A wicked problem

According to the authors, the most promising solution to avert the public- health-nanny state's rush to dish out remedies is to hive off some existing health tax resources into portable Healthy Living Vouchers and let the invisible hand of the consumer do the rest. Vouchers grew out of economist Milton Freedman's idea to provide par- ents with education purchasing vouchers which are tied to educational taxes. The increased consumer sovereignty would allow families to select the best schools for their children, not only the local pub- lic school. The idea is simple and com- pelling: empowering the citizen as con- sumer and he or she will choose wisely and buy lifestyle, diet and exercise expe- riences tailored to his or her needs to lose weight. [Neil Seeman] and [Luciani] describe an interesting number of voucher-like experiments which are underway in sev- eral parts of the world. Education vouch- ers in the United States, appear to benefit the most socioeconomically disadvan- taged populations in the US: poor black Americans. It is also worth noting that few public policy ideas are more contro- versial because of the ideological right- left divides which attend the idea, whether in the US or in Sweden or else- where where vouchers have had experi- mentation. The idea veers eerily close to Medical Savings Accounts, which may be nice as a private insurance benefit, but hold little value as a fair or viable public policy option in this country.2