The Classical Liberal Account of Public Health
Abstract
This chapter examines the sharp contrast between the classical liberal and modern definitions of public health. The former stresses the transmission of disease from one person to another through any number of different means. The latter expands the definition of public health to include all matters pertaining to the physical, mental, and social well-being of any and all people, without limitation as to their causes. That narrower, classical definition does call for government intervention in select cases. These include inspection, quarantine, lockdown, or infrastructure projects like sewers, or individual interventions such as masks, drugs, or vaccinations. That classical definition, however, does not reach such individual vices as obesity and smoking. Under the classical approach, all cases warranting intervention prefer localized and specific interventions broader measures which are more likely to have negative collateral consequences. Narrower measures target the social peril while reducing, if not eliminating, negative collateral consequences to both individual liberty and overall prosperity that come with excessive intervention. In disputed cases, the burden of proof lies on the government to show that the intervention was justified and the means were well tailored to the desired ends. In most historical cases, this justificatory framework was adopted, but major departures from these rules made the public response to COVID-19 a disastrous and costly mismanagement of a grave social problem.