Wednesday, 20 February 2013

Doctors Without Boundaries


It seems that ‘medical experts’ are once again recommending the imposition of radical policies in an attempt to improve public health. This is a perennial problem – doctors see a real and growing medical problem, and then they appear in the media with some mixture of tax and regulatory policies that might help to deal with the problem. The issue is that doctors are not economists. They often recommend either policies that would either prove impossible to realistically implement – like Denmark’s recently-repealed fat tax – or policies that would deal with the problem in an extremely expensive and intrusive way. There are a few different reasons why this might be happening.

It could be an example of salience bias. Doctors are on the frontline of the war against obesity. They treat people who are dying of obesity-related conditions, or have their quality of life reduced by debilitating diseases like diabetes. What they don’t see are the costs of their policy recommendations. They miss the costs of implementing and enforcing the taxes and regulations they favour and the possibility that those taxes will be avoided and regulations ignored. They do not consider the regressive impact of taxes on products such as food and tobacco. They see the people dying of heart disease, not the people whose freedoms are curtailed by regulations, the businesses who get tangled up in excessive red tape.

From a more charitable perspective, medical experts may simply be trying to shift the Overton Window. Taxes, especially regressive ones like alcohol duty that consumers perceive as hitting them directly in the wallet, tend to be unpopular. The smoking ban has got less controversial as the number of smokers has fallen, but there are still vocal, concentrated minorities who want the right to smoke in pubs and who tend to be a lot more interested in supporting it than apathetic non-smokers are in opposing it. By advocating radical policies to try and improve public health, doctors increase the perceived political feasibility of moderate, reasonable taxes and regulations. For this reason, it might be optimal for them to advocate extreme government interventions even if the intervention itself would not be optimal.

Doctors’ paternalistic interventionism can be extremely annoying. But abrasive libertarians can be even more so. 

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