The first, reasonable, question you may ask is why would I want to prevent health? But that would be splitting hairs – “preventative bad health” just doesn’t quite have the same ring to it.
But the real issue is just what is this preventative health, why does it matter and why is it relevant now?
At its purest form much of preventative health is just like motherhood – something so wonderful and wholesome that it is hard to disagree with. At varying levels it aims to avoid the development of disease, support the early diagnosis of disease or reduce the negative impact or complications of established disease. All worthy aims.
Using condoms, washing hands, cleaning areas of food preparation or providing immunisations are all areas of preventative health. Early screening and testing for a range of diseases, especially diseases with a family history, gets a tick too.
Unsurprisingly, preventing drug abuse, stopping smoking, eliminating excessive drinking, embracing a healthy diet and exercising regularly are also winners. Nothing to disagree with so far.
The Rudd Government decided that preventative health needed a bit of a kick along and, back in April of last year, established a Preventative Health Taskforce. It narrowed the scope of consideration somewhat, with terms of reference focused on lifestyle or consumption issues solely, requiring the development of “a blueprint for tackling the burden of chronic disease currently caused by obesity, tobacco, and excessive consumption of alcohol”.
The task force delivered their strategy to the Minister a couple of months ago, yet only released it yesterday. The delay in releasing it was no doubt caused by the vast array of Rudd Government spin doctors obsessing with how to turn a document that talks endlessly of tax rises, advertising bans and promotional restrictions into a politically palatable policy response. It must almost be driving them to drink!
What worries me is that, in all of the discussion of ways to reduce the incidence of smoking, alcohol abuse and obesity, there seems to be very little debate about when we start to cross the line of unreasonably telling people how to live their lives or instructing businesses how to run their businesses. So long as you don’t live in an information vacuum, you already know these things are bad for you, yet people choose to engage in them anyway.
What’s more, they already pay the price for it too. Let’s pick on smokers – everyone else does and, unlike a pint of beer or a Big Mac, every cigarette does, apparently, do you harm. Smokers pay $5.5 billion in tobacco excise alone every year. GST comes on top of this. According to a 2005 federal government report that more than recoups the $670 million that smoking costs the hospital system, while leaving plenty for other areas of smoking related healthcare too.
So we know that most smokers understand the risk and are paying the price. Drinkers pay plenty in tax too and, I contest, know that both chronic and acute harms can result from prolonged or short term abuse of alcohol. That just leaves the obese. While there may not be a fat tax, fresh food is GST free, unlike take-away. Regardless, I would certainly challenge you to find me any overweight person who thinks it healthy to be overweight.
You see, life is full of risks. From getting up in the morning and crossing the road, driving your car, jumping in a plane, jumping out of a plane for that matter, we make all manner of calculated risks all of the time.
At what point do we simply acknowledge that people choose, of their own free will, to smoke, drink to excess or eat to excess? When will we be spending enough on telling people they shouldn’t do these things? When will we be overly inconveniencing those who choose to simply enjoy the odd drink or an occasional chocolate donut? When will we be impeding legitimate businesses from selling legitimate products?
I do need to engage in a little disclosure. I used to work in the alcohol industry, so I fully expect some to attack me as a heartless voice of evil industry. I also don’t have any children, so I know others will explain that I just don’t understand what it’s like when little Billy or little Lizzie nags to eat some sugary breakfast cereal after seeing some of the evil advertising that invades their homes.
However, I can claim to have some understanding too. My father died of smoking related cancer when I was 12. I believe we should ensure people are informed of the risks. We should discourage such risky behaviour. There is a place for “sin” taxes. We should strongly enforce laws that prohibit minors from engaging in risky practices that they don’t have the judgement to assess. And we should absolutely enforce laws that already prohibit drink driving or otherwise prevent harm being done to innocent parties. But there are limits to how much government can or should control the free will of people, so long as their actions do no harm to others.
There are some reasonable ideas contained in the Preventative Health Taskforce report. Increasing the provision of fresh food to remote indigenous communities, while also reducing tobacco and alcohol abuse, is critical to tackling obesity, diabetes and many other endemic problems. Sadly, the capacity for informed choice simply does not exist in some of these communities.
Preventative health has a very important place. So do parts of this report. But please, higher taxes, advertising bans and bigger warning labels only serve to tell us what we already know and punish us for what we already choose to do. People are already largely informed and somewhat punished. So please, let’s pick the best bits of new thinking out of this report, but let’s leave behind the tired old headlines that simply point to doing more of the same