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Killjoys: A Critique of Paternalism
Eating sugary food, drinking alcohol and smoking cigarettes are legal activities. But politicians still use the law to discourage them. They raise their price, prohibit or limit their advertisement, restrict where they can be sold and consumed, and sometimes ban them outright. These politicians thereby violate John Stuart Mill’s famous principle that people should be free to do whatever they like, provided they harm no one but themselves. Why? What can justify these paternalistic policies? Killjoys reviews the full range of justifications that have been offered: from the idea that people are too irrational to make sensible decisions to the idea that they are effectively compelled by advertising to harm themselves. The author, Christopher Snowdon, exposes the logical or factual errors that undermine each purported justification. He thus provides a comprehensive critique of the health paternalism that has been adopted by governments around the world.
185 pages, Kindle Edition
Published October 26, 2017
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March 7, 2019
The author compares soft (nudge) and hard (coercive) paternalism. He describes the characteristics of modern 'public health' paternalism and why he thinks it is bad, then finishes by giving some suggestions on better ways of regulating 'sin' products.
The author is generally fine with nudges (as long as they conform to the limitations laid out by Thaler/Sunstein) but dislikes any attempt to make a behaviour less attractive beyond the point necessary to account for externalities.
The author worries that modern public health paternalism considers its duty to restrict any behaviour that harms a significant number of people (where harm is measured by lifespan, ignoring any pleasure received from the behaviour). It has lots sight of its real responsibility, which is to protect from health risks that cannot be avoided by the individual. For example pollution or Ebola.
The focus is on the UK (especially the use of tobacco, alcohol and 'unhealthy food' in the UK) but the principles apply to most countries.
The author's viewpoint is essentially that of Mill in 'On Liberty', that is: "you should be free to do what you want, as long as it doesn't harm others -- oh, and making people feel uncomfortable doesn't count as harm.". Disclaimer: My own views are similar to the author's.
I noticed a reference to a study from this infamous researcher:
> Even putting a light above the fruit bowl can significantly increase the number of people who opt for fruit in school canteens (Wansink 2015).
which is an excellent reminder to actually check studies referenced in a book, check for other studies that might contradict the first study, and generally look at the research in case the author is ignoring everything that disagrees with their point of view. (I am not claiming this is what happened here)
Interesting points that would be worth thinking about in more detail:
- At what point does something become harm? Clearly physical harm is not the only kind of harm, and mental harm exists, but I think Mill is correct that allowing anyone to claim harm when someone else does something that makes them feel uncomfortable will not work well. There seems to be a gradient between 'direct physical harm' on one end and 'I don't like knowing that gay people exist' at the other, and knowing where to draw the line is difficult.
- How do we handle addiction? If you argue that addiction overrides someone's real desires, and prevents them from maximising their utility, then restricting addictive products more might make sense. Presumably people know that there products are addictive when they begin using them, and are making a choice which is rational at that time knowing that their preferences will be changed. Preventing children from using addictive products may still make sense, since we generally consider them to be not quite rational yet.
One argument that I have thought about for a while is the existence of the NHS. Since my taxes pay for the NHS, and any increase in NHS costs will result in an increase in my taxes (or a reduction in benefits, or a reduction in my children's benefits), then this essentially turns behaviour that would otherwise only pose a risk to the individual into a negative externality that affects everyone. It gives all tax payers a reason to want to control others' behaviour.
My personal bias means I conclude from this that we should no longer have the NHS, the author offers another way out: he suggests that the cost to the NHS of heavy drinkers and smokers is actually lower than average due to their lower life expectancy. (I have not checked these studies yet, but it seems feasible).
Either way, it does not seem defensible on economic grounds to set the tax on tobacco so high as it currently is. Tobacco duty brought in 8.8 billion last year. The duty (ie. sin tax) alone, excluding VAT, is currently 16.5% of the retail price plus £4.57 on a packet of 20, more than half the cost of an average pack of cigarettes is tax. The duty alone on wine is £3 a bottle (again, more than half the price for cheap supermarket wine). Even if smokers cost more to the NHS than they save by dying early, the tax is surely too high if the only goal is to pay for this externality they are imposing on other NHS users.
Here we are ignoring the pleasure smokers get from smoking, and the displeasure others get from seeing and smelling smokers, because it is hard to calculate. If we did try and do the calculation, I imagine smokers get more pleasure than others get displeasure.
The true reason for the tax is not really hidden, it is an attempt to protect smokers from themselves mixed with a little bit of moral puritanism. "Smoking kills, also it is a dirty habit." The moral side is obvious from a lack of lobbying groups trying to stop people from:
- skiing
- mountain climbing
- running (lots of injuries here!)
- not running (exercise is the best way to extend your life-span)
- being fat (although this is starting to change!)
- eating meat
- not eating vegetables
- not taking vitamin D supplements
- etc.
'Sugar' is beginning to join the usual sins of gambling, drugs, cigarettes and alcohol, but is not quite at the point where it is acceptable to shun people who eat donuts in public.
Overall I enjoyed the book, since it made me clarify my own thinking on some of these issues. If you haven't read Mill's On Liberty, do that first. If you don't understand how someone could possibly be against banning smoking, then this book might be an interesting insight into a different point of view.
The author is generally fine with nudges (as long as they conform to the limitations laid out by Thaler/Sunstein) but dislikes any attempt to make a behaviour less attractive beyond the point necessary to account for externalities.
The author worries that modern public health paternalism considers its duty to restrict any behaviour that harms a significant number of people (where harm is measured by lifespan, ignoring any pleasure received from the behaviour). It has lots sight of its real responsibility, which is to protect from health risks that cannot be avoided by the individual. For example pollution or Ebola.
The focus is on the UK (especially the use of tobacco, alcohol and 'unhealthy food' in the UK) but the principles apply to most countries.
The author's viewpoint is essentially that of Mill in 'On Liberty', that is: "you should be free to do what you want, as long as it doesn't harm others -- oh, and making people feel uncomfortable doesn't count as harm.". Disclaimer: My own views are similar to the author's.
I noticed a reference to a study from this infamous researcher:
> Even putting a light above the fruit bowl can significantly increase the number of people who opt for fruit in school canteens (Wansink 2015).
which is an excellent reminder to actually check studies referenced in a book, check for other studies that might contradict the first study, and generally look at the research in case the author is ignoring everything that disagrees with their point of view. (I am not claiming this is what happened here)
Interesting points that would be worth thinking about in more detail:
- At what point does something become harm? Clearly physical harm is not the only kind of harm, and mental harm exists, but I think Mill is correct that allowing anyone to claim harm when someone else does something that makes them feel uncomfortable will not work well. There seems to be a gradient between 'direct physical harm' on one end and 'I don't like knowing that gay people exist' at the other, and knowing where to draw the line is difficult.
- How do we handle addiction? If you argue that addiction overrides someone's real desires, and prevents them from maximising their utility, then restricting addictive products more might make sense. Presumably people know that there products are addictive when they begin using them, and are making a choice which is rational at that time knowing that their preferences will be changed. Preventing children from using addictive products may still make sense, since we generally consider them to be not quite rational yet.
One argument that I have thought about for a while is the existence of the NHS. Since my taxes pay for the NHS, and any increase in NHS costs will result in an increase in my taxes (or a reduction in benefits, or a reduction in my children's benefits), then this essentially turns behaviour that would otherwise only pose a risk to the individual into a negative externality that affects everyone. It gives all tax payers a reason to want to control others' behaviour.
My personal bias means I conclude from this that we should no longer have the NHS, the author offers another way out: he suggests that the cost to the NHS of heavy drinkers and smokers is actually lower than average due to their lower life expectancy. (I have not checked these studies yet, but it seems feasible).
Either way, it does not seem defensible on economic grounds to set the tax on tobacco so high as it currently is. Tobacco duty brought in 8.8 billion last year. The duty (ie. sin tax) alone, excluding VAT, is currently 16.5% of the retail price plus £4.57 on a packet of 20, more than half the cost of an average pack of cigarettes is tax. The duty alone on wine is £3 a bottle (again, more than half the price for cheap supermarket wine). Even if smokers cost more to the NHS than they save by dying early, the tax is surely too high if the only goal is to pay for this externality they are imposing on other NHS users.
Here we are ignoring the pleasure smokers get from smoking, and the displeasure others get from seeing and smelling smokers, because it is hard to calculate. If we did try and do the calculation, I imagine smokers get more pleasure than others get displeasure.
The true reason for the tax is not really hidden, it is an attempt to protect smokers from themselves mixed with a little bit of moral puritanism. "Smoking kills, also it is a dirty habit." The moral side is obvious from a lack of lobbying groups trying to stop people from:
- skiing
- mountain climbing
- running (lots of injuries here!)
- not running (exercise is the best way to extend your life-span)
- being fat (although this is starting to change!)
- eating meat
- not eating vegetables
- not taking vitamin D supplements
- etc.
'Sugar' is beginning to join the usual sins of gambling, drugs, cigarettes and alcohol, but is not quite at the point where it is acceptable to shun people who eat donuts in public.
Overall I enjoyed the book, since it made me clarify my own thinking on some of these issues. If you haven't read Mill's On Liberty, do that first. If you don't understand how someone could possibly be against banning smoking, then this book might be an interesting insight into a different point of view.
September 29, 2018
I enjoyed reading this book not because I agree with all Mr Snowdon's views but because it made me think.
It is a book of two intertwined halves, one half looks at the philosophical justification for restricting state intervention, the other half looks at evidence concerning 'health paternalism.' The second half is much more successful than the first.
The discussion of the justification for restricting state intervention is based almost entirely on the work of JS Mill. There is no doubt that JS Mill is a good example of mid-nineteenth century Liberalism but he cannot be quoted as if his arguments are universally accepted. Mr Snowdon quotes JS Mill as if his words should settle the matter in question rather like an Evangelical Christian quotes the bible at non-believers and expects them to acquiesce.
The generation of Liberal philosophers after Mill largely dismantled his work, as philosophers generally do with the generation that preceded them. Mill's idea of 'self regarding actions' is very easily unpicked, the idea of 'positive freedom' in Liberal philosophers such as TH Green showed the limitations of Mill's narrow conception of freedom, and Mill's individualism is at odds with all our collective identities, including society, nation, class, culture, race, family, religion, sexuality and any others you may care to mention.
The narrow application of Mill's work to Health Paternalism also raises questions about the wider implications of such a view of state intervention, so for instance do his arguments apply to recreational drug taking?
Mr Snowdon no doubt thinks JS Mill's words are gospel but others, including me, do not.
There is some discussion of what it means to be in Mill's terms 'a rational human being', which is helpful, although I have never understood why the rationality of humanity should be a factor in determining state intervention? If we are irrational so then are the state decision makers and so their decisions are no more reliable than ours. If we are rational then the decisions of those in power are as reliable as ours. The mistake seems to be to assume that those who make up the state are different in kind to those who are governed, the only difference is power - which can be analysed in terms of class or social structures or ideas of benevolence or corruption, but essentially the decision making capabilities of governed and governors are (sadly) the same.
For me, Mr Snowdon's discussion around the evidence concerning Health Paternalism is far more successful, whether you think Health Paternalism is compatible with the work of JS Mill (which is apparently the measure of all good) or not, it doesn't seem to work very well. The evidence collected and applied from Studies and elsewhere is by far the strongest part of the book and the most persuasive argument for being wary of Health Paternalism. Having disagreed with the better part of Mr Snowdon's words on JS Mill and his application to Health Paternalism I found I agreed with the better part of the conclusions he came to by looking at the evidence.
Mr Snowdon seems to self identify as an economist, on the evidence of this book he is rather better at that than philosophy. In advocating the teaching of economics in schools he writes, "it is no coincidence that economists are more rational than the average person", thereby unintentionally demonstrating that economists are as given to Paternalism as the rest of us. 'If only more people thought like us, the world would be a better place - how can we change people to be more like us?'
Which kind of sums up my frustration with the whole book because although Mr Snowdon's reasoning is flawed I entirely agree that basic economics ought to be taught in schools.
Worth reading, but be prepared that unless you are a convinced economic and social liberal of the mid-nineteenth century school you may want to throw the book across the room.
It is a book of two intertwined halves, one half looks at the philosophical justification for restricting state intervention, the other half looks at evidence concerning 'health paternalism.' The second half is much more successful than the first.
The discussion of the justification for restricting state intervention is based almost entirely on the work of JS Mill. There is no doubt that JS Mill is a good example of mid-nineteenth century Liberalism but he cannot be quoted as if his arguments are universally accepted. Mr Snowdon quotes JS Mill as if his words should settle the matter in question rather like an Evangelical Christian quotes the bible at non-believers and expects them to acquiesce.
The generation of Liberal philosophers after Mill largely dismantled his work, as philosophers generally do with the generation that preceded them. Mill's idea of 'self regarding actions' is very easily unpicked, the idea of 'positive freedom' in Liberal philosophers such as TH Green showed the limitations of Mill's narrow conception of freedom, and Mill's individualism is at odds with all our collective identities, including society, nation, class, culture, race, family, religion, sexuality and any others you may care to mention.
The narrow application of Mill's work to Health Paternalism also raises questions about the wider implications of such a view of state intervention, so for instance do his arguments apply to recreational drug taking?
Mr Snowdon no doubt thinks JS Mill's words are gospel but others, including me, do not.
There is some discussion of what it means to be in Mill's terms 'a rational human being', which is helpful, although I have never understood why the rationality of humanity should be a factor in determining state intervention? If we are irrational so then are the state decision makers and so their decisions are no more reliable than ours. If we are rational then the decisions of those in power are as reliable as ours. The mistake seems to be to assume that those who make up the state are different in kind to those who are governed, the only difference is power - which can be analysed in terms of class or social structures or ideas of benevolence or corruption, but essentially the decision making capabilities of governed and governors are (sadly) the same.
For me, Mr Snowdon's discussion around the evidence concerning Health Paternalism is far more successful, whether you think Health Paternalism is compatible with the work of JS Mill (which is apparently the measure of all good) or not, it doesn't seem to work very well. The evidence collected and applied from Studies and elsewhere is by far the strongest part of the book and the most persuasive argument for being wary of Health Paternalism. Having disagreed with the better part of Mr Snowdon's words on JS Mill and his application to Health Paternalism I found I agreed with the better part of the conclusions he came to by looking at the evidence.
Mr Snowdon seems to self identify as an economist, on the evidence of this book he is rather better at that than philosophy. In advocating the teaching of economics in schools he writes, "it is no coincidence that economists are more rational than the average person", thereby unintentionally demonstrating that economists are as given to Paternalism as the rest of us. 'If only more people thought like us, the world would be a better place - how can we change people to be more like us?'
Which kind of sums up my frustration with the whole book because although Mr Snowdon's reasoning is flawed I entirely agree that basic economics ought to be taught in schools.
Worth reading, but be prepared that unless you are a convinced economic and social liberal of the mid-nineteenth century school you may want to throw the book across the room.
October 4, 2018
A small book, but it took me a while to read because it would make me so angry I'd have to set it down for a while. It is very well written and the author takes steps towards showing the few times paternalism has worked even though his personal bias comes through loud and clear.
The approach is interesting, Snowdon seems to believe in "the exception that proves the rule" approach. Overall, this was an eye opening book for me. It's one of those things that you feel is there in the background but when it's laid out in full right before your eyes it changes everything.
The approach is interesting, Snowdon seems to believe in "the exception that proves the rule" approach. Overall, this was an eye opening book for me. It's one of those things that you feel is there in the background but when it's laid out in full right before your eyes it changes everything.
Displaying 1 - 3 of 3 reviews