Health at all costs? How health-first paternalism is promoted by government to corrode choice

12 Dec 2013

This report argues that government-funded health lobbying is leading to increased regulation of any behaviour deemed detrimental to health.

Executive summary:

  • Public health policy has broadened from traditionally indiscriminate and/or communicable risks to the health of the population toward discriminate and/or non-communicable risks to the health of the population.
  • The broadened definition has created a ‘health-first paternalist’ approach to public policy that prioritises health above traditional public policy considerations, including the rights of individuals and human rights, when they are in conflict with health priorities.
  • Under this model, state sponsored universal healthcare and the subsequent costs to public finances have justified government regulation of any behaviour detrimental to health.
  • Approaching public policy from a ‘health-first paternalist’ perspective leads to freedom and human rights being expensive and dispensable when they are in conflict.
  • Even when ‘health-first paternalist’ policy options fail, they are still advocated for because the potential for health benefits outweigh any perceived costs.
  • Since 2008 the Commonwealth has funded at least $100 million of research that can be used to justify ‘health-first paternalist’ policies, though this paper doesn’t assess the research’s merit.
  • Government increasingly funds research and advocacy from the ‘non-government’ sector to advocate for ‘health-first paternalist’ policies, including through grant funding criteria.
  • Both the government and ‘health-first paternalist’ advocacy groups see the role of government funding to as helping build the public case and evidence-base for the introduction of ‘healthfirst paternalist’ policies.
  • The targets of ‘health-first paternalist’ policies are designed to reduce consumption of alcohol, gaming, tobacco products and unhealthy foods.
  • ‘Health-first paternalist’ policies designed to target tobacco are now being replicated on gaming, unhealthy food and alcohol with questionable evidence of their merit or efficacy.
  • ‘Health-first paternalist’ policies justified with research is based on:
    • Questionable ‘social costs’ studies of individual behaviour that concludes there are significant public and private costs to people’s freedom.
    • Risk inflation research that shows that behaviours lead to increased risks of cancer, or that they have equivalent addiction rates to illicit substances (This paper does not seek to dispute whether they are accurate, only identify the intention to highlight these risks).
  • Some research is showing poorly designed ‘health-first paternalist’ policies are driving consumers to consider or engage in substitution, such as higher volumes of cheaper products and illicit drugs.
  • As outlined in Figure 1, ‘health-first paternalist’ policies are self-reinforcing: if a policy is effective it should be followed up with a stronger policy because it is effective, if it fails it should be followed up with a stronger policy so that it is effective.
  • Public funding for ‘health-first paternalist’ research is its own self-reinforcing cycle with advocates arguing for policy action by government off the back of government-funded research that was introduced as part of government policy action.
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