Each of us is, to a certain extent, dangerous to his or her own
health, but how far do we want the government to curb our freedom
to be "foolish"? In a look at such highly charged health issues as
smoking, alcohol, road safety, and AIDS, Howard Leichter analyzes
the efforts of the United States and Great Britain to confront the
seemingly constant tension involved with this question. Leichter
contends that both governments are now paying less attention to
providing access to health care and more to forcing or encouraging
people to change their behavior. The result has been a
transformation of health politics from a largely consensual to a
largely conflictual enterprise: health promotion policies often
provoke debate on issues filled with scientific uncertainties,
while taking on the quality of a disagreeable moral crusade. A
primary concern of this book is to account for the differences, as
well as the similarities, between the two countries in their public
health policies. Leichter examines, for example, why seat belt
regulation flourished in the American states even when federal
action was blocked while, in Britain's more concentrated political
structure, similar regulation faced a tortuous political path
through the Lords and Commons. Finding that the United States is
more apt to use formal regulation and that Britain tends toward
voluntary agreement, Leichter compares the two approaches. Neither
government avoids conflict, he maintains, but regulation, despite
its problems, is more effective.
Originally published in 1991.
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