Can Social Costs Justify Public Health Paternalism?

Harm and Helmets: How Harmful Social Costs Fail to Justify Paternalistic Health and Safety Regulations

“…Despite its popularity, not all political theorists have reacted warmly to the social costs argument from harm. Jessica Flanigan (2015) forcefully argues that social cost justifications for health regulation cannot appeal to financial burdens faced by state insurance programs caused by unhealthy individual behavior. If the state is obligated to provide healthcare for its citizens, then it must do so without punishing citizens in the form of benefits exclusion or penal taxes, regardless of how expensive healthcare is to provide (240).…”

“…However, political theorists are numbered among those who tend to accept that the social costs argument from harm resolves the moral controversy surrounding many safety regulations (Anomaly 2009; Feinberg 1987; Goodin 1989; Huster 2015), and the argument from harm has managed to escape serious moral investigation. Some humanists and social scientists have expressed concerns that third-party harms may not be able to carry a political justification of state intervention because the burden of proof is too high (Kniess 2015), the moral reasons are too weak (De Marneffe 2006), the costliness of risky behavior is morally irrelevant (Flanigan 2015), the concept of “harm” is too vacuous (Smith 2004), or the third-party costs are simply too low (Wikler 1983). However, despite these concerns, no significant theoretical assessment of the claims, requirements, and moral consequences of appealing to social costs as justificatory grounds for state intervention has been attempted.…”