I recently canvassed several interns who are working on preventative health measures in D.C. and asked if there was any new ideas being tossed about. They said “No”. This got me thinking – with all the talk about preventing future illness, why are so few ideas tossed about in public? In order to get this ball rolling, I have two such ideas.
1) Free Sunblock at public beaches, pools, etc. If sunblock is indeed effective at blocking cancer, offering sunblock free might be a good idea. It would displace a large amount of private purchase, but it might also encourage people who forget or are otherwise uninterested to put some on. It could be held in despensers by snack stands where people could not freely refill there bottle, but could freely put it on. If the quantity of money saved from prevented cancer is in the ballpark of the cost of the program (minus the cost savings of people who would otherwise use sunblock), it would be a success.
2) Free earplugs at concerts, clubs, etc. Many studies demonstrate that young adults today have worse hearing than an average fifty year old had only a few decades ago. The accepted reason for this is excessively loud music. In particular, concerts and clubs are both very loud, and very practical venues for free earplug distribution. The idea is that bad hearing can be costly for a number of reasons – increased accidents (not hearing a car coming, etc), hearing aids later in life, etc. While earplugs are currently ‘uncool’ to wear to most outings, providing them free would increase the quantity of people wearing them, which would decrease their ‘uncoolness’. Consequently, a large number of people might protect their hearing, and the message of auditory protection would be heard. Most importantly, earplugs are very cheap to make and could be distributed at a low cost – making this idea much more viable than free sunblock.
I hope to start a dialog about potential preventative health measures. Surely a detailed cost benefit study of these ideeas is needed, but having ideas to study is an important step.
N.B. I am not suggesting an all encompassing nanny state, but rather that when the public bears the costs but not the benefits of an individuals risky behavior (failing to apply suntan lotion and subsequently contract cancer), there should be room for policy improvement.
The Bush administration stresses the importance of abstinence only education. Ignoring religious issues with premarital sex, does this policy have a chance of preventing the spread of sexually transmitted diseases? Any economist would say – NO!
Consider you have a child who wants to ride a bike. You can tell him he should not ride a bike because it is dangerous, or you can warn him to wear a helmet in the hope that this will one day save his life. Well, unless you are a parent who can physically stop him from riding a bike, and you can only do this for so long, your best bet is to suggest the helmet. Why? Because deciding whether or not to ride a bike is a fairly large decision. An economist might coin the word dutility (Decision Utility – Pronounced like Utility but with a D), and say that deciding whether or not to go for a ride takes about 20 of these ‘dutils’ (Like the economic construct utility). The idea is that larger decisions require more dutils making them less responsive to any particular source of input *. As much as you lecture about the dangers of bike riding, it would probably be fairly difficult to overcome this 20 dutil decision with a simple diatribe. Deciding whether or not to wear a helmet is a much less costly. It’s not time-consuming to don one, it’s not particularly annoying to wear one, and most importantly, it does not interfere with the larger decision of whether or not to go for a ride. Let’s guess this takes about half a dutil. For such a low cost, the added safety seems pretty worthwhile. Much like a stream, it is easier to gently alter its course than cause it to run uphill.
Now let’s consider sex. Deciding whether or not to have sex for the first time is a much larger decision than whether or not to ride a bike. Let’s say that for the average American this decision is worth 500 dutils. Perhaps this number is much higher. Whether or not a person decides to have sex before marriage requires consideration of many factors, including sex drive, love, lust, peer pressure, potentially sexually transmitted diseases, religion, etc. So many factors are in play that any one of them is unlikely to have a significant impact. Thus sex education, while perhaps having a 5 dutil influence, is unlikely to change the behavior of a person. On the other hand, deciding whether or not to use protection is a much smaller decision- akin to wearing a bike helmet. Asking someone to use protection is not asking them to do a u-turn, just to bear a very so slight right. Maybe this happens to be a 3 dutil decision for the average person. Whatever the unquantifiable dutility, evidence shows that sex education is far more effective than abstinence only education.
* This need not be true. A person who is on edge about a decision can be easily swayed. We can start to think about marginal dutility as being more important that total dutility.
