People who make bad health choices fuck everyone else. Regulate them like polluting factories. Serge Faguet Follow Mar 28 · 4 min read

Negative externalities are regulated

As a society we have long agreed that free markets tend to produce negative externalities and those should be regulated.

The most classic negative externality is that of a polluting factory. The factory makes money by producing something while polluting the environment. This privatizes profits while imposing costs on the rest of society which the profit-generating entity does not pay for.

Private choices can cause harm to the health of other people

The COVID-19 crisis demonstrably shows that a private individual can take actions which have negative consequences for other people in society. The simplest example is someone who knows they are sick with the virus and goes to hang out with old, vulnerable people. Most of us will agree that this kind of behavior should be regulated and punished.

The key point in this article is that when a private individual takes actions detrimental to their own health, they are also imposing significant costs on the rest of society.

Smokers fuck other people, and right now we are bailing them out

If I smoke my entire life (despite the abundance of data about harm smoking causes) then I am polluting the rest of society in two distinct ways connected with the COVID-19 crisis:

My weaker immune system is less capable of resisting the virus and thus I transmit the virus more readily to others. My propensity to require mechanical ventilation increases by ~3x, and thus I am overloading a limited medical care system and potentially killing other people.

Note that the above costs are not paid for by the individual who smokes. They are paid for by society at large. These people collect gains (such as presumed enjoyment from smoking), transfer costs and risk to society, and then in a crisis get bailed out at society’s expense.

Sleeping badly, eating badly, not exercising, drinking excessively fucks other people

This of course is not limited to smoking. It is also about eating badly, sleeping badly, not exercising, excessive alcohol consumption and other things which are traditionally considered to be just hurting the individual, but in fact hurt humanity as a collective organism.

The COVID-19 crisis demonstrates that we are not just a collection of individuals, we are also a collective organism. That collective organism is damaged when individuals damage themselves.

Again: I sleep badly = my immune system is weaker = I have a higher chance of infecting you and killing you.

Why the fuck should you be OK with this?

Don’t get distracted by metaphysical discussions of free will and whether people are responsible for their own decisions

There are lots of discussions about whether individuals are to blame for bad decisions or society is or companies are or advertising is or whatever.

Here’s an analogy: our body is a collection of individual cells which have some level of agency. Sometimes those cells act in ways that harm the body — e.g. become cancerous.

We can start discussing whether the cancerous cell itself is to blame, or the central nervous system which smokes is to blame, or the genes of the parents, or the Schrodinger wave equation.

It doesn’t matter. Blame is a stupid story our minds make up about causality which we do not actually know.

What matters is: there’s a component of the overall system which harms the overall system without factoring that in the component’s individual decisionmaking. The incentives of the component and the system have to be altered so that the overall system thrives.

Treat people who make bad health decisions the way we treat polluting factories

It is time to think of smokers or other people who hurt their own health analogously to polluting factories: as people who generate costs to everyone else that they do not pay the full price for. And regulate them as well as those who enable them.

This may take the form of investing in education and self-awareness programs for those people. Significantly increasing health insurance premiums for those who can’t demonstrate good health habits. Significantly increasing taxes on goods and behaviors which are damaging to individual (and thus collective) health.

I am sure others will come up with much better ideas than I will. My main goal is to point out a serious incentive misalignment in the system which is currently not being recognized or addressed strongly enough.

Ban cigarettes now

Start by banning cigarette smoking or taxing it so heavily that ~nobody can afford it. I don’t see why society should be exposed to additional health risks and pay additional taxes because some people are smoking those things.