, any paternalistic measure should pass a high bar of evidence, and policies like a soda ban which are plainly elitist should inspire extra skepticism. (One measure that does pass this test would be bans against smoking in restaurants, since there is ironclad evidence that secondhand smoke causes lung cancer.) As it turns out, the evidence with regard to soft drinks and obesity is not at all clear, and the same goes for salt, Bloomberg’s other fixation.

Image via

Moving on, if liberals want to promote public health, we should focus on areas where the government is already leaning on the scale in favor of certain behaviors. For example, the new transportation bill gutted subsidies for public transportation, walking, and biking in favor of more new highways. This is part of a half-century government project of stupendous spending on car-centered development. (Notable also how the conservative belief in the free market goes right out the window when it comes to valorizing white suburban dwellers against those sneering bike-riding, subway-taking liberals.)

The result of all this spending on cars was summed up memorably in a recent Slate piece on walking:

Why do we walk so comparatively little? The first answer is one that applies virtually everywhere in the modern world: As with many forms of physical activity, walking has been engineered out of existence.

Liberals would stand on much firmer ground if we confined our public health initiatives to reversing these sorts of trends (while carrying on with usual cleanup of lead, mercury, and their ilk, of course), instead of mandating class-coded restrictions on what you can eat and drink.

Follow Ryan on Twitter and his personal site.

Ryan Cooper is a National Correspondent at The Week, and a former web editor of the Washington Monthly. Find him on Twitter: @ryanlcooper

Comments

  • TCinLA on July 01, 2012 1:54 PM:

    I'd be quite happy to see agricultural subsidies that go to any form of factory farming ended, but most particularly subsidies that go to pork and chicken production - in fact all meat production. If the world is as overpopulated as it is, we do not need to continue to get our protein from a system in which less than 10 percent of the grains/grasses etc. consumed end up as "food value".

    Reducing the intake of meat will do more to promote public health than anything else besides stopping smoking. I gave up meat 8 years ago. Today I have a 156 cholesterol, I am the proper weight/body mass for my height, my blood pressure is 128/67, and at my last physical, the doctor said "you're in great shape for a 50 year old, sir." Given that I passed 50 quite a few years ago, that is good news indeed.

    I'd definitely be happy to see an end to subsidies for tobacco production.

    BTW: lowering your salt an sugar intake really does have a positive effect on your personal biology. I speak from experience.

    The truth is, the American diet is largely poisonous in the long term, and the really bad news is the rest of the world can't wait to adopt it (something that is impossible on a world-wide scale, since the 5% of the planet that is us has to consume 27% of the world's resources to sustain our unsustainable lives).

  • dr2chase on July 01, 2012 1:57 PM:

    Regarding non-car transit, note the recurring calls for helmets for cyclists. This is innumerate nanny-statism at its finest, because the exercise benefits of cycling are so large compared to the minor risk of a crash (any crash) that it is estimated that helmet requirements kill more people than they save. In Europe, there have been studies comparing mortality rates and expected lifespans for commuters who do or do not use bicycles; to choose not to commute ride by bicycle, is to increase your chance of death in a given year by 39% ( http://archinte.jamanetwork.com/article.aspx?articleid=485349 and yes, they corrected for other risk factors. )

    Do ANY of the nanny state rules have statistical data suggesting that they would reduce mortality by 28%? (39% higher = 28% lower)

  • c u n d gulag on July 01, 2012 2:14 PM:

    Yeah, I'm with you on this one.

    Bloomberg's soda "ban" is stupid, because it limits the amount in one container.

    If he really meant it, they'd do some sort of 'purple finger' thing, so, once you "maxed-out" and bought one soda, you'd have a choice of trying to steal one, or hacking off the finger to get another one or two.
    Otherwise, this law's toothless, since you always buy another one - or another-other one, or another-other-other one, etc.

    And salt's another one. It's not like it's cocaine or heroin or something, where a teaspoon-full is cost-prohibitive.
    You can either carry a salt shaker, or one of those little fast food salt packets, in a pocket.

    As for "No Smoking" bars and restaurants, I never understood why we don't allow people, both owners and consumers, a choice?

    Have bars where people cant's smoke - at all. Period!
    And ones where they CAN smoke.

    If people don't smoke, they can decided to either NOT GO IN - or, go in, and take their chances that those few hours will kill them.

    Same for smoking restaurants.

    Give people a choice.

    I can practically guarantee that, if I had the money to have a bar/pub, and where smoking's ALLOWED - I'd make a fortune!

    The brilliance of this "No Smoking Law" was that it focused on the workers, and their future health.
    I worked for over a decade in bars while smoking was still allowed. Millions of people did. We had great smoke-eaters on the ceiling, which sucked up the smoke - Hell, they almost sucked out your lungs, they were so strong!

    Workers could have a choice, too. It's not like working in a bar or restaurant where smoking's allowed is more hazardous than being a coal miner, a logger, or a commercial fishing worker.

    If people want to work in a smoking establishment, where they can smoke if the want to, or not, why stop them - whether they smoke or not?
    BTW - studies years ago proved that smokers who were drinking in a bar were far better tippers than non-smokers. Diners are another story - smokers were pretty scattershot on tips, from really cheap to really high.
    Sorry, I can't find it right now.

    Of course, I'm still a couple-of-cigarettes-a-day smoker, so wtf do I know?
    I'm a suicidal maniac.
    And no - I don't smoke IN my home - or anyones home who's not a smoker.

    Also, when I started in the work force back in the mid-70's, there were ashtrays everywhere!
    Not just at bars and restaurants, but at peoples work stations, on the line in banks - pretty much anywhere where there weren't flammable materials nearby.

    And you could smoke pretty much everywhere - even in movie theaters and ballparks - where you could sneak-smoke a joint or two or three, and REALLY enjoy the film or game! And almost no one complained back then! Especially at the little movie theaters showing classic movies in NYC.

    Ah, good times, good times...

  • c00p on July 01, 2012 2:54 PM:

    Great post! Hear, hear! Let people make choices that don't hurt others.

  • KadeKo on July 01, 2012 3:00 PM:

    As a lefty, I'm wondering where all the righties who give a crap about governance went.

    The kegger is over and we're the only side who's worried about cleaning up the apartment.

    I'm beginning to wonder if we should spend political capital and effort on this, in today's media climate. Half of The Nitely Noose will be about "how markets can solve it" or "tax money should go to some church or K-streeted up thinktank".

  • schtick on July 01, 2012 3:03 PM:

    Those restrictions and laws are made for hypocrites. They get a thrill preventing people from enjoying themselves and making them live the same boring lives they suffer with.
    It reminds me of the stupidity that is rampant with the DUI laws. A woman was talked into having a couple drinks with a friend in the late morning, left to go home and ended up hitting a man and killing him. Yes, she was hit with drunk driving, and the friends of this man blasted and crucified her until she got the max in prison and they also made sure she served the max by going every year to protest her release.
    A few years ago, a snot nosed 19 yr kid had just gone to court for DUI when he was caught again in the same month at 4 in the morning. This time, he killed someone. Guess what? Not a peep from all these hypocrites that were all for the max punishment for "their" friend. What happened to the kid? Slap on the wrist. He did no time. He prolly has his license back now and is still driving drunk.
    And I've said for years, if people knew what was being pumped into their meat products, they would never eat meat again. I'm willing to bet if they ever were lucky enough to see how these animals were grown and slaughtered, they'd never eat meat.
    People should wonder about the contracts these companies have with people to only use products they say to use, keep the animals as they say and then lose their contract if they talk to anyone or let the animals be filmed in anyway.
    And I'm with Gulag on smoking. Most of these people wouldn't go into a bar to begin with. Why not have a choice? If it's still legal to smoke, why not allow smoking in bars? Restaurants, ok, but bars? Sheesh.

  • FlipYrWhig on July 01, 2012 3:17 PM:

    Doesn't this create a libertarian-friendly defense of the health care reform law? Without uninsured free riders getting in accidents, wrecking their bodies, etc., there goes the crucial shaming device by which governments get to defend paternalism: to wit, "if you don't wear a helmet and crash your motorcycle and end up in the emergency room without insurance, we have to pay for it, so put on the damn helmet or forfeit your right to ride." If everyone already has insurance, coercion fails to apply.

  • DAY on July 01, 2012 4:27 PM:

    @FlipYrWhig- ER doctors call those folks "organ donors"!

    We are being distracted with soda pop bans and "smoking WILL kill you! "PSAs, while we are being robbed blind by Big Energy, Big Ag, and Big War!

    Read Rachel Maddow's "Drift" for a sobering look at how the latter has brought Ike's warning to fruition.

  • SecularAnimist on July 01, 2012 4:51 PM:

    What a load of pretentious bullshit.

    The soda ban has nothing to do with "morality" and nothing to do with "class".

    So-called "soft" drinks MAKE PEOPLE SICK. THEY KILL PEOPLE. And in doing so they drive up medical costs for everyone.

    This article reads like nothing more or less than paid propaganda for the soft drink corporations.

    Except that their propaganda would not be so transparently stupid.


  • emjayay on July 01, 2012 5:48 PM:

    Holy crap all of a sudden it's like I'm at AynRand.com or something.

    The overall smoking rate in the US was 42% in 1965. Now, 19%. California, 13%. Because of anti-smoking advertising, no smoking ads on TV, warnings on packs, higher and higher cigarette taxes, etc. Cigarettes are now $11.90 in NY. And $14.00 in Norway. Sometimes a little Big Brother works to everyone's advantage.

    With an average of less than one fifth of adults smoking, it would be pretty hard to run a bar or restaurant that allowed it. It turns out that even smokers don't usually want other people's smoke in their faces or enjoy the smell of old cigarette smoke coming from the carpets and drapes.

    I don't think banning smoking or ant-smoking ads actually divert very many people from other issues.

  • emjayay on July 01, 2012 5:59 PM:

    Soda isn't being banned in NYC. The proposal is to limit it to 16 ounces, if it's the sugared kind. You could buy more 16's or get refills. There are still hearingss to come. Regular grocery stores could sell the 2 litre bottles or whatever.

    There was a proposed 5 cents per ounce (?) tax in NY state, but it didn't pass. This is Bloomie's substitute. I would prefer and support a tax, and forbid some things like sugared soda on SNAP.

    34 percent of adult New Yorkers are overweight and 22 percent are obese. Also, one in five New York City kindergarten students are obese. This is a public health problem like smoking. It costs everyone in any health care system. Which is, one way or another, everyone.


  • FlipYrWhig on July 01, 2012 6:18 PM:

    I know that my experience with soda consumption -- at one point I had one of those enormous refillable tankards from 7-11, I think it was called, no lie, XTreme Gulp -- also had to do with my being a cheap-ass bastard. It's invariably a better deal to get the largest quantity of soda the vendor has. I would look at the sign and think, well, for a dime I get all those extra ounces, I'd be a fool to pass that up! I didn't really have a well-formed desire to consume X ounces of soda, I had a desire to consume the greatest amount of Food Product as judged by cost per unit of food-like substance. Eliminating the largest serving sizes completely negates that judgment. I don't know how many people look at it the way I did, but if there's a significant number of people like us, we'd be consuming less with a move to smaller containers, and not missing it at all, because we were pursuing the deal, not the volume of drink.

  • Snarki, child of Loki on July 01, 2012 10:40 PM:

    Re: smoking.

    It wasn't that long ago when ALL restaurants were "smoking". Sure, they might have a "no smokers" zone, but cigarette smoke does not respect those little signs, and the non-smokers had to suffer. "Oh, just find a smoke-free restaurant!" Nope, none, or very very damn few.

    Now we're in a situation (most places) where ALL restaurants are "non smoking", the shoe is on the other foot. Perhaps now we can find some sort of reasonable mix of smoking- and non-smoking-restaurants, but we would NEVER have gotten to this point without the smoking bans.

    If smokers just affected themselves, then they'd deserve a bit more slack on being able to light up. True "liberty" in this context means that I get to assault smoker's lungs with the chemical weapon of MY choice whenever they light up. Mutual disarmament is better.

  • Anonymous on July 02, 2012 8:07 AM:

    Basically what FlipYrWhig says - nobody buys a 36 ounce soda because they genuinely want 36 ounces of soda. Bloomberg's bill removes people's freedom do something that people only want to do because they're manipulated into it by gigantic corporations (for the most part - I suppose there may be some places that sell gigantic sodas that are mom and pop operations).

  • CharlieM on July 02, 2012 10:01 AM:

    @emjayay
    Ummm....No. Given current situation in localities where smoking is entirely banned in bars, restaurants, I suspect that anyone allowed to open a "Smokers Only" bar would probably do very well for themselves.
    I rarely go to bars anymore. Primarily because I'd rather sit on my own porch and have my beer and tequila with my smokes rather than go without. I doubt I'm the only one.
    Catering to a statistically small subset of the population doesn't mean the model wouldn't be viable. There are viable industries for all types of activities not indulged by the population at large (sky-diving anyone?).

  • TeamAmercia on July 02, 2012 11:06 AM:

    While I'm not sure a soda ban is the best way to go about it, there is a pretty good argument that the increased obesity is due almost entirely to increased calorie intake and not to inactivity:

    http://lanekenworthy.net/2012/05/31/why-the-surge-in-obesity/

    So I think it's important to focus on ways to get people to pay more attention to what they are eating/drinking. I'm also for more bike lanes, etc.

  • low-tech cyclist on July 02, 2012 12:31 PM:

    It would be nice if someone just required that a certain fraction of a restaurant's soft drink offerings (1/3, say) be sugar-free.

    Typically, when you go into a fast-food place, the only diet drinks are (a) diet Coke, and (b) water. That's a pretty sucky choice, especially if you don't care much for cola in the first place, but still want to drink something sweet with your meal.