Dark Bilious Vapors

But how could I deny that I possess these hands and this body, and withal escape being classed with persons in a state of insanity, whose brains are so disordered and clouded by dark bilious vapors....
--Rene Descartes, Meditations on First Philosophy: Meditation I

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07/08/2005: The free-market dogma....

I never cease to be amazed by the religious fervor with which seeming proponents of laissez faire capitalism and "free-market regulation" hold their opinions. In an interesting op-ed this morning on obesity policy, Paul Krugman gives us an example. To give you the context, the topic under discussion is the difficulties that public health authorities are encountering in attempting to stem the rising tide of obesity in America:

The obvious model for those hoping to reverse the fattening of America is the campaign against smoking. Before the surgeon general officially condemned smoking in 1964, rising cigarette consumption seemed an unstoppable trend; since then, consumption per capita has fallen more than 50 percent.

But it may be hard to match that success when it comes to obesity. I'm not talking about the inherent difficulty of the task - getting people to consume fewer calories and/or exercise more may be harder than getting people to stop smoking, but we won't know until we try. I'm talking, instead, about how the political winds have shifted.


More broadly, the ideological landscape has changed drastically since the 1960's. (That change in the landscape also has a lot to do with corporate financing of advocacy groups, but that's a tale for another article.) In today's America, proposals to do something about rising obesity rates must contend with a public predisposed to believe that the market is always right and that the government always screws things up.

You can see these predispositions at work in an article printed last month in Amber Waves, a magazine published by the Department of Agriculture. The article is titled "Obesity Policy and the Law of Unintended Consequences," suggesting that government efforts to combat obesity are likely to be counterproductive. But the authors don't actually provide any examples of how that might happen.

And the authors suggest, without quite asserting it, that because people freely choose obesity in a free market, it must be a good thing.

"Americans' rapid weight gain may have nothing to do with market failure," the article says. "It may be a rational response to changing technology and prices. ... If consumers willingly trade off increased adiposity for working indoors and spending less time in the kitchen as well as for manageable weight-related health problems, then markets are not failing."

How can medical experts who see obesity as a critical problem deal with an ideological landscape tilted in the direction of doing nothing?
As I view it, in my own cynical fashion, we have two competing ideas here, and we need to keep them straight. On the one hand, there is something to be said for the virtue of freedom. Each of us are (at least, for the purpose of legal and moral analysis; I don't want to broach the question of free will versus determinism right now) presumed to be free agents who can elect to do whatever we want to do. And given that freedom, there are strong arguments that free agents should be allowed to do whatever they want to do (providing, of course, that the rights and the well-being of others are not significantly and adversely affected). And if people freely choose to engage in behaviors that are objectively detrimental to their health... well, hey--basically each of us is responsible for his/her own damnation, right?

However, that's quite a different thing from the assertion (often made in the serious tones of one proclaiming a religious dogma) that whatever equilibrium point that is found by free market is somehow "correct" in some objective sense. The fact of the matter is that a free market is often the most efficient process by which decisions are made about the allocation of scarce resources. However, unless one wants to define "best outcome" as "outcome reached by the untrammeled operation of free market forces" (a definition that seems to me to be pretty self-evidently wrong), it is clear that there may be situations in which the allocation of resources by a free market may well be "wrong" or "less than optimal" in an objective sense, because the "correctness" of the allocation "decisions" made by a free market will be heavily dependent on the ability of (and the actual use of that ability by) the participants in that market to make rational decisions about their behavior in the market. And even a cursory reading of human history clearly demonstrates that human beings often make decisions that are anything but rational.

Eating decisions in a free market are a case in point. A rational decision maker, examining the medical evidence concerning the health effects of obesity on the population, cannot help but come to certain conclusions about the effect of one's eating habits on one's health. Each individual actor in the market may elect to disregard that evidence and make purchasing decisions that are less than optimum in this context (i.e., choose to go to McDonald's and order the Super Sized 2 Big Mac Value Meal and The Real Thing™ instead of a salad and low-cal dressing), and that's their right. But if we agree that there are certain outcomes which are objectively more desireable than others (e.g., that its is better for the population of the U.S. to, in the aggregate, weigh less than to weigh more), then the fact that most of the people participating in the free market economy make purchasing decisions that result in the less desireable outcomes (namely, that the population is, in the aggregate, getting fatter, not thinner) can only be described as a failure of the free market.

Only a dogmatic adherent of the laissez faire religion could say otherwise with a straight face.

And of course, Krugman does note that a lot of the obesity problem has to do with the problem of irrational actors--particularly children and adolescents--in the market:
It is more important, however, to emphasize that there are situations in which "free to choose" is all wrong - and that this is one of them.

For one thing, the most rapid rise in obesity isn't taking place among adults, who, we hope, can understand the consequences of their decisions. It's taking place among children and adolescents.

And even if children weren't a big part of the problem, only a blind ideologue or an economist could argue with a straight face that Americans were rationally deciding to become obese. In fact, even many economists know better: the most widely cited recent economic analysis of obesity, a 2003 paper by David Cutler, Edward Glaeser and Jesse Shapiro of Harvard University, declares that "at least some food consumption is almost certainly not rational." It goes on to present evidence that even adults have clear problems with self-control.

Above all, we need to put aside our anti-government prejudices and realize that the history of government interventions on behalf of public health, from the construction of sewer systems to the campaign against smoking, is one of consistent, life-enhancing success. Obesity is America's fastest-growing health problem; let's do something about it.

Len on 07.08.05 @ 07:06 AM CST

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