While the blog was out of action I noticed a lot of people linking the following article by Andrew Dickson and Bill Kaye-Blake (from Groping to Bethlehem).
All the links focused on how the article made the case for a tax on sugar. That is fine and all, it was an externality case that we can discuss, appeal to evidence and value judgments on, and then decide whether we agree or not. In fact, I get the impression that is the exact point that the authors are raising after setting up the pro-argument.
However, I didn’t get the impression that many people made it to the second half of the article (given the way it was used) – and the second half was absolutely glorious.
The second half starts with this:
But a major focus of the calls from many “health” campaigners is the impact that taxing these drinks might have on the contested term “obesity”.
The focus on obesity reveals the other public health fantasy: socially engineering perfect bodies.
This is true – a focus on obesity rather than externalities stemming from consumption is a different argument. And seems to crawl towards rhetoric used by those who want others to take on some ideal form.
Then there is this:
If, for instance, we decided to tax sugar-sweetened beverages and had a subsequent reduction in diabetes and improvement in dental health, would the tax be judged unsuccessful if BMI didn’t change?
In fact, diabetes and poor dental health affect people of all body sizes, who can all be healthier, regardless of BMI. But if a sugary drink tax collected enough healthcare funding to pay for diabetes and dental care, would public health campaigners still demand more just to make people slimmer?
These are important questions. If we are actually thinking about the externality, an “output target” in terms of rates of obesity and the average BMI makes very little sense. Instead, the focus should be on the link between consumption and disease – the change in BMI’s or obesity rates is symptomatic here.
This leads to the question:
What we must ponder is why public health campaigners and researchers feel the need to complicate a very simple relationship by dropping in the term obesity whenever possible, despite its longstanding logical and ideological problems.
Or, put differently: why are they so determined to define and control body mass when they could just target disease?
I also struggle with this question – why does it often feel that the “costs” are ex-post justifications for targeting something that a group of people just don’t like?
The entire idea of determining social policy on the basis of an idealised form for how individuals should be is an incredibly strong normative assumption. The same argument holds for other target based measures, such as GDP targets. And the use of economic language to “justify” and obsfucate this violates the fact economics is supposed to make these value judgments, regarding individuals, transparent.
This IS NOT an argument against active policy based on improving individual well-being and based on clear knowledge of the value judgments involved – in fact I am a huge fan of the introduction of mechanism design in this area, as there is a lot of self-reporting by individuals that obesity is something they are very unhappy with in their own lives.
But the reason I keep reiterating this is that:
- Many of the underlying justifications for targeting obesity are being based on the authors normative belief’s about whether others should be obese – same arguments hold with alcohol, tobacco, and other “sin goods”. Yes there are significant issues of choice and reasonable knowledge, but it is a long bow for this to lead us to an oversimplistic tax argument.
- As an individual I strongly, and totally, disagree with this inherent value judgment. A willingness to justify social action to punish individual difference is something I find morally abhorrent. Banning and constraining individual choice because it doesn’t fit our view of what a sensible individual would do is something that is ethically wrong, prior to any consideration of outcomes. I know that is a pretty deontological view of policy, but if we are going to consider things normatively without just thinking our view of societies social welfare function is totally an utterly right it is necessary.