Freedom and Liberty in NCDs - Which side of the debate are you on?

We contrast freedom as freedom from government intervention (in the case of commercial freedoms) versus freedom from harm / disease.  Which side of the spectrum are you on and why?  What is the relevance of this debate to our work with NCDs?

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My feeling is that without question, the free market does not promote health and wellness.  If we are to completely uphold negative rights like many in the USA would advocate, and rid ourselves of as much government intervention as possible, we will be left with a society who's health is determined by the free market.  There is no way that companies, such as Pepsi, Coca-cola, big-pharma, Nestle, and others, who are chasing profits, will consider the health of their buyers in any meaningful way.  They will look out for their profits and try to maximize them.

A good example of this question can be found in the sugary beverage debate.  In Massachusetts right now there is a debate about whether sugar sweetened beverages should be exempt from sales taxes like other foods are.  I do not believe they should be.  They are empty calorie drinks, they have been directly linked to obesity, and as a government we are treating them like broccoli and apples, as essential food items.  At the same time there is an epidemic of obesity in this country and in many places around the world because of these food items and others.  If we do not take a stand as a society and say we deserve better, of course we will continue to make decisions that are pleasant in the short-term but destructive in the long-term.

These used to be a debate in the tobacco industry in this country but most now believe the government should play a role in protecting society by taxing cigarettes and discouraging their use.  Is it time to think the same way for other things like soda and candy?

What are your thoughts?  

In the battle against NCDs, there is no doubt as to which side of the spectrum we belong to - the Freedom from disease/ harm one.

Tobacco/ obesity/ et al- the morbidity and mortality figures are astounding and shell-shocking - we have around 400,000 deaths per year JUST by second hand smoke exposure!

There have been studies recently showing us how imposing smoke free laws brings down the number of heart attacks in the region over a number of years!

If government regulations in the form of imposing taxes and other measures can help curb these pandemics, I am all in their favor !!

We are talking about PREVENTABLE DEATHS/ MODIFIABLE risk factors.... and it would be amazing if all of us were to remember that age-old adage -


Cheerz and lets keep up the good work !

I am on the 2nd side (Freedom from Harm/Disease). Because, without freedom from disease, freedom from government intervention is valueless.

The government gives us freedom but they are harming us by not banning the tobacco and junk foods which do real harm to our life. So at first I need Freedom from disease.

Hey Jason, I have said this before and I will say it again. By and large, most people think choice (aka freedom and liberty??) to be a good thing. I would argue the opposite. To make a good choice needs two factors – one, that the choices on offer are good, and two, that the person making that choice is well-informed to make the best choice for them. Let me tell you one example where this does not work. In the UK’s national health care system, one gets a choice of local hospitals in which to receive their care. However, this might result in those higher up the social ladder (and actually ironically more likely to be healthier) to choose the best hospitals. This will only widen social inequality, and we know a more unequal society is worse for everybody in that society (read Wilkinson and Pickett's The Spirit Level – the rich in a more unequal society are more likely to have a security guard at their front door..).

The second issue with choice in my mind is does the wider community benefit from it? Again, I think not. The fact that one can choose to drive a gas-guzzling four-wheel-drive car in the long run benefits nobody apart from the driver. The irony with an unhealthy diet is that the heart attack it results in not only costs money to society, but ends up debilitating the heart attack sufferer. Perhaps this is why millions of American do not believe in the right to free healthcare?! If their society encourages them to make choices such as burgers and chips every day, then that consumer must surely pay for his heart attack! Makes sense to me now…

The problem with the above two paragraphs as that I of course assumed people are a communal creature. Ultimately they are a selfish animal – read Richard Dawkin’s analysis on the selfish gene. So actually, one cannot expect most people to care about social inequality, or whether or not their car is trashing the environment, and whether their diet will eventually lead to more healthcare costs. There is much written and said by those right-of-centres on the ‘nanny-state’, as if it is something to be avoided to allow the human race to progress.

However, the irony is that the best things about society are all-pervasive, and that the ‘nanny-state’ often means progress. People have short memories. It really is only the last half century or so that a large proportion of people have had choice in their lives – choice on what to eat, what places to visit, what to buy. But in these incredible times, some of the best things have been nanny-statist. Sanitation for example, and the sewage/water purification systems set up in developed countries towards the end of the 19th century. Also, why can I not buy petrol with lead in it? For an effective society that works for all, you need some ground rules. Only then can all the billions of people on this small planet live in relative harmony with each other.


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