Free Markets, Free People

When Nanny becomes Bully

We’ve talked at length here at QandO about the dangers of the Nanny State to individual autonomy – liberty/freedom.  If there is a zero sum game out there, it is the trade off between the power of the Nanny state and the degree of individual autonomy you are able to exercise.

I think why this health care bill bothers, no, outright scares libertarians is the degree of encroachment it represents in terms of individual autonomy.  The premise I’m talking about is well stated here:

[I]individual autonomy is the core value of a democratic society; there is an inherent trade-off between individual autonomy and public health under health paternalism; and the abandonment of individual autonomy in health policy poses a threat to our other freedoms.

I’d change one word – individual autonomy is the core value of a free society. I’m not sure how it can be considered any other way. There is a trade-off between the state assumption of responsibilities and the amount of individual autonomy you retain. Call it a liberty index if you wish, but every time the state takes over more responsibility for the lives of the citizens, by whatever means, the liberty and freedom of that citizenry is commensurately reduced.

And, as the state takes more responsibility and attempts to enforce it, there is a less than subtle transition from a Nanny state to a Bully state.

The Institute for Public Affairs lays out that case quite well and uses health care to do it. the IPA focuses on a shift in thinking among our ruling elite who support the welfare state that is driving this transition from Nanny to Bully. The transition is based on the failure of their first assumptions. Their assumption was that if the state (Nanny) provided relevant and important health information to the public, the public would heed it and change its behavior to take advantage of that information to live healthier lives.

The provision of that information hasn’t yielded those results. Instead, people still smoke, drink and are fat. Obviously, at least in the opinion of some, that model isn’t working and something better is necessary – for their own good, of course. Nanny can’t get the results she wants simply by providing the information she thinks should motivate others into living the lifestyle she finds most healthy, so she must look elsewhere and at different methods.

To get the results desired, given the “failure” of the previous assumptions, different assumptions are necessary. See if you recognize any of these or can see them coming:

Most of the health care burden is driven by disease that results from lifestyle decisions.

Most of the health care burden is therefore, in theory, preventable.

The cost of most lifestyle-related disease is not recovered from the individuals with such diseases or from the industries whose products contribute to these diseases.

Individual autonomy cannot be the paramount value in health care.

Individual choice as a basis for health is ‘too simplistic’.

Individual freedoms may have to give way to the coercive power of the State.

Interventions, including coercive actions, to change behaviour may proceed in the absence of evidence of their effectiveness.

Individuals have a clear responsibility to refrain from lifestyle decisions that lead to disease and, consequently, treatment can be denied to those who refuse to change their behaviour.

For those of you who can manage to look at the health care bill objectively and have listened to descriptions of what it requires should have absolutely no problem understanding that the list of new assumptions are clearly evident in that bill. One only has to think “individual mandate” to know that the assumption “individual autonomy cannot be the paramount value in health care” is being acted upon. The hiring of 16,000 new IRS agents to enforce that mandate speaks to the assumption “individual freedoms may have to give way to the coercive power of the State”.

So it certainly isn’t at all a leap to also understand that at some point, to keep this from being another in a long line of centrally planned failures, the attempt to intervene and change behavior and to coercively enforce the “responsibility” to refrain from lifestyle decision which lead to disease and the consequent health care costs, will be acted upon. The Nanny state becomes the Bully state.

And for those of you who would wave this away with a “this can’t happen here”, I’ll simply remind you of what was signed into law yesterday and the fact that some of the assumptioins listed above, as I’ve pointed out, have already been acted upon.



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21 Responses to When Nanny becomes Bully

  • And for those of you who would wave this away with a “this can’t happen here”, I’ll simply remind you of what was signed into law yesterday and the fact that some of the assumptioins listed above, as I’ve pointed out, have already been acted upon.

    As Congressman John Dingell (D-Mi) said yesterday on WJR’s Paul W. Smith show:
    “The harsh fact of the matter is when you’re going to pass legislation that will cover 300 million American people in different ways it takes a long time to do the necessary administrative steps that have to be taken to put the legislation together to control the people.”

    You don’t have to go any further than that to find the real agenda for this Congress and Adminitration.

  • I think the Tanning bed tax is a perfect example of this encroachment, and it was passed along with the bill no less. I think this tax should be something everyone points to as what we should expect in the coming years if this stuff stands as is.

  • The compulsion to use mass compulsion, and then the blase cheerleading of it by human blanks, are elements of earlier forms of society where individual freedom hadn’t yet unfolded and developed. What we had here in America was indeed something unusual and exceptional. It has been fading slowly. Now it’s rushing out of existence. But it wasn’t like a lot of us didn’t see it coming. This health care thing was never about health care. It has always been about herd management.

    Are you going to trust a medical system brimming over with government employees and/or public employee union members? The built-in negligence alone of such an arrangement should give you pause. We already have 100,000 deaths a year in the U.S. from hospital borne infections.

    The herd is already being culled.

  • Hey!  wanna have fun with numbers!!!!!   As a public service to you!
    You have a CHRONIC health condition according to the health care bill if your BMI is over 25….(Page 534) (SEC 1045. State Option to Provide Coordinated Care Through a Health Home for Individuals with Chronic Conditions)
    ‘‘(2) CHRONIC CONDITION.—The term ‘chronic condition’ has the meaning given that term by the
    Secretary and shall include, but is not limited to, the following:
    ‘‘(A) A mental health condition.
    ‘(B) Substance use disorder.
    ‘‘(C) Asthma.
    ‘‘(D) Diabetes.
    ‘‘(E) Heart disease.
    ‘‘(F) Being overweight, as evidenced byhaving a Body Mass Index (BMI) over 25.
    So, as entertainment I’ve provided the link for calculating your BMI – find out if YOU TOO qualify as being a CHRONIC problem by the government –
    I’m 5’10” and I weigh 183 lbs – and ….ding! (26.3) yes, I’m CHRONICALLY OVERWEIGHT according to our new law.
    And NOW, unlike Sunday Morning when I woke up, the GOVERNMENT CARES, and it’s become their business.
    I love our Brave New World.

  • Whenever you try to make Government into your mommy and daddy, it becomes Big Brother.

  • Oh, and another Government program that obviously is working well!
    Saturday mail delivery by the US Postal Service?  Bu-Bye!
    Nanny will be too busy building up those arms of hers to deliver your mail on Saturday kids….

  • Oh By the way, the entire argument that your individual health decisions are a burden on society is a bogus one entirely.
    Even if you have full blown socialized health care it is NOT TRUE that unhealthy persons cost more in the aggregate than healthy persons.
    Follow me on this.  Everyone will eventually die and become some sort of burden on the system. But if man A drops dead at 65 and man B lives to be 95, then you tell me, which one is likely to be a burden on the system?
    As you get older you will use more health services, that is just a statistical fact.  Furthermore, a person who dies at 65 will use up zero pension benefits.  So in reality society is better off cost wise if we smoke and eat our way into an early grave.
    So the entire reasoning is bullcrap.

    • Thats where the one little CHRONIC condition missing from lookers list, but implicit in the system:

      (G) Geriatricism

      “Individuals have a clear responsibility to refrain from lifestyle decisions that lead to disease and, consequently, treatment can be denied to those who refuse to change their behaviour.”

      Allowing costs to be saved from the inefficient treatment of old people and be directed to the young is of  benefit to society.

    • So, you’re saying we may have to smoke some old folks – I’m under 65 still, so I guess I’m safe for now.

    • Kyle id like to see some numbers on that.

  • It’s bad on two levels, it seems to be no more than an immediate tax on employers and this will inevitably be passed onto employees so reducing their purchasing power, hardly clever when you want to spend your way out of recession, and they seem to have abandoned the constitution to get it passed at all. The US is only united because all the states agreed to the constituition. Now it’s been abandoned, I expect the secession movement to grow exponentially. It’s the end of the USA show!


  • Get ready to “Enter the Carousel.”  Now don’t balk it is for the good of everyone.
    For those to young to remember the attribution, it is from Logan’s Run

    (1) IN GENERAL.—There shall be in the Service a commissioned Regular Corps and a Ready Reserve Corps for service in time of national emergency.
    (2) REQUIREMENT.—All commissioned officers shall be citizens of the United States and shall be appointed without regard to the civil-service laws and compensated without regard to the Classification Act of 1923, as amended.

    Does this make it possible for a “national emergency” to turned into a “crony jobs” program with uncontrolled wages ?