Dear Public Health: the public despises you, so you are probably doing it wrong (part 1)
Back to the present, we have a compelling illustration of the descent of “public health” and its abandoning the pretense of caring about people in the John Ashton scandal. For those who do not know, he is the head of a British organization that fancies itself The Faculty of Public Health and claims to represent public health (so take that as your starting point, even though it is really more a political think-tank like any other). He recent went off like a drunken adolescent on Twitter, personally attacking people who questioned or expressed disagreement with his extremist anti-ecig positions. He then pushed a fabricated story into the press in which he claimed that he was merely retaliating for nasty things that were said about him, though it turns out those were all said after his tirade. His attacks were of a tone that might even cost an NFL player his job, let alone a professional who is supposedly working in the public interest. Surprisingly, the FPH suspended Ashton from his duties and claimed to be conducting an investigation. Not so surprisingly, a week later, they proudly announced he was returning to his duties. No one ever apologized.
(For more on the story in case you are not familiar, follow back the links from and , and see in particular who led the charge about it.)
…. Our observation was that in economics we often lean on the convenient myth that people’s goal is to maximize their lifecycle welfare, and that social policies should be based on that. It is easy to demonstrate that this is an oversimplification of behavior, and to argue from an ethical standpoint that there should be some departures from this in policy. But at least our simplified fiction is basically sound, both practically and ethically: Trying to maximize their welfare is roughly what people do, and there is an obviously defensible case to be made that trying to assist with such maximization is an important ethical goal — if not the ethical goal — of public policy.
We observed how sharply this contrasted with the implicit objective function in almost every public health policy discussion, which is basically “maximize longevity at any expense, and everything else be damned.” The economists who study medical care at least interject into this the caveat that some financial expenditures are too much to pay for the tiny bit of extra longevity they provide. But to the public health people, all other costs and benefits are trumped by the one objective.
See the rest of his post at the link above