Public health campaigners are in many ways the modern version of religious puritans. Or at least, that’s the case according to Christopher Snowdon in his new book Killjoys, published earlier this month by the Institute of Economic Affairs.
In the book’s opening chapters, Snowdon outlines the philosophical basis for opposing paternalism of all varieties. He begins with a brief exposition of John Stuart Mill’s utilitarian ‘harm principle’: the idea that the only justification for interfering with the liberty of others is in order to prevent harm to others. It thus follows that coercing someone purely for their own good is unwarranted, according to Mill. There are various arguments used to defend the harm principle, ranging from the idea that “promoting liberty will foster originality” to the claim that “paternalism drains people of their vitality by making decisions for them.” But, in Snowdon’s view, these are not the strongest arguments for adopting a classical liberal view of paternalism:
Mill’s simplest and strongest case for individual liberty arrives...when he writes that a person’s ‘own mode of laying out his existence is the best, not because it is the best in itself, but because it is his own mode’. Since people have different tastes and preferences, it is undesirable for others, even if they are the majority, to impose foreign preferences upon them.
The vast majority of economists lie in the same utilitarian tradition as Mill, and many accept the importance of individual freedom—not paternalism—as a means of maximising overall wellbeing:
...economists believe that markets produce the best outcomes if competition exists and if choices are voluntary. For this, consumers must be reasonably well informed and reasonably rational. Like John Stuart Mill, mainstream economists assume that the average consumer is basically rational, which is to say he generally acts in accordance with his preferences.
The majority of Killjoys applies this classical liberal approach to contemporary paternalism and the justifications employed by the killjoys who support it. It tackles soft paternalism (sometimes called ‘nudge’ policy), hard paternalism, and finally the most prominent form of paternalism in the contemporary world: “public health” paternalism.
Snowdon’s evaluation of nudge policy (first popularized by Richard Thaler and Cass Sunstein's 2008 book Nudge) is fairly positive, despite his misgivings about some of work in behavioural economics underpinning it. He appears cautiously optimistic about efforts to correct our cognitive biases by altering ‘choice architecture’ (e.g. adding organ donation questions to driving licence forms or ensuring faster payment of income tax by reminding taxpayers that their money goes to public services). After all, this is simply applying common private sector practices to the public sector in order to make it more effective:
When government action is required for the nudge, it is when the government is already involved. Tax collection, organ donation and driving licences are all within state control. If they can be made more effective and efficient by using the same persuasive techniques that are second nature in the private sector, why not do so?
However, Snowdon also highlights a key reason to view such soft paternalism with a critical eye. Since “most governments are more paternalistic and less libertarian than the nudge theorists”, there is a serious possibility that such interventions form the basis for a slippery slope into more coercive forms of paternalism.
Unsurprisingly, Snowdon views hard paternalism in a far less positive light. Using Sarah Conly’s unusually candid book Against Autonomy: Justifying Coercive Paternalism as a foil, he demolishes the arguments of those who would ban cigarettes, ban trans fats, increase required savings and even potentially ban soda. Conly’s key argument rests on the idea that humans all share certain universal goals: namely health and financial security. Think like an economist, and you recognize this as a nonsensical justification for coercive paternalism:
If we judged people’s desires by their behaviour – as economists do – we would not conclude that pristine health is their only goal. Even stated preferences do not imply that people prioritise a long life over all other considerations. When The Who sang ‘I hope I die before I get old’ in 1965 they were reflecting a stated preference for living fast and dying young that is not uncommon. A young man who leads an unhealthy or risk-taking lifestyle while claiming to have little or no interest in getting old is being consistent in his stated and revealed preferences.
Conly recognizes the existence of such trade-offs, qualifying her paternalism with the idea that the benefits of an intervention must exceed the costs. But, as Snowdon highlights, her cost-benefit analysis is vague and arbitrary. Like many paternalists, subjective valuation trumps consistent application of her principles:
The more one reads of the paternalism literature, the more one is struck by ad hoc exceptions being made to supposedly universal principles. That these exemptions tend to reflect the public mood of the day only confirms Mill’s fears about the tyranny of the majority. Smoking and eating dominate both Against Autonomy and Sunstein’s Why Nudge? as if they were in a separate class of risky pursuits. When it comes to activities that pose an acute risk of death at a young age, such as motorcycling and mountaineering, paternalists have little to say other than that participants should, perhaps, be forced to wear a helmet. There must be a suspicion that dangerous sports get a free pass because they are seen as daring, unusual and physically demanding whereas drinking, smoking and drug taking are undemanding, common and intoxicating.
Snowdon concludes the chapter with an defence of ‘slippery slope’ concerns, using mandatory seatbelt laws as one such example. Such minor infringements of the harm principle aren’t particularly destructive in themselves, but they do “change public perception about the objectives of criminal law.”
‘Public health’ paternalism
According to Killjoys, the modern ‘public health’ lobby is just an updated form of the groundless puritanical moralism that Mill sought to combat in his day. Snowdon describes it as “quasi-utilitarian” in its rhetoric, but decidedly not utilitarian in practice. After all, a philosophy that aims to maximise the length of our lives is not the same as one that aims to maximise satisfaction of our rich tapestry of individual preferences:
...‘public health’ paternalism cannot be justified by welfare economics or utilitarianism. It is simply a form of ends paternalism in which health and longevity are assumed to be overriding goals.
The case for public health interventions is clearly strongest when there is no alternative to collective action: “tackling health risks in the share environment which cannot be controlled by the individual, such as air pollution, or those involving people (or animals) who carry infectious diseases.” But the public health lobby has experienced significant mission creep in recent decades:
Since the 1970s...the scope of public health action has moved beyond hygiene and contagious disease to target self-regarding personal behaviour. As Richard A. Epstein explains, the modern ‘public health’ movement ‘treats any health issue as one of public health so long as it affects large numbers of individuals’.
Snowdon is at his strongest when analyzing the politics of public health paternalism. He reveals the different strategies used to curtail individual freedom in the name of keeping us alive longer:
Being a political movement, the literature of ‘public health’ paternalism differs from that of the academic texts discussed in earlier chapters in two important respects. Firstly, it tends to focus on short-term policy objectives rather than present a full vision of what it thinks society should look like. Long-term objectives are rarely made public, perhaps because the logical outcomes are so extreme that they would alarm the median voter. Only recently, for example, has the goal of cigarette prohibition been openly discussed in the ‘public health’ literature despite it being the only natural conclusion of the anti-smoking crusade.
Appeals to compensating for negative externalities are also exposed as creeping paternalism:
That negative externalities are used by paternalists as an excuse for interference can be seen in the way they demand taxes be set far higher than the Pigouvian rate [the rate at which the cost of negative externalities are compensated for] and demand excessive regulatory responses to questionable externalities.
He also tackles anti-advertising crusades based on general anti-capitalist hostility to free markets, and various other methods employed by the public health lobby to forcibly impose their own vision of the good life on the rest of us. If you’re going to read just one chapter of the book, make it this one.
Following a section exploring the harms of paternalism—higher costs, substitution effects, black markets, in some cases unintended consequences of poorer health—Snowdon devotes the final chapter of Killjoys to describing effective, welfare-enhancing, classical liberal alternatives to paternalism. More education, Pigouvian taxes, and creating an environment conducive to innovation in harm reduction are all key pillars of this strategy.
Although I didn’t explicitly call myself a libertarian until I was 16, I first felt libertarian after thinking about the smoking ban when I was a lot younger. Back then, my views were based on a purely instinctive disdain for those who think they know how I should live my life better than I do. Many others share this attitude towards different forms of paternalism, and Killjoys gives them the intellectual ammunition to resist modern-day puritans. It’s also a solid introduction to applied economics and looking at the world through utilitarian lens.