Friday, May 12, 2006

# Posted 9:57 AM by Patrick Porter  

HEALTH POLICE: Physical health is one part of the public good, obviously. Its important that people are able to obtain healthy food and to live a healthy lifestyle.

If that is what they want.

But there are other things that make up the public good. Like the freedom not to be healthy. Or to be healthy but enjoy a little indulgence now and again.

A fixation on ensuring that everyone can spend ten extra years in a nursing home seems to be a very narrow understanding of the quality of life. And it threatens the existence of a relaxed, free society.

Personally, I would rather live in a society where people are not only entitled to do things that are bad for their health, but are not harassed for doing so. One where children can enjoy an ice-cream occasionally.

If you think that's stating the obvious, now in the UK, the Mr Whippy ice-cream van is deemed a menace.

This is the sort of place where it starts. It starts with laws prohibiting advertising certain unhealthy food to children. Then the state starts monitoring what they eat, outside the schoolyard.

It also extends to adult behaviour. There are proposals on the table seriously discussing denying health care to smokers.

Instead of encouraging responsible parenting which can put a brake on childhood health problems, the state becomes substitute parent.

Intead of devising creative solutions, such as allowing bars to have smoking or non-smoking licences, we just ban smoking outright from the public sphere, sending smokers to enjoy their habit in their back garden shed.

There is an argument that at least some pubs or bars, where people go voluntarily to ruthlessly destroy thousands of brain cells, should also be able to permit their patrons to smoke. Maybe trying to find a market-based solution might be a more sophisticated approach to protecting people from passive smoking than the heavy hand of the state.

Freedom, and an atmosphere of freedom, dies incrementally. Not only via the sinister apparatus of the police state, but also at the hands of the humourless, puritanical bureaucrat.

Farewell Mr Whippy. And I hope the poor migrants who often sell ice creams and other evil products can find new jobs in the pristine, healthy new Britain.
(14) opinions -- Add your opinion

Agreed. If I feel like going into a pub, have a beer & a smoke I should be able to. I would suggest simply placing a sign at the entrance that "Smoking is permitted within" & have the staff sign a release (from the suggested effect of second-hand smoke.) Do you know in New York City it's unlawful to permit smoking even in private clubs? Imagine, one can't have a fine cigar after dinner !!!
I didn't know that!

I can see the argument that people might want to go out for a drink without inhaling smoke second-hand.

But a blanket ban seems illiberal to me. Some pubs should be able to permit it, while other pubs might prefer not to, at least as an experiment in letting people negotiate this for themselves rather than relying on the state to make all decisions for them.
Or, how about "One way to cut waiting lists: don't treat people with the wrong views"
Mike Daley

"There are proposals on the table seriously discussing denying health care to smokers."
"But a blanket ban seems illiberal to me."

Erm, so what is it? Illiberalism is fine when it involves paying for other ppl's self inflicted injuries, but not when trying to stop others from suffering the same injuries?

IMHO a more pragmatic approach needs to be taken with this issue. Cigarette smoking in states with government provided health care is going to be a non-productive drain on the public purse, so the government should work to reduce the amount of smoking that the population does.

- Factory
The argument about smokers paying for their healthcare in the UK is pointless anyway. They already do that through the high duties imposed on tobacco sales.

Besides, although few people will admit it you don't actually save on healthcare costs if you don't smoke, it merely means those costs will be spent on some other old age illness you develop (another cancer, or just nursing home care) and increased pension costs from a longer live. And given that people seem fairly resistent to the idea of working longer to pay for their increased lives...

There was a very good episode of Yes Prime Minister that dealt with this very issue.
"Responsible parenting" - what a smug middle class notion! In rich countries, rates of obesity and smoking are highest amongst lower socio-economic groups. Perhaps health is the responsibility of the state, and this is one way to level out the playing field. Leaving it to individual choice implies that we are all equally informed, equally aware and equally able to make choices to be healthy - or unhealthy. This is not the case.
Hey Anonymous,

You say 'smug middle class' like its a bad thing.

There are many forms of middle class smugness. One of them is a paternalistic view of the relationship between the state and the citizen.

While the possibility of physical health is one important element in the public good, it is not the only one. In the name of solving one health-related problem, some folk want the state to impose a uniform lifestyle on everyone, attacking the recreational freedom and choices of the working-class you claim to speak for.

You are right that the state has some role in ensuring that people can make responsible decisions for themselves. In public schools, for example, health education should be part of the curriculum.

Just don't close down the Mr Whippy van or ban all smoking in all pubs!
Spot on. It is a constant battle to make sure policymakers etc acknowledge the indivdual's rights and responsibilities to look after themselves and those for whom they have responsbiity. Maybe the reflex response of getting the government to do something stems from a lack of faith in individuals' ability and judgement - if true it would be worrying for a democracy.
Patrick, they are following the MADD(mothers want to destroy drinking outright) process. At first you try to make it socially unacceptable and if it doesn't work raise the penalties. I know twenty year old men who have spent time (over a week!) in jail for drinking. Not drinking and driving, just drinking. These people are worse then cancer.
Yay, a public/private debate. There's conflicting Rights at play here. There always are; when people assert a right, someone else will assert the contrary. (Viz abortion for a prime example of this lazy rhetorical trope gone crazy.)

So what do we have? A right to choice? Or a right to health? If I crash my car, do I have more or less of an entitlement to public health treatment than if I smoke? Or if I cross the road? What if I smoked twenty years ago? For a month? Or what if I didn't inhale? Could I, even, when I need money for chemotherapy, sue my parents for getting me started on smoking by smoking themselves?

The ironic thing is that people who argue that denying people, say, the right to smoke and get healthcare on the NHS are often the people who call for a 'small state' and who elsewhere might employ the rhetoric of the 'nanny state' catering to worthless drop-outs who don't want jobs anyway. And the converse applies. People want the state to validate the decisions they make - and not other people's. This is obviously untenable.

So it seems to me that given this morass of conflicting factors and uncountable, unquantifiable externalities, all the state can do is treat everybody equally on the basis of severity of condition, and that the public should be prepared to pay more if it wants more 'trivial' conditions to get treatment.

But then, what the heck, I study literature. If I made policy, you could probably all sue me for negligence when you need an op I didn't budget for.
Ummm... is it me or is the issue with Ice Cream vans as much one of parking and congestion as health. Certainly a number of the examples given in the Times article definately pertain to that difficulty. Another point is that councils are simply trying to take pragmatic action against a nuisance - congregation outside of schools is a huge problem, especially in ceratin London boroughs. I'm really not sure how much this has to do with principled stands on children's health, although FYI it is well known that Ice Cream & chip vans in many areas sell cigarettes (usually Spanish imports) under the counter, including to older children, to subsidise their trade.
From personal experience, screw those punks driving those vans - I don't care if the neighborhood 8 year olds are allowed to stay up past midnight on my block in Queens, I'd still love to pull the trigger on a large caliber sidearm right next to that dingingpopgoestheweaselplaying anthropomorphized ice cream cone with that sh*t-eating grin on his face...

Personal vendettas aside, as a person mildly obsessed with health, and someone who has said loud and derogatory things about the mentally-deficient choice to suck poisons and call it a vice, I do believe that it is going too far for the government to enact a smoking ban on bars (pubs for you europeans).

As far as smokers and healthcare - I'd like to see the numbers on the tobacco tax, and where that money goes - if that money filters (no pun intended) back into the health care system, then that's sensible and fine, and no penalty need be imposed. If it's otherwise, then just like all the neocons don't want to pay for immigrants, no more should they want to pay for people making the conscious choice to be a bane upon health care.

Back to bars and pubs (this is a scattered train of thought, i know), I would make the personal choice to avoid smoking bars. If there was a choice, I would simply choose nonsmoking locales. I see no overarching loss in that. My problem generally lies in that while as a nonsmoker, I concede smokers their right to do so, smokers rarely, likewise, concede my right Not to have to be exposed to carcinogens. Their response is that I should go somewhere else. Until these smoking bans, there was nowhere else to go. I should no more be denied the right to Not be working on cancer, than smokers should be denied the right to the black lung. Some middle ground has to be found, I guess is the main bullet point to take away from this presentation.

The second part of the rant:

Removing unhealthy beverages and related advertisements from schools is a different story. Study neurophysiology for five minutes, and you'll understand how easily a child's mind, personality, and biology can become permanently fixed around these terribly detrimental choices.

And I agree with the previous post that "responsible parenting" is, to an extent, an illusion of the middle class and beyond. The reason so many low-income families are overweight, have diabetes, etc? - Because you can feed a family of five for under ten dollars at McDonald's. Because they don't always have the money to do any better, the education to know any better, or a combination of the two and worse.

Parents can only be expected to do so much, when most of the time, their children are at the mercy of the world around them - a world designed to suck them in as consumers of whatever happens to have the slickest packaging and tastes the best, irregardless of its nutritional value. Children have to have good choices made for them, being that for the most part, they cannot make them on their own. The state does have to be concerned when kids in high school are allowed to go buy two boxes of french fries for lunch, and they aren't eating anything else. That's a problem.

While I initially rejoiced in coming to the smoke-free bars of Los Angeles and New York, and laughed at the fools outside shivering or sweating just to take a few steps closer to untimely demise, I'm coming to see the more insidious side of it. It's a very particular erosion, small though it may be, of civil liberties and choice. The erosion of these freedoms always starts small, and it usually starts with Puritanical idealogues...we all know where it goes from there.
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