Nanny Nudger Strikes Again!

Just a couple months after banishing 32-ounce sodas from select establishments in New York City, the Nanny Nudger – aka Mayor Michael Bloomberg – is at it again. This time the man wants to nudge mothers into breastfeeding their newborns at the hospital by hiding bottles and scolding women who ask for them.

After all, science agrees that breastfeeding is best! Besides, they’re not really banning the bottles for mothers that need or really want them… they’re just making them harder to get. This will make more women breastfeed and lead to healthier children!

Of course, these results will come at a slight cost to personal freedom and responsibility. Mayor Bloomberg seems intent on proving old libertarian rhetoric about health care: the more the government pays your medical bills, the more the government will try to get you to do things to lower those bills. There are three problems with this.

First, these nudges only address the symptoms of bad decisions, and are likely to encourage more of them. We know that when millions of individuals make their own health decisions based on their own preferences, a lot of them make pretty bad decisions. Traditionally the government has tried to educate its citizens about the consequences of these decisions. But the more the government actively tries to steer citizens towards good decisions, the less incentive the citizens have to become educated about their decisions or feel responsible for them, because they can begin to assume that the government will always be steering them toward the good decisions. This leads to a cycle of poorer decisions and stronger nudges, not better decisions and fewer nudges.

Second, even if there were no consequences to surrendering more decision-making responsibility to the government, there is no clear way to define a “good” decision, and science often changes its mind about what’s best for us. Just read any history of nutritional science over the last 50 years. Or just read the headlines every once in awhile. The human body is extremely complicated, and I don’t trust the government to act quickly enough to change its nudgers when scientists change their minds about what’s best for us. Human bodies can also be very different from one another, and I don’t trust the government to properly accounts for those nuances with its black and white rules.

Third, even if government could consistently and competently turn legitimate scientific recommendations into helpful policy nudges with no consequences, the lack of limitations creates a frightening future. If your only criteria is “what science says will make you healthier,” and there are no apparent limits on what you are allowed to do, well, you could do almost anything. Science agrees that inactivity is killing us; will Bloomberg make escalators run slower to nudge you onto the stairs? Require twenty-five jumping jacks to avoid waiting longer for prescriptions? There’s no telling what a creative technocratic Nanny Nudger might do, and that’s a kind of uncertainty that should concern anyone living under Bloomberg’s jurisdiction.

Fortunately, Bloomberg is just the mayor of one (extremely large) city. He can experiment with all the nudges that are apparently within his power, and his citizens are free to resist, or leave. (OK, everyone doesn’t have the luxury of mobility, but I expect there are enough people with A) the ability to move, and B) the ability to adjust their future nudge expectations based on previous nudges, to C) respond accordingly. Maybe Bloomberg’s nudges will result in a healthier populace that fully appreciates his parental guidance and clamors for more. But given the history of the world…. I doubt it.