My Health, My Decision

I have a layover in Minneapolis, Minnesota for the next hour, and that gives The SuperSpade a chance to see and discuss issues occurring wherever we are.

Minnesota Governor Tim Pawlenty has proposed what he calls a “Health Impact Fee” as part of his upcoming budget proposal. The Minneapolis Star Tribune refers this as effectively a “Cigarette Tax.” These sorts of issues raise interesting questions about the rights and roles of government in health-related personal decision making.Even people who smoke acknowledge that there are negative health risks associated with that. Most people who engage in “high health impact” activities will quickly admit this as well. In neither case, however, do the risks outweigh the benefits to these individuals.

The Libertarian in me says that we should let these people live their lives and “penalize” them through things such as a “High Impact” fee. It says you [should] have the right to do what you wish, no matter what it is or who disagrees with it or who is uncomfortable with it. However, this breaks down for me in the case of smoking, which also adversely effects the environment and the health of those in close proximity.

The Uber-Liberal in me says that we should insure and provide a safety net for all, including the Risk-Lovers. It says that we will take care of you no matter what; Universal Health Care covers the crazy and the sane. The case where this breaks down is something like abortion. I am adamantly Pro-Choice, but I do not think the government should pay for the procedure.

The Fiscal Conservative in me says that the “Health Impact Fee” is right on. If I don’t smoke, why should I pay for someone that does? Efficient economics tells us that the market should price things at what they are worth to the consumer (e.g. Northwest Airlines charging everyone [including people like me who actually NEED the leg room] $15 for Exit Row seats. That almost went horribly wrong when we switched planes!!). This approach says that the blanket approaches of Garlin the Libertarian and Garlin the Liberal are so fair that they are unfair. This falls short in the case where I [willingly or unwillingly] engage in “High Health Impact” behavior(s) and cannot afford coverage.

I’m not crazy or the victim of a split-personality disorder. I am, in a word conflicted. I would like your thoughts on the role of government in personal health decisions. Should it enable everything? Should it do nothing? Somewhere in between? Your comments are appreciated.


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About Garlin Gilchrist II

I am the City of Detroit's first ever Deputy Technology Director for Civic Community Engagement. My job is to open up the city's public data and information for the consumption and benefit of all Detroiters. I currently live in Detroit, my hometown, with my beautiful wife Ellen and our twins Garlin III and Emily Grace. I'm from Detroit. I created Detroit Diaspora, and was formerly the National Campaign Director at I also co-hosted The #WinReport on "The Good Fight," a an award winning, nationally syndicated radio show that was one of Apple's Best of 2013. After graduating with degrees in Computer Engineering and Computer Science from the University of Michigan, I became a Software Engineer at Microsoft. By day, I helped build SharePoint into the fastest growth product in the company's history. On my personal time, I sought out opportunities to connect my technical skills with community building efforts across the country. This led to my co-founding The SuperSpade: Black Thought at the Highest Level, a leading Black political blog. I served as Social Media Manager for the 2008 Obama campaign in Washington, and then became Director of New Media at the Center for Community Change. I spent two years creating and implementing a strategy for the Center to take it's 40 years of community organizing experience into the digital age. I speak before diverse audiences on effective & responsive government, empowerment in revolutionary new organizing spaces, increasing civic engagement & participation through emerging technologies and protecting civil rights in the age of the Internet. Full bio here.

3 responses to “My Health, My Decision”

  1. Free says :

    I get overwhelmed whenever I hear of “risk taxes.” Where does it start & end? Risky: smoking, being obese, being promiscuous, skydiving, talking trash in the wrong venue…

    I always wanted a national health care progam – until I lived in England. It wasn’t bad, but it still so favored the wealthy. On the other hand, some care is better than none.

    See? Overwhelmed! 🙂

  2. Anonymous says :

    First, the best way to write a convincing argument is to address both sides of the issue. This doesn’t mean you have to agree with both sides but you must address them. (right on brotha)
    Second, Are we going to tax people with high blood pressure or poor eating habits that are obese? People who drink obsessively?
    If they are trying to discourage this risky behavior then start taxing away but you have be an equal opportunity taxer.

    What sense does it make that the rich get more tax benefits. I make just above the proverty level working at my nonprofit job (doing service all year long) I don’t get any major tax benefits. There are other ways to tax and increase profit to benefit society. They can discourage risky behavior by addressing the root of the problem. Everytime they raise the price of smokes people still buy them.
    My Point: the tax is to make money not discourage the behavior that causes it in the first which would be a better solution and there are tons of other ways to make money to improve society hint: lessing the tax benefits of the wealthy.

    Personal interest: My dad has throat cancer from smoking but he started smoking way before they started talking about the long term effects. (I hate smoking with a passion but he is blue-collar workers who deserves quality health insurance who support a family of five) Tax Cheney, an old white man with a rifle is by far a bigger danger to society

  3. Tone says :

    Personally, I think that society has the right to encourage or discourage certain behaviors that significantly affect or take place in the public domain. It boils down to a balance between personal freedom and affect on public good.

    For behaviors that are patently bad for society, (i.e. the costs drastically outweigh the benefits) society explicity illegalizes. Those are things like stealing, killing, dealing drugs, that kind of thing.

    For less drastic behaviors that aren’t explicity illegal, I think society is justified in discouraging them with dis-incentives like taxes. For example, while smoking in public places is becoming explicitly illegal in many locales, smoking in general (non-public places) is not considered as detrimental to public good and therefore isn’t explicitly illegal. So, society impedes it by taxing cigarettes.

    Similarly, I think society would be justified in taxing fast food at a higher rate to enourage healthier eating habits.

    On the flip side to dis-incentives, society does offer incentives to enourage behaviors. For example, society has deemed marriage to be a benefit for public good. As such, there are tax benefits to being married as opposed to being single.

    In regards to universal health care, I think it should be available for children up to a certain age: like 16 or so.

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