What often strikes me in these pictures – trade unions protesting this or that – is how well fed they all are. Majority are overweight, some are obese.
Which brings me to this: total public health spending is a material fraction of GDP in many developed countries. It is a major, if not the largest, item in total public spending. This makes public health – the health of the public – a commons, doesn’t it?
If it does, then does the concept of the tragedy of the commons apply to public health? Aren’t some people overpollute their bodies? Can we think of smoking and excessive drinking and overeating and drug use and general neglect and disrepair of one’s own body and mind – as littering and vandalism and destruction of a public resource?
If we believe in the benefits of public health spending, shouldn’t we then start regulating the use of the commons?
Shouldn’t we, following Elinor Ostrom, “develop a system, carried out by community members, for monitoring members’ behavior”? “Use graduated sanctions for rule violators”? “Build responsibility for governing the common resource in nested tiers from the lowest level up to the entire interconnected system”? Etc, etc, etc.
Should we then deny a chocolate cake to an overweight person just like a sensible bartender denies a drink to a person who is already drunk?
Just a thought.