Originally Posted by thismama
And people pay for roads and education and health issues apparently caused by smoking, the supposed obesity epidemic etc etc on and on. Policing other people's bodies is a slippery slope.
Ok... lemme try to parse this out...
I assume roads and education were separate from smoking, right?
First of all, there ARE a lot of folks (in the field of Transportation Planning at least) who see the way our roads are funded as a MAJOR problem with our transportation system. In California, for example, only 70% of our expenditure on the road system is paid for by "user fees," which include gasoline taxes, vehicle registration, and truck licensing fees (among others). There's a push on the policy side to get that to 100%, because there's no reason why people who don't drive cars should subsidize those who do. (A similar issue comes up with zoning regulations that require businesses to provide parking... "The High Cost of Free Parking" is a fascinating book by Donald Shoup on that subject.)
With education, quite simply, the cost of NOT providing it is higher than the cost of providing it. The system evolved over time due to the needs of our society, and now that we're eroding it, we're seeing detrimental effects (poorly-prepared work force, juvenile crime, etc.) But then, we provide certain educational services, and if parents want something different than that, they pay for it themselves.... sort of like paying for certain health care services, and then if people want something different, they pay for it themselves.
A good deal of the (extremely high) taxes on cigarettes go to offset the health costs of smoking. Additionally, personal health insurance will charge you higher premiums if you smoke. There are some jobs you can't *get* if you smoke (firefighter, for example) and there are jobs where you can't smoke at all while you're there (teachers come to mind). There has been a push and shift over the years to put the financial burden of smoking squarely on those who smoke... and I entirely support that.
There's a HUGE difference between "command and control" solutions to societal decision-making issues (policing) and economic solutions. Most of the time, you get the result you're going for much more efficiently if you simply make the undesirable decision more expensive, and the desirable decision cheap or free. What result are we going for in this case? A lower c-section rate, that more accurately reflects the true medical indication for c-sections.
People inevitably turn this into a "rich vs. poor" thing, though, when you propose this issue. The problem with that is, as long as you have rich and poor, the rich *will* have choices that the poor don't. And, saying that this makes elective c-section a province of the rich exposes a huge fallacy: poor people can value things, too. And they can scrimp and save and bargain with their doctors and hospitals and GET the c-section that's so important to them if they need to... just as many moms who are struggling to make ends meet have done for homebirths that aren't covered. What's backwards about our current system is that the most EXPENSIVE options are covered, but the cheaper, safer ones are not necessarily. The notion that people have to carefully consider their decisions and make financial considerations a part of that is not, IMO, a problem... it's part of the solution.