Published in The National Post, January 9, 2004, p. A11.

Warning: The Public-Health State Can Kill You
by
Pierre Lemieux

 

Dr. Carolyn Bennett, the new Minister of State for Public Health, wants her state to help people stay healthy. The creation of a new Public Health Cabinet position is very significant -- not of something new, but of the recognition of a form of government that we can call the Public-Health State. In his book Seeing Like a State, anthropologist James Scott argues that the 19th-century idea that the central purposes of the state was the improvement of all members of society -- their wealth, skills and education, longevity, productivity, morals, and family life, provided the foundation for social engineering. Peddling his ideal city, where "mankind will be reborn," French architect Le Corbusier wrote, "Authority must now step in, patriarchal authority, the authority of father over his children." The public-health state is the continuation of these dreams, albeit with a softer, more matriarchal -- maternalistic, shall we say -- figure. There is a corpus of economic theories, and some evidence, suggesting that the paternalistic, benevolent, public-health state can be much more dangerous than egoistic state rulers. In their Power to Tax, James Buchanan (1986 Nobel laureate in economics) and Jeffrey Brennan write about constraints imposed on state power: "Such constraints become much less effective, and may well be evaded, if the motive force behind governmental action is 'do-goodism.' The licentious sinners we can control; the saintly ascetics may destroy us." When the state favours some of its subjects, it is always (or nearly always, some economists would prefer to say) at the expense of others. Whose health will the public-health state take care of? How many obese people will suffer anguish or depression because of Health Canada's attack on their self images? How many smokers have been scared into sexual impotency by Health Canada's antismoking propaganda (the limp cigarette image)? How many hunters decide not to see a doctor for depression or related problems because they have to declare such problems to the state every five years if they hope -- and it would be only a hope -- to keep their hunting guns? How many individuals have suffered depressions or physical ailments caused by stress, or even perhaps committed suicide, because of financial problems caused by the outrageous taxes necessary to finance all this? Don't ask public health bureaucrats to answer such questions, or even to inquire into them: They are not interested. "If it could save only one life," goes the standard public-health mantra. We can often verify that an intervention has cost at least one life -- like the New York City bouncer killed for enforcing the municipal smoking ban in bars; or the teenager killed by rival cigarette smugglers just before New Year's Day; or the child killed in smuggling gangs crossfire in mid-December. All this is coming to Canada, and more. The Minister of Public Health wants to help some Canadians to get healthier at the expense of other Canadians' health, this much we know. It may be that the number of the former is greater than the number of the latter. It may be that the number of peaceful individuals killed or handicapped by the state is lower than the number of individuals made healthier. The only thing we know for sure is that the public-health state uses force to take sides in favour of some peaceful individuals against others. It makes some happier, others miserable. Of course, counting corpses is not part of the liberal tradition more than for the state to measure fat, to peep into people's private lives, and to pidgin-moralize about lifestyles. Sometimes, we are tempted just to laugh at all this. For example, Health Canada's Web site pontificates: "Healthy sexuality is a positive, dynamic and enriching part of being human. Health Canada has developed products to help in the education of healthy sexuality." What do these old statocrats (most of them probably menopausal or prostate-worried) know about sex? And what are they doing in our bedrooms, anyway? The public-health state is no laughing matter; it is the number one public health danger at the beginning of the 21st century. As German poet Friedrich Höderlin said, "What has always made the state a hell on earth has been precisely that man has tried to make it his heaven." After historian Robert Proctor's path-breaking research, we know how the Nazi state made promotion of health (i.e., of some people's health) a priority. "Food is not a private matter," ran one Nazi slogan. It was in the rulers' interest to have strong and lean praetorians, instead of fat, lazy citizens, as suggested by a Nazi propaganda poster reproduced in Proctor's The Nazi War on Cancer. Of course, our state is much, much nicer. Yet, if we let it loose, the paternalistic public-health state will be no less dangerous. Perhaps people will start noticing this when the idea of requiring a parenting licence, which has been circulating in the academic public health literature for two decades, will appear on the public opinion radar screen. But there are many other things happening. The point is that we will be oppressed for our own good and perhaps, what is worse, happy like contented cattle.