For the past few years, I have been researching paternalistic ‘public health’ pressure groups. This has mostly involved reading the public choice (economics) literature on interest groups and the public health literature on policy-making, and applying it to case studies from the last two decades. There will be a book at some point in the next year focusing on the use of evidence and activism in public health policy-making. In the meantime, I have published a number of papers this year looking at other aspects. This post is to talk you through them so you can see what Frank Zappa used to call the conceptual continuity.
One of the the big questions - one that I have been fascinated by ever since I started the research for my book Velvet Glove, Iron Fist twenty years ago - is why do paternalistic pressure groups exist at all. As I say in Bootlegging Baptists: The Logic of Paternalistic Collective Action:
The very existence of single-issue pressure groups dedicated to wholly paternalistic action to stop other people consuming tobacco, vapes, alcohol, sugary drinks and certain foods should pose a challenge to public choice economists since paternalism is, by definition, not self-interested. Not only have these groups apparently overcome the free rider problem but they appear to have done so without offering any collective or selective benefits to their supporters.
That article is out from behind the paywall until January and is the best place to start if you’re interested in this stuff.
What do these people believe? The ‘public health’ lobby has its own view of how policy-making works which, like the public choice account, focuses on self-interest, but it is simplistic to the point of banality and only looks at the self-interest of their opponents. I’m not even sure that they believe all that stuff about the ‘tobacco playbook’. It seems more of an attempt to stigmatise their opponents and grease the slippery slope, as I argue in The Corporate Playbook.
The public health literature on corporate political activity makes no meaningful contribution to political science because it identifies very few, if any, tactics that are distinct to ‘unhealthy commodity industries’. Any organised interest group would respond in the same way if put under similar pressure. Civil society campaigners – including public health activists – use most if not all of the same strategies. The literature on ‘unhealthy commodity industry’ tactics is better understood as part of a political strategy by public health actors to undermine the opposition than as a serious attempt to advance our understanding of the policy-making process.
Anti-industry rhetoric has degenerated into outright anti-capitalism among many ‘public health’ academics. I provide many examples in the latest paper in this series, Anti-Capitalism and Public Health.
Maybe it’s not really about health and is more about things like overthrowing ‘neoliberalism’? If so, it would explain why self-proclaimed ‘public health’ experts are so dismissive of practical solutions to the problems they purport to be concerned about. In Not Invented Here, I give three examples: e-cigarettes, weight loss jabs and alcohol-free drinks. Zion Lights and Kristian Niemietz give some more.
The conclusion of Bootlegging Baptists is fairly gloomy if you are of a liberal disposition. It suggests that there will be an endless erosion of personal freedom:
If the arguments laid out in this paper are correct, there will be a tendency towards ever-greater regulation of risky but pleasurable activities so long as pressure groups aimed at suppressing such activities for paternalistic reasons are able to secure funding from elite sources. The paradox of participation will ensure that organised grassroots opposition remains negligible, unless the opposition also secures funding from external (non-industry) benefactors or is able to mobilise consumers by offering selective incentives.
Note the glimmer of hope in that last line. So how might a consumers’ rights group offer members selective incentives? That is the question I try to answer in The People versus Paternalism.
A more fruitful approach would be to emulate CAMRA, the BASC and many other organisations by offering financial incentives in addition to exclusive social gatherings. Take vaping, for instance. If a politically engaged individual chose to form The Vapers’ Association, they could contact e-cigarette manufacturers and retailers, requesting that they give their members a discount of 10% or 20 % off their stock (or off selected items from their range). The annual savings to an individual who takes full advantage of this deal would exceed the annual membership fee of, say, £50 . The companies would benefit from the deal since it would encourage loyalty to their brand, encourage consumers to switch from other brands and help them promote certain products. Businesses offer targeted discounts all the time for these reasons. Looking at my mobile banking app, I see that I can currently take advantage of cashback offers for everything from rental cars to theme parks. In principle, there is no reason why the hypothetical Vapers’ Association should limit itself to offering deals only on vaping products, but they are the obvious place to start.
So there you have it. Problem identified and solution offered. As I say, there will be more to come, but that’s enough for now.
"The literature on ‘unhealthy commodity industry’ tactics is better understood as part of a political strategy by public health actors to undermine the opposition than as a serious attempt to advance our understanding of the policy-making process."
This is true. But I would also argue that its effect is to simultaneously blind themselves to their own self interests. Self deception is a persuasive feature of all humans. The continual pointing to the nefarious intentions of Big Tobacco conceals their own motivations primarily from themselves. I suspect this is largely involuntary and unconscious.
The self interests of those in TC require problems to remain relevant, hence funded and in jobs, careers, etc. That they are obviously pursuing their own self interests explains their continued, instinctive, use of Big T in order to redirect their own gaze away from themselves and their own self interests. As I said, I think this is largely the unconscious mind protecting itself.
Have the "every accusation is a confession" concept crossed the pond? It is overwhelming in American national politics right now, for an obvious reason (and in my personal life, but that is a story for the next beer we might somehow someday have together).
It seems like a powerful observation for several of the points you are summarizing here. It seems like it might have some persuasive power beyond the preaching to the converted that we all specialize in.