The Annals of Soft-Despotism

Lies, Half-Truths, and Sheeple

The idea of preventative public health has been swallowed hook, line, and sinker by the Chattering Classes.  Intuitively it makes sense.  Tax payers fork out billions of scarce, hard-earned dollars paying for the health care of others.  The more healthy a person is, the less they will cost the public health system.  Therefore, spending on prevention (to stay healthy) saves public money in the long term.  So, frugality with the public purse is a powerful argument for spending gazillions on preventative health care.  Specious, but powerful.  Such are the days of ignorance in which we walk.

To the frugality argument is added a second powerful, emotive appeal.  Preventative health measures appear to save lives.  If one has a certain sub-set of genes, and if one avoids high carbohydrate diets topped with lashings of sugar, one will likely avoid obesity and its attendant health problems, such as Type II diabetes and heart attacks.  In New Zealand we have whole ethnic populations with such susceptibilities.  Clearly, eating more appropriately saves lives.  So, who could argue against preventative health?  It saves money and it saves lives. 

Here is one of the world's great prophets on the matter--President Obama:

. . . there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse.  That makes sense, it saves money, and it saves lives.  [Remarks to a Joint Session of Congress, Sept 9, 2009]

But what puts a completely different gloss on these superficial arguments is that we are talking about arguments to justify government spending on health.  Because government is not primarily, nor directly responsible for the health of human beings, its muscling in has devastating unintended negative consequences. 

Firstly, preventative health spending does not save money: it vastly increases the demand for more government money--which will be met by borrowing or spending tax dollars.  Preventative health does not lower public health costs, but exponentially increases them.  The healthy end up costing the public purse much, much more.  They live longer.  They get hip and knee replacements.  Towards the end of their lives they are frequently in and out of hospital.  Moreover, since the public pays out for retirement income in one form or another, the longer people live, the (much) more cost and expense to the taxpayer.  The argument that preventative public health saves public money in the long run is bogus.

As Jonah Goldberg opines:

From a purely actuarial perspective, all of these people--Barack Obama, Bill Clinton, Michael Bloomberg--who claim that our health-care system needs to be reformed because our life expectancy is too low (it's not), miss the point that if we dramatically increased life expectancy in this country we would lose money on the deal, because that would mean dramatically increasing the length of time old people collect retirement benefits and increase the number of claims they make on the health-care system. . . .

That's why researchers have found time and again that over the course of a lifetime smokers and obese people (and particularly smoking obese people) cost less than healthy people.  Politicians who insist that prevention will save lives are right.  Politicians who insist that saving lives always saves money are wrong. [Jonah Goldberg, The Tyranny of Cliches: How Liberals Cheat in the War of Ideas (New York: Sentinel/Penguin, 2012), p. 230f.]

And, we may add, those politicians who insist on both are either deliberately deceptive and misleading, or just plain foolish. 


The "saving life" argument rests on ethics, not economics.  But when the government sets out to save lives two very important consequences follow: firstly, the responsibility of each individual and family to take care of one's own is diminished, laid off, and in many cases vaporised.  Secondly, there is no limit to government intervention into the lives of (formerly) free citizens.  When a government becomes despotic to the point that it moves to direct how people shall live, move, exercise, eat, and recreate it ends up decided who lives and who dies.  Why?  Because government nannying costs money--tax payers' money--and in the end the government has to choose who gets the "help" and who does not, because money is finite.  It runs out. 

We have all become like sheep, and the government is leading us beside the green pastures and the still waters.  It gets to determine where and when we shall eat and lie down.  In the end, it also gets to decide if we will be permitted to partake. 

And that is where a well-intentioned worldview becomes sinister.  Underlying the desire to keep "the system" healthy is a desire for the experts to determine how others should live and, ultimately, to determine who should live.  In health-care systems where the government handles all of the costs the government inexorably is forced to choose who is deserving of certain medical treatments and who is not.  In Canada and the United Kingdom, you can't get some surgeries or treatments if you are over-weight or past a certain age, not because of relevant medical concerns but because the government has decided you're not worth the investment. [Ibid., p.230f]

The argument that the government public health system can saves lives is a half-truth.  In the end, death is inevitable and the government can do nothing about it.  But the government that can overreaches to tell us how to live, move, and have our being is the government that starts to treat us like animals, not human beings.

As de Tocqueville said, it is especially dangerous when a government moves to enslave men in the minor details of life.   Instead of saving lives, such a government enslaves lives.