Wednesday, 6 May 2009

Batty Boffin In Bacon Butty Bombshell!

Professor David Spiegelhalter, who holds the ominously-titled Chair of Risk Understanding at Cambridge University, gets a platform on the BBC news site today for this judicious counterblast against the pusillanimous spirit of the age. Read it and slather on the ketchup.

But how he got this published, I don’t know. Literally thousands, over the course of our lifetimes, will surely die as a direct result of this single article’s dangerous advice. It is all very well to prate of free speech, but surely even one death is too many? Would you die for the smidgen of entertainment or information you got from this three-minute bit of pop-science filler? What if that death struck somebody you knew - or those thousands were all the people you knew? I rather think that question answers itself, don’t you?

Flaming torches at the ready, people - this is WAR!

[Wipes dribble from chin]

Sorry about that, everybody. I seem to have been briefly channelling Anagrammatic Ares, the patron deity of War-Toss. Anyway...

I have one quarrel with this article. In the good Professor’s explanation of the Prevention Paradox, I found the following summary puzzling:

These issues [of trying to get people to change what they do] are tricky, and reflect a basic tension between individuals' and society's points of view.

If everyone improved their lifestyle just a bit, then the benefits to the overall health of the nation would be large but each individual would not notice the difference.

This is supposed to explain why it's rational for people as social agents to want everyone to improve their lifestyle, and yet rational for them to consider personally that the game is not worth the candle. Alas, it makes no sense.

People are individuals. If the benefits to 'society' are large in such a way as to bring no noticeable benefit to any of its component individuals, who exactly is supposed to care about this whopping largeness, and why? Pfft! I may as well claim that public health in India is far better than it is in Britain, since the population is twenty times as big, and the top five per cent alone can rival us in aggregate health, even before we get to adding the healths of the other billion folks on top!

This absurdity made me suspect that either the Prevention Paradox was being mis-stated, or else that I was completely misunderstanding it. I even went so far as to figure out a partial justification, supposing that benefit per individual rose with number of hygienic individuals. That’s plausible - after all, it’s usually better to be surrounded by healthy people, as well as to be healthy in oneself. Unfortunately, a bit of Googling suggests that the Prevention Paradox is in fact stated quite accurately in the given form.

The only sense my layman's brain can make of this is that the 'paradox' arises where much of the impact of medical risk falls upon people other than the risk-taker. But isn't that just the familiar concept of moral hazard, hiding behind a white coat?

Be this all as it may, I think Prof Spiegelhalter fails strangely to follow through on his best previous points, when he urges the tension between the 'social' and the individual interests in living healthy lifestyles. If society’s interest is really a separate thing, then he seems to be neglecting the jollier half of it.

Suppose we start at the other end of his main argument, warning that,

"If everyone constrained their lifestyle a little bit, the costs to the overall happiness of the nation would be grave, but each individual would not notice the difference."

My happiness paradox and his health paradox ought now to cancel out. Yet his version appears to be respectable and widely-credited, whereas mine... does not. Such lack of public balance can only yield miserably inefficient solutions. I’m afraid that my social duty is clear.

I will gorge down this bacon, guzzle these beers, and Dyson up this chocolate, reckless of the risks I'm running - not because the pleasure they grant is worth it in purely selfish terms, but as an earnest sacrifice towards the overall happiness of my nation.

No, really!

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