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So far, much of the law’s prevention efforts are benign, such as building exercise facilities, offering anti-smoking programs, or providing more medical screening.
But with budget-cutting negotiations on the horizon in Washington, political pressure is mounting to reduce the rapid rise in health costs by targeting so-called preventable conditions, such as obesity, or a person’s level of exercise.
“We don’t believe in individual freedom to the extent of letting people make poor health decisions and just wither away without help,” said Mick Cornett, the Republican mayor of Oklahoma City, which has a new public program called “This City Is Going on a Diet.”
Both governments and companies are inclined for now to use incentives to help people make better health choices rather than use penalties (more carrots than sticks, you might say). But even that requires a supposition on what constitutes health and what can maintain it. What about alternative means of health, such as prayer, used by millions of people? Will government intervene in some way on those different types of choices?
Preventive intervention requires extreme caution, not just for the sake of personal liberty but also because government itself can often make unwise choices.
The drive to improve health for all is a worthy goal, but that sentiment should not give free license to dubious methods of achieving it. Some ideas make clear sense, such as placing fruit at eye level in school cafeterias. Others, such as reducing benefits for overeaters, are a slippery slope toward assuming government cares more about individuals than individuals do about themselves – or that it always knows best.
Often a person’s choices – such as abusing drugs, smoking, and even overeating – do bring high costs to society. But means other than coercion must be considered to preserve personal integrity and to allow for different ideas about health.