Friday, March 05, 2004

Lifestyle diseases

Why do we fund "lifestyle diseases", such as those caused by smoking, eating McDonalds, or failing to exercise? Surely these are an individual's responsability; they know the risks and should pay the price?

There are two problems with this. Firstly, risk may be poorly understood. Half the population can't do percentages, so we can hardly expect them to behave like actuaries (something economists persistently fail to understand). And secondly, these choices are sufficiently widespread and accepted that interfering with them would be grossly intrusive and destructive of people's pursuit of the good. We don't ban Big Macs, or cigarettes, or alcohol or sunbathing because too many people enjoy them and they are perceived as being a part of a normal, everyday life - and we continue to fund their long-term health effects for the same reason.

What we do do is prevention. Inform people of the risks, and encourage them to act appropriately. Hence "slip, slop, slap", "make it click", "every cigarette is doing you damage", "press play", "had enough?" etc. And sometimes, we draw a little from the "personal responsability" ethic by taxing things (both helping to recoup health costs and discouraging behaviour). Interestingly, some of the very advocates of personal responsability in health oppose these programs. Which shows how much they care about people making informed choices...

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