In this week’s post I was determined not to mention COVID. That resolve has obviously not lasted very long, given its mention in the first sentence but the topic I would like to address is the government’s plan to address obesity and obviously the catalyst for that strategy is to mitigate of the effects of a second spike in COVID.
It isn’t actually the plan for reducing obesity that I would like to discuss, rather the fact that the government feels it appropriate to intervene in peoples’ eating and general health. The announcement made me wonder where the boundaries of government lie, or is government so intertwined with everyday life that it is right that it should be guiding or, indeed, legislating on all matters, even including how much I eat or how little I exercise?
The parameters of government influence are not clear and varies country by country depending upon a range of other influences, such as power of monarchy, religion, whether a written constitution is in place and the extent to which power is devolved to regional governments. It will also vary depending upon the philosophical viewpoint of the political party in power at the time or the overarching influence of more systemic political force, as we have seen most vividly recently in Hong Kong as the imposition of the Extradition Bill, enabling China to tighten its control over the territory.
From a philosophical perspective, modern government seems quite distant from the thinking of John Stuart Mill, who believed that “the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others” (The Harm Principle), The idea is predicated on the notion that the individual knows what is good for him or herself and therefore, as long as the action of the individual does not negatively impacts others, the individual should be able to proceed with the act. When set in the context of the specific act being done, it becomes easier to argue whether or not the harm principle is being violated. For instance, whilst obesity may be viewed as a personal issue and one to which individuals should be able to determine themselves, the ramifications of their action/inaction can have a material impact on broader society, such as through increased healthcare costs and therefore higher taxes. Or, as research from the Kings Fund summarises: “Unhealthy behaviours such as smoking, drinking excess alcohol and unhealthy diets are key drivers of poor health outcomes and have significant consequences for individuals, the NHS, the economy and society.”
The government intervention can be direct, as we have seen in the legislation to restrict the selling of certain products to sections of society, such as tobacco and alcohol to children or imposing higher taxes on products containing higher levels of sugar or salt. Whilst the individuals consuming these products may baulk at the higher cost, the research from the Kings Fund indicates a degree of acceptance given the corresponding health benefits.
I believe one of the most interesting government interventions and is more indirect compared to the measured mentioned above, is the introduction of ‘nudges’ into policies to influence behaviour. The Behavioural Insights Team of the Cabinet office: ‘Nudge Unit’ was introduced under David Cameron’s government in 2010, drawing on the work of US academics Richard Thaler and Cass Sunstein. The foundation of the nudge approach is what Thaler and Sunstein termed liberal paternalism, or influencing individuals to make choices, the outcomes of which will be better for them. This underpinned the introduction of the new workplace pensions regime in 2012 where individuals were automatically enrolled into a pension but had the ability to opt out. We have seen the success of the strategy with very high participation and low opt-out. Indeed, “in 2019, four out of five private sector employees were saving in a workplace pension. This compares with just two out of five in 2012, prior to automatic enrolment being introduced.”
At the outset of writing this piece, I was somewhat indignant at the idea that government can implement policies on the premise that it knows what is best for me. On reflection we have to look to the collective good and as long as there is transparency and openness to policy, it is probably right that unhealthy behaviours are nudged into shape!
 On Liberty (1859)  https://www.kingsfund.org.uk/sites/default/files/2020-03/tax-regulation-briefing-2020.pdf  Institute for Fiscal Studies, Automatic enrolment – too successful a nudge to boost pension saving? https://www.ifs.org.uk/publications/14850