The Economist, Dec 7, 2010, ran an editorial titled “not all tragedies are preventable‘ in which they provide a benefit analysis of the legislation to add rearvision camera to all new cars to prevent ‘back over’ injuries and deaths. They point to the potential for a greater benefit by shifting the cost of rear vision to other health areas. I agree in principle with their criticism that it is an expensive way to prevent these deaths and injuries. But would money be spent better elsewhere?
Regulation that enforces the installing of a direct benefit tool onto a ‘must buy’, at the manufacturing level provides a simple, straightforward, and readily regulated mechanism. What other health problems can attract that mechanism to its funding? Seatbelts and bike helmets work through a similar straightforward mechanism. But take the touted big health issue, nutrition for babies of poor families. The only direct funding mechanism even close is the taxation system. And does the media trot out nightly reports on the malnutrition of babies with a caveat that, ‘this could happen to anyone, so support legislation to increase your taxes?
The market mechanisms – media attention, editorial bias (who’s to blame) and a manufactured unit and price – doesn’t exist in the public health sphere. So it is not going to happen. Obesity, diabetes, renal disease, heart disease, lung disease, are all not going to change per force of any market mechanism because there is no prevention that everyone in the population can buy into to prevent THEMSELVES being at risk. Prevention is partly opting out, sacrificing a trivial lifestyle for a more meaningful lifestyle. And partly opting in like ‘buying specific units that give a benefit eg nutrition that indirectly prevents the problem.
Market place mechanisms cannot provide a funding process for the prevention of important health issues. Their mechanisms are tied up with inducing health problems because you can buy units that increase risk, but units that decrease risk do not actually reduce the risk while for people who simultaneously buy units that increase risk. It is not an account ledger eg 2 apples cancels out 2 cigarettes. There is no inverse economic law that can create an economic incentive flow the way of health benefits.