Tag: paternalism

Health Policy Topics in New, Online Version of The Encyclopedia of Libertarianism

The Cato Institute’s Libertarianism.org web site has released a new, online version of The Encyclopedia of Libertarianism.

The Encyclopedia offers “a general guide to the social and political philosophy that today goes by the name of libertarianism,” including several chapters of interest to health policy scholars:

Estimate: Massachusetts Diverts 99% of Tobacco Money to Other Causes

From this weekend’s Lawrence (Mass.) Eagle-Tribune
Millions of dollars originally intended for smoking cessation programs in Massachusetts have been diverted to offset budget deficits, leaving the state struggling to fund quit-smoking hotlines, treatment programs and anti-tobacco advertising, the New England Center for Investigative Reporting has found. … 
“Roughly 99 percent of all the tobacco dollars that come into the state are used for something else,” said Stephen Shestakofsky, recently retired executive director of Tobacco Free Massachusetts, an anti-tobacco advocacy group. He was referring to the nearly $254 million in tobacco-related legal awards given to Massachusetts in 2012. More than $561 million in tobacco taxes was also collected, bringing the state’s total tobacco tally to just over $815 million, the CDC reports.
On the one hand, it’s not as if I’d urge the state of Massachusetts to sink vast sums into the paternalist project of hectoring its citizens to quit, especially not at a time when its taxpayers are already having to foot a steep tab for its RomneyCare health insurance experiment. On the other hand, we can now see that it was the purest pretense for attorneys general in states like Massachusetts to have portrayed the Great Tobacco Robbery settlement of some years back as motivated by a supposed need for new “public health” outlays, as opposed to sheer plunder and the interests of the various lawyers involved.  
That’s worth remembering next time you hear a proposal to extract large sums from the food industry (either through taxation or, as some in the legal profession would like, by suing them for it under some creative theory) with the promise that funds will then be earmarked for anti-obesity efforts. In practice, after voters’ attention wanders, funds ordinarily get earmarked for the advancement of the political interests of those in power.  
More on the late-1990s Medicaid-tobacco settlement from Cato chairman Robert Levy here, here, here, and in his book Shakedown, and from me here, here, and in my book The Rule of Lawyers

More about the Calorie Police

It’s nice to get quoted in the Los Angeles Times, even if the author obviously didn’t understand what I was getting at. I’ll try to clear up the confusion here.

Karen Caplan writes:

Does Kuznicki (or anyone else) really think that the goal of a healthy diet is simply to minimize the total number of calories consumed? (Perhaps these are the same folks who swear by Taco Bell’s Drive-Thru Diet.)

A 12-ounce serving of whole milk contains 12 grams of protein, along with 45% of the calcium and 36% of the vitamin D you need each day. The same amount of soy milk also has 12 grams of protein and 14% of the daily recommended intake of iron.

Care to guess how many vitamins and minerals are in a can of Coke?

I certainly don’t think that a healthy diet means only reducing one’s calorie intake. I do, however, believe that the stated goal of the policy was not to improve overall health, but to reduce obesity. And for that, which one do you pick?

a) consume fewer calories


b) get more calcium and vitamin D.

Does anyone seriously suggest that (b) is the right choice? Is this what passes for nutritional advice at the Los Angeles Times? Eat whatever you want, and as long as you take your vitamins, you won’t get fat?

The policy we’re talking about was not intended to make sure that people get all their vitamins and minerals. It was intended to curb obesity. And for that purpose it will do essentially nothing, as I noted, I still think correctly, in the original post.


Eradicating Social Evils

The goal of a new Chinese government campaign is to “eradicate all social evils” and “advocate a healthy, civilized and high-minded lifestyle,” according to the Washington Post. Some elements of the state just don’t like the way the Chinese people are using their newfound freedom.

On a different level, we face the same arguments here in the United States. Both the Hillarys and the Huckabees in our world seek to fight “social evils” and lead us to “a healthy, civilized and high-minded lifestyle.” The Huckabees focus on our souls, urging the government to stamp out sin and push us to do God’s will (as they see it). The Hillarys often focus on our bodies, with campaigns against smoking, popcorn, sodas, salt, and all manner of “unhealthy lifestyles.” Then again, the Hillarys do want to save our souls, as well, with campaigns to eradicate racism and sexism and spread the environmentalist gospel.

In China, economic freedom is giving people an opportunity to throw off old social rules and restrictions and to experiment with living their lives as they choose. Economic freedom has the same impact here, and in both countries there are powerful people who don’t like the choices free people make.

The Return of Dan Coats

Former Indiana senator Dan Coats is running for his old seat again, 12 years after he left Congress and turned the seat over the now-retiring Evan Bayh.  Coats says he’s very concerned that “our elected officials in Washington continue to run up massive deficits, recklessly borrowing and spending record amounts of taxpayer money with no regard for the future generations of Americans who will inherit this staggering and ever-increasing debt,” and he has the support of conservative congressional leader Mike Pence. But I remember a Senator Dan Coats who enthusiastically promoted big, paternalist government. In the Heritage Foundation’s Policy Review, I responded to a Coats essay on his “Project for American Renewal,” launched with Bill Bennett, this way:

Coats says that the Project for American Renewal “is not a government plan to rebuild civil society” and that he favors “a radical form of devolution [that] would redistribute power directly to families, grass-roots community organizations, and private and religious charities.” But in practice he apparently believes that the federal government should tax American citizens, bring their money to Washington, and then dole it out to sensible state and local programs and responsible private institutions. Surely we have learned that government grants do not create strong, creative, vibrant private organizations. Rather, organizations that depend on government funding will have to follow government rules, will be unable to respond effectively to changing needs, and will get caught up in games of grantsmanship and bureaucratic empire-building.

Moreover, nearly every one of his bills would further entangle the federal government in the institutions of civil society. Under the Role Model Academy Act, the federal government would “establish an innovative residential academy for at-risk youth.” Under the Mentor Schools Act, the feds would provide grants to school districts wanting to develop and operate “same gender” schools. The Character Development Act would give school districts demonstration grants to work with community groups to develop mentoring programs. The Family Reconciliation Act would “provide additional federal funding … to implement a waiting period and pre-divorce counseling” for couples with children.

Many of these bills are intended to address real problems, such as the effects of divorce on children and the terrible plight of children trapped in fatherless, crime-ridden, inner-city neighborhoods. But why is it appropriate or effective for the federal government to intrude into these problems? Surely local school districts should decide whether to build same-sex schools or residential academies for at-risk youth; and if the people of, say, Detroit decide that such options would make sense, any theory of responsible, accountable government would suggest that the local city council or school board both make that decision and raise the funds to carry it out.

Many of Coats’s bills deal with symptoms – they try to reform public housing by setting aside units for married couples or to provide mentors for children without fathers – rather than dealing with the real problem, a welfare system that guarantees every teenager her choice of an abortion or an apartment if she gets pregnant. Some of the bills accept the federal Leviathan as a given and tinker with it – for instance, by requiring that every federal dollar spent on family planning be matched by another dollar spent on abstinence education and adoption services. Others just follow the failed liberal policy of handing out federal dollars for whatever Congress thinks is a good idea – school choice, restitution to crime victims, maternity homes, community crime-watch programs.

Over the past 60 years, we’ve watched the federal government intrude more and more deeply into our lives. We’ve seen well-intentioned government programs become corrupted by the ideologues and bureaucrats placed in charge. We’ve seen schools and charities get hooked on federal dollars. The nature of government doesn’t change when it is charged with carrying out conservative social engineering rather than liberal social engineering.

Let’s not forget that if, say, Coats’s Maternity Shelter Act were implemented next year, Donna Shalala, the secretary of health and human services, would be charged with implementing it. She might appoint HUD assistant secretary Andrew Cuomo to run it, or maybe unemployed ex-congressman Mel Reynolds, or maybe just some Harvard professor who thinks single motherhood is a viable lifestyle option for poor young women. One reason conservatives shouldn’t set up well-intentioned government programs is that they won’t always be in power to run them.

In the Washington Post, after criticizing various Clinton administration policies that seemed to reveal that Democrats just couldn’t give up their addition to big government, I wrote:

Republicans suffer from the same weakness. The latest example is the Project for American Renewal, launched Sept. 6 by William Bennett and Sen. Dan Coats (R-Ind.). Bennett and Coats endorse “devolution of federal authority and funding to state governments” but go on to argue that Republicans “need to offer a vision of rebuilding broken communities - not through government, but through those private institutions and ideals that nurture lives.” They stress that “even if government undermined civil society, it cannot directly reconstruct it.”

They talk the anti-big government talk even better than new Democrats, which is why the 1994 election saw a historic shift toward GOP. But look at the “be it enacted” clauses that follow of Bennett and Coats’s libertarian whereases.

As part of the Project for American Renewal, Coats has introduced 19 bills. They include:

  • The Mentor Schools Act, to provide grants of $1 million to school districts to develop “same gender” schools.
  • The Role Model Academy Act, to establish an innovative residential academy for at-risk youth.
  • The Kinship Care Act, to create a $30 million demonstration program for states to use adult relatives as the preferred placement option for children separated from their parents.
  • The Restitution and Responsibility Act, to provide grants to states for programs to make restitution to victims of crime.
  • The Assets for Independence Act, to create a four-year, $100 million demonstration program to establish 50,000 Individual Development Accounts, to be used for the purchase of home, college education or small business.
  • The Community Partnership Act, to institute demonstration grants for programs to match communities of faith with welfare recipients and nonviolent criminal offenders.

And on and on it goes. Most of the goals are good: Some students do better in all-boys or all-girls schools; children who lose their parents should ideally live with other adult relatives; restitution is a valuable aspect of dealing with a crime. But why does the federal government need to do any of those things? If the 10th Amendment and the new-found commitment to devolution of power mean anything, they mean that residential academies, victim restitution and welfare reform should be undertaken by state governments - if not local communities or even nongovernment groups.

And surely the First Amendment would recommend that such a worthy goal as matching “communities of faith” - that is, churches - with people in need should be undertaken without government support. As for 50,000 Individual Development Accounts, I’d like one - wouldn’t you?

Like the Democrats, the Republicans just don’t get it. They’re still living in the Washington that Roosevelt built, the Washington where if you think of a good idea you create a government program. But conservative social engineering, like liberal social engineering, will fail. Worse, it will create new problems.

Later that year Ed Crane, writing in Cato Policy Report, was perhaps even harsher, referring to the “vaguely Orwellian titles” of Coats’s proposed bills:

I mention that little episode because it is illustrative of a certain wide- eyed innocence on the part of many of our conservative friends. The most recent example is the Project for American Renewal being put forth by Sen. Dan Coats (R-Ind.) and neoconservative intellectual Bill Bennett, also of Empower America. It consists of some 19 bills that Coats has submitted in the Senate in an effort “to find some ways to nurture civil society.”

Most of the bills have vaguely Orwellian titles like the Compassion Credit Act, the Community Partnership Act, or the Family Reconciliation Act. Almost all of them amount to nothing more than conservative social engineering. The last bill, for instance, “would provide additional federal funding to states under the Family Preservation and Social Services Act, to implement pre-divorce counseling.” The Assets for Independence Act “would create a four-year $100 million demonstration program to establish 50,000 Individual Development Accounts.”

Never mind that, again, one would search in vain for the enumerated power in the Constitution that says most of those initiatives are within the purview of the federal government. Never mind even that conservatives who celebrated James Buchanan’s Nobel Prize for his work in public-choice theory should recognize that those little conservative policy gems will one day grow into the liberal monsters that so disappoint Jack Kemp.

The concern here is that some conservatives have in the post-Reagan era adopted what might be called the government habit. That is particularly true of neoconservatives, who trace their intellectual heritage to the left and who, for the most part, have a fundamentally benign view of the state. The problem to them has not been the power of government but the misuse of that power by wrongheaded politicians and bureaucrats.

Thus, Bill Bennett writes in the introduction to a booklet promoting the Project for American Renewal, “If the liberal fallacy is an abiding faith in the all-sufficiency of government, then the conservative fallacy could easily become an abiding faith in the all-sufficiency of nongovernment.” Well, not if Dan Coats has anything to say about it. And Coats is more of a traditional conservative.

The argument one hears from many conservatives, particularly inside the Beltway, is that you can’t replace something with nothing. But that sentiment simply reflects the government habit. After all, the American people are not “nothing.” Why not rephrase the issue: you can replace a failed government welfare program that has wasted billions, created dependency, and destroyed lives with the responsiveness, compassion, and prudence of a free people.

We can hope that a dozen years out of public office will have restored Dan Coats’s traditional Republican skepticism about government schemes. But as has been widely discussed, he’s spent those years working as ambassador to Germany and then as a lobbyist on Pennsylvania Avenue, two places where faith in individualism, civil society, and limited government is rare.