Back to obesity again by mattsteinglass
August 5, 2009, 8:54 am
Filed under: Conservatism, Health, Liberalism and the Left

Megan McArdle has written another post on obesity, responding among other things to some of the points raised by Ezra Klein and to those raised here. I’m going to just respond to her responses to the points I raised. To the question I asked earlier, “What exactly is the harm in trying to reduce obesity?”, Megan responds:

Of course, in their minds, none of this trying has costs, or at least, not any interesting ones.  I mean, sure, maybe it’s a huge infringement of property rights, but those are sucky and archaic anyway, and no one cares about them except right wing nut jobs who don’t deserve to have anything they want.  And okay, maybe people want to live in the suburbs despite ample warnings from the television that driving is making them fat, but they must not really understand this, and at any rate, once we’ve made them all skinny they’ll be so happy with their new flat-front capri pants that they won’t even notice they have a 45 minute train commute and have to go grocery shopping every day.

This is a big tangled ball of different threads, but I’ll try and untangle them. What is the “huge infringement of property rights” Megan refers to? Here are a few things I think of when I think about public policies in the “property” realm to create or encourage less obesogenic lifestyles: devoting more road space to more bike lanes and sidewalks, and less to cars. Changing zoning laws so that commercial businesses can be mixed in more easily with housing, thus allowing people in more neighborhoods to walk to the store. Spending more public money on rail and other public transit, and less on highways. Removing parking-space requirements for new housing. Building more and better parks and playgrounds. These are cases which involve property that is already public, or already existing government regulation of private property, or more government construction — which might involve higher taxes, and which conservatives might thus legitimately oppose, but that’s not the same as infringing on someone’s property rights. I cannot think of an obesity-reducing program that would involve a “huge infringement of property rights”.

What about the “people want to live in the suburbs” argument? Well, what about it? People have every right to live wherever they want, and no one is going to stop them. People also want to live in the city, and in walkable neighborhoods. That’s why housing in cities and walkable neighborhoods costs more than housing in non-walkable suburbs. But urban planners have to make urban plans. Since the 1940s, those planners have been zoning the US for a lot of non-walkable suburbs, in large measure because they were working under an obsolete and ideological utopian modernist paradigm of how people should live that never matched up to the way people actually do live, and that incidentally ignored the existence of traffic jams. Now, the new generation of urban planners has a different and much more complex and multifaceted paradigm that takes account of people’s preferences for walkability and of public health issues. The planners are making these plans, one way or another. The question is whether they should or should not take account of the issue of whether a given plan for a neighborhood is likely to make more of the people who live there fat.

On the “train commute” question, I do not understand where Megan derives the assumption that devoting more public money to rail transit leads to longer commutes. In every place I’ve ever lived, the availability of robust public transit alongside private cars reduces congestion and leads to shorter commutes than would otherwise exist. People who live in Alexandria, VA and Westchester, NY are free to drive to their jobs if they prefer; when they take commuter rail, it’s generally because that is quicker (and less expensive than parking). For international comparisons, it is much easier to get around in Paris or Hong Kong than in Jakarta or Lagos; it used to be hard to get around in Beijing, but then, well, they built a bunch of new subway lines, and now it’s a lot easier.

The more-frequent-shopping question may have a real issue buried back there somewhere. The argument is presumably that local food stores are uncompetitive on price with big-box supermarkets, so they tend to disappear, and the only way to maintain the option for people to walk to the store would be regulatory intervention against big-box supermarkets. But I think one can find a happy medium where planning does enough not to discriminate against local stores, by permitting density etc., without eliminating the big-boxes. We already have a lot of small food stores that survive even though they charge much higher prices than big-box supermarkets. We call them “convenience stores”, and they’re not exactly unheard of, even in suburbs.

Megan then responds, I think, to my point that while I agree with her that obese people are unlikely to lose much weight themselves, it would be good to engage in public-health initiatives to keep overweight people from becoming obese, and especially to keep kids from getting fat in the first place.

I know, I know . . . it’s for the children!  I am very fond of children.  But I do not actually think that they are some sort of master race in whose name anything at all can be justified.  And if I did, I’d be a lot more worried about, oh, abortion, than McDonalds ads.

I also do not think that children are a master race in whose name anything at all can be justified. The GM bailout, say, is hard to justify in the name of the children, per se. But preventing children from becoming obese is pretty easy to justify in the name of the children who are being prevented from becoming obese. Restoring PE in public schools is easy to justify in the name of the children in public schools. And so forth. More generally, anti-obesity interventions probably aren’t very effective for adults who are obese, but may be quite effective for children who aren’t obese yet. Eating and exercise are habits, and habits are formed more easily in childhood.

I don’t understand what this has to do with abortion.

The deeper point is that Megan’s argument is broadly that obesity is one’s own personal business and no one else has any business interfering in it. There is, however, a class of relationships in which everyone, even libertarians, understands that “it’s none of your business” does not apply, and that is the relationship of a society towards its children. This is true at the personal level — it is my business if the rest of society is doing things that will tend to make my children fat — and at the collective level — it is all of our business if we are doing things that make our children fat, because we are responsible for them.

On the kid issue, Megan then argues:

Kids exercise less not because crime is higher, or even because we’ve become more suburban, but because they’re no longer allowed to operate unsupervised until they’re quite old, and Mom and Dad both work.  Schools don’t have P/E because they’re using the time to teach kids to read.  Maybe those were bad tradeoffs.  But they’re not irrational tradeoffs, and switching them back is not costless.  

I think the fact that kids are not allowed to walk to school is a real example of counterproductive hysteria, and I oppose it. I’m sure such irrational fear of public spaces has indeed contributed a lot to rising obesity. There’s a bit of a shift in the opposite direction now, which is a hopeful sign.

Schools don’t have PE not because they’re teaching kids to read, but because they’re teaching kids to pass standardized tests. How to assess educational quality without driving schools to implement counterproductive changes like canceling PE for test prep is a real problem. But one thing this makes clear is that educational assessment reforms have to establish rules about what things schools are not allowed to do to improve their test scores, and eliminating PE is one of those things. Before the No Child Left Behind bill was implemented, if you had asked voters or even the bill’s authors “should we eliminate PE to raise reading test scores?”, I’m confident the answer would have been no, that’s a bad tradeoff.

Finally, Megan argues that we should care about the “costs” of trying to reduce obesity

because not least among those costs is the simple fact that the government cannot do everything well.  Making all sorts of changes in the name of obesity means not making others that might be more important, because we have limited political and bureaucratic bandwith.  Do you want obesity intervention, cap and trade, or health care reform?  You may not be able to have any of them.  But you probably can’t have all three.  And if you did, you’d make it more likely that the government would screw all of them up.

Megan is mixing up two things here. The first is the question of what government can do. The second is the question of how easy it is to pass legislation. Government can, in fact, do an unbelievable number of things reasonably well all at once. The US government defends the country against foreign invasion, checks everyone’s automobile for harmful emissions, teaches millions of kids trigonometry, builds highways and water hookups to new suburbs, reviews grant applications for research on molecules that might treat rare cancers, and so on through a million iterations. Everyone would be worse off if the US government didn’t do these things, and you can’t realistically have a government in a modern developed country that doesn’t. But the US Congress has an increasingly hard time passing legislation on a lot of different things all at once. The question of whether a government can do effective obesity intervention, cap and trade, and universal health insurance coverage all at once can be answered in one word: France. Even the question of whether we can get bills on all these things passed is a bit of a red herring — Megan raised the whole obesity issue because she believes it is inevitably folded into universal health insurance legislation, so we’re really only talking about two issues, health care and climate change. Admittedly, it is looking pretty hard to get legislation passed on those two issues. But that is an argument about what strategy liberals ought to be adopting to get their most important goals accomplished, given the dysfunctionality of Congress. It’s not a rights-based argument about whether or not government should try to help people avoid obesity.


The education of Ezra Klein by mattsteinglass
July 29, 2009, 8:49 pm
Filed under: Health, Liberalism and the Left

Here’s my post for DiA on the possible radicalization of the new generation of moderate liberals of the Ezra Klein style:

THERE was a pretty illuminating exchange yesterday between Matt Taibbi and Ezra Klein, two pithy guys whose hair is currently on fire. Mr Taibbi was born with his hair that way; Mr Klein’s hair is usually neatly combed, but has finally ignited in despair at the spectacle of inadequate health-care legislation emerging, or not, from the 111th Congress. “This whole business, it was a litmus test for whether or not we even have a functioning government,” Mr Taibbi wrote…

Read the whole thing!