Recently, I became aware that a friend of mine (and occasional collaborator in various projects relating to mental health) was working on research to discuss the public health approach to dealing with depression. As there is some anecdotal evidence that the symtomology of depression can be lessened by the physical cleansing from the body of various foul-smelling proteins (which are quite possibly related to the tau proteins related to brain changes in PTSD and CTE among war veterans, survivors of various personal horrors like rape and child abuse, and football players), my friend makes the sensible argument that a public health approach to depression makes sense, and that encouraging a low-cost treatment of depression that encourages the body’s ability to heal itself through internal cleansing could decrease the high costs of depression to societies such as that of the United States and Canada where up to a third of the population may be diagnosed with forms of depression over the course of their lives.
In the present day and age, it is common to see arguments being made for and against various policy decisions by government for public health reasons. For example, the landmark legal cases against tobacco companies proceeded because governments had the standing to sue companies for products which led to increased government expenditure since so many smokers were dependent on various government-provided health care. Likewise, there is a great deal of official hostility on the state level towards those parents who refuse to immunize their children on various grounds–and there are various acceptable grounds for it–on the argument that the efficacy of vaccines depends on their near universality, which is said to be a public health concern. In one recent conversation I had with some parents who were less than enthusiastic about vaccines, there was concern about a new law being argued in the Oregon legislature (by no means a beacon of good sense) that would create an infrastructure for roving health checks by people who would visit parents and administer unpopular vaccines themselves.
Nor are these the only cases where public health concerns have serious implications. It is not hard to think that the current rush to legalize marijuana will have public health consequences, especially when one considers that driving while under the influence of weed is at the same level of severity as driving under the influence of alcohol, and we have already seen that regulation of firms dealing with alcohol can be quite dramatic. In the state of Oregon (again, it is easy to pick on the place where I live), for example, self-contained bars are forced to place a sign that forbids the entry of those who are under 21, which means that no one under 21 can be trained as a bartender legally, that no children are allowed to even walk through the bar on their way to other parts of a restaurant and that no one can order children’s menu items in the bar, because all of that would signal that something illegal was going on. One can expect that if the use of marijuana becomes increased due to its increasing legality in many areas, that there will be similar efforts to regulate marijuana for the interests of the state in terms of convenience as has already been done with alcohol.
It is considered axiomatic that government has a right to intervene in a matter where taxpayers are expected to foot the bill in some fashion. If a company pays its employees low enough wages that they are able to qualify for various kinds of entitlements like food stamps and subsidized health insurance, this is considered a matter of seriousness since those companies are externalizing important costs (like the feeding and health care of employees) on the larger public as a whole. And even those of us who have considerable ambivalence (not to say hostility) to the tendency of government to insert itself into all kinds of areas where its presence is neither helpful nor particularly desired by one or more parties must admit that there are cases where government is within its bounds to intervene on behalf of ordinary people in the face of immoral behavior by businesses, even if governments do not intervene in ways that are usually ultimately beneficial even to those whose interests they claim to represent. Colson’s law applies here. We who would wish to be free of government interference need to have a conscience, because when it comes to the preservation of virtue or at least the control of vice it is necessary to be governed either by conscience or cops, and if we do not have cops we must therefore have a conscience. A corollary of Colson’s law is that there can be no freedom without morality, since the absence of moral self-control will invite, and even demand, the increase of burdensome bureaucratic controls to counteract the lack of private virtue among a body politic.
Yet there are second-order considerations that must be taken into account as well. While it is considered obvious that government has an interest in affairs that affect the budget, the complications of this are not always recognized. To what extent are governments bound to pay for the results of their own behavior. Since a great deal of mental health problems in terms of PTSD and depression and substance abuse (itself usually a second-order problem, being used to self-medicate first order mental health struggles) results from the behavior of governments, namely in involving itself in foreign wars, it might be argued that government is itself a root cause of a great deal of mental health problems. This is especially true when there are numerous layers of problems, such as the situation when traumatized veterans of foreign wars come home and engage in behaviors that lead to the victimization of their spouses and children. Likewise, the ways that many large cities subsidize sports through taxpayer-funded stadiums can be said to be a contributing factor in the mental health problems that result from sports like football. Likewise, state universities have found themselves to be occasionally responsible for providing a safe place to sexual predators, as at Penn State, for example. Not only can governments on a federal, state, and local level be contributors to mental health crises through their actions against public health or their inaction with regards to those who harm others, but seldom does the public health argument that leads to government intervention taken to the next level. If the expenditure of taxpayer dollars allows government the right to intervene in the affairs of others, does the payment of taxes not provide the ordinary person with a right to know and to judge on how their money is being spent? It is not hard to see how public health arguments themselves are far more complex than often meets the eye.