Fresh food, sewerage and an understanding of elementary hygiene have led to longer and healthier lives. This is public health in action. This is good. But this source of good is in danger of being corrupted. Instead of increasing the sum of human happiness, public health activists are in danger of decreasing it. They are trying to do good, but the road to hell is paved with good intentions.
Public health activists in their zeal to do good have crossed the boundary between public and private health. Between helping and hurting people. The public and private spheres both impact upon the individual. Public spheres are those that the individual can not really influence. Private are those they can. This difference is fundamental.
Both spheres act upon the probability of getting sick. But one is primarily under the control of the individual and the other is not. In one the individual is able to accept or reject the risk payoffs in the other they are not. Public health officials are right to campaign against one and wrong to campaign against the other.
We accept the increased risk of drowning when we go swimming, of a heart attack as we enjoy the “good” life, having a traffic accident as we drive our car, of a sporting injury or even injuring our back as we make love. We willingly accept the risks that come with the pleasures that make life worth living. It is not public health to stop us from enjoying these activities. It is a gross violation of our rights.
We could probably extend our life if we ate raw oats and Brussel Sprouts for breakfast. We choose not to. Just because it is in the name of public health, it does not make it good.
In Australia it is illegal to ride without a helmet – be it on a horse, bicycle or motorbike. It is also compulsory for occupants of a car to wear seat belts – both in the front and back seats. Childproof fences have also been made compulsory around swimming pools. Medicines come in childproof containers and cigarette lighters have childproof locks. These are now accepted. They are not controversial. You are a crank if you question their wisdom.
They were all introduced in the last twenty years amid some debate. They were all perceived to infringe freedom. But the freedom was impinged for the good cause of public health. Those who objected on each issue were not sufficiently numerous. The do gooder could ignore their objections and impose restrictions on their behavior – for their own good.
This obviously begs the question of what will the Nanny State impose upon us next? It could be padding when walking on the pavement. People regularly fall and injure themselves. It could be carrying lightning conductors, not being allowed to eat chocolate or meat. It could be anything. They appear preposterous, but they will be implemented for our own good. One iota at a time our freedom will be taken away in the name of our own good. It is like the Afrikaner justifying apartheid because the “blacks can’t look after themselves”
Public health is no longer about helping people to live long and fruitful lives. It is about telling them what to do. It is the ultimate example of the Nanny State. Nanny knows best. Do what nanny says and you will live a long and healthy life. You will be bored. Life will be spent perpetually concerned about your health, for not all the public health in the world will stop you from dying.