Can Social Costs Justify Public Health Paternalism?

Abstract

Proponents of coercive public health interventions often justify seemingly paternalistic polices on the grounds that unhealthy citizens do not merely harm themselves with their unhealthy choices—they also harm their fellow citizens, who must then pay for medical services. For example, one justification for motorcycle helmet laws is that helmetless riders are more likely to be injured in ways that require expensive emergency services. Cigarette taxes are justified on the grounds that smokers will ultimately impose disproportionate burdens on the public health system relative to non-smokers, so smokers should bear some costs to offset those predictable burdens.