限售含糖饮料,何错之有?

It has been a frustrating week for well-intentioned and interventionist political leaders. Michael Bloomberg and David Cameron have been roundly defeated in their efforts to prod citizens into health.

对于那些好心好意、奉行干涉主义的政治领导人而言，有件堪称令人挫败的事。迈克尔•布隆伯格(Michael Bloomberg)和戴维•卡梅伦(David Cameron)逼民众过健康生活的努力遭遇惨败。

Both the mayor of New York, who wants to limit the size of sugary drink cups in restaurants and cinemas, and the UK prime minister, who sought a minimum unit price for alcohol, lost the argument. They were portrayed as social nannies pushing policies that discriminated against the poor and minorities, who deserve some pleasures.

纽约市长希望限制餐馆和影院含糖饮料杯的最大容量，英国首相则试图为酒精饮料设置最低单价，二者均在争论中败北。人们说，两人好像“社会保姆”，推行的政策对那些理应享受一些乐趣的穷人和少数族裔人群构成歧视。

They were still right. Societies should try to limit alcoholism and obesity, as they have cracked down on tobacco use. Freedom matters and the ideal policy is both effective and unobtrusive, but they both managed to tread the line between illiberalism and irresponsibility. As with tobacco proscriptions, they will probably be accepted in the end.

但两人仍然没错。各国社会已经采取严厉措施禁烟，也应当尝试针对饮酒和肥胖问题做出限制。自由弥足珍贵，理想的政策也应当既有效、又不唐突，但布隆伯格和卡梅伦都在不自由和不负责任之间找到了微妙的平衡。与禁烟措施一样，这两项政策最终可能将被接受。

John Stuart Mill defined it nicely in On Liberty : “The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.”

约翰•斯图亚特•穆勒(John Stuart Mill)在《论自由》(On Liberty)中的阐述颇为精辟：“对于文明群体中的任一成员，违反他的意志、正当地对其施加权力，唯一的目的是防止他对别人造成危害。个人自己的好处——无论是物质上还是道德上的——不足以构成正当理由。”

Targeting non-communicable health conditions such as obesity, diabetes, high blood pressure and alcoholism is an especially sensitive issue since – to put it bluntly – rich people tend to live more healthily than poor people. Any tax or regulation that penalises the latter must have demonstrable benefits for society as a whole.

将矛头对准肥胖、糖尿病、高血压和酗酒等非传染性病症是尤为敏感的问题，因为坦白说，富人的生活往往比穷人更健康。任何针对穷人的课税或惩罚性规定，必须从整体而言对社会有明显益处。

After his regulation was overturned by the New York Supreme Court, Mr Bloomberg published research on how obesity correlates with consumption of sugary drinks, and where they are concentrated. Both are low in elite districts of New York City such as the Upper East Side and Greenwich Village, and high in poorer areas such as the Bronx and Bedford-Stuyvesant.

在自己推出的法规被纽约州最高法院(New York Supreme Court)驳回后，布隆伯格发表了一份研究报告，该报告探讨了肥胖与含糖饮料摄入量的相关关系以及不同区域的肥胖人群比例。两项指标在上东区(Upper East Side)和格林威治村(Greenwich Village)等上层社区都数值较低，在布朗克斯(Bronx)和贝德福德-施托伊弗桑特(Bedford-Stuyvesant)等中下层社区则数值较高。

There is thus a clear link between social status and health. Call it the Lloyd Blankfein principle. The chairman and chief executive of Goldman Sachs grew up on a public-housing project in East New York – close to Bedford Stuyvesant – but now lives by Central Park. He was once overweight but he dieted and exercised to get in shape as his fortunes rose.

因此，社会地位和健康之间存在明显相关性，可将其称为“劳埃德•布兰克费恩(Lloyd Blankfein)原则”。这位高盛(Goldman Sachs)董事长兼首席执行官在纽约布鲁克林区东纽约（East New York，靠近贝德福德-施托伊弗桑特）的公租房中长大，但现在住在中央公园附近。布兰克费恩曾经超重，但随着个人财富的增加，他通过节食和锻炼恢复了正常体型。

Societies would be healthier if everyone followed his path but it isn’t possible. In practice, people enjoy – or find comfort in – sugary drinks and fatty foods or cheap alcohol. The Institute for Fiscal Studies in the UK estimates that a “fat tax” would cost the poor seven times as much as a proportion of income as the wealthy.

如果每个人都遵循布兰克费恩的足迹，社会将变得更加健康，但这是不可能的。事实上，人们可从含糖饮料、高热量食品或廉价酒类中获得快乐或安慰。英国财政研究所(Institute for Fiscal Studies)估计，穷人缴纳的“肥胖税”占其个人收入的比例可能是富人的7倍。

Mill’s principle and the social effects make blunt intervention to force people to eat and drink more healthily hard to justify. In November, Denmark dropped a “fat tax” that it imposed in 2011 on foods with a high fat content. Shoppers had evaded the tax by driving over the border to shop in Sweden, and it had other unintended effects.

穆勒提出的原则、以及各种社会效应，使得以直接干预方式强迫人们采取健康饮食习惯的行为很难站得住脚。去年11月，丹麦撤销了2011年开征的一项针对高脂食品的“肥胖税”。此前，购物者逃避这项税的方式是，开车越过国界，前往瑞典购买被课以“肥胖税”的食品。征收这项税还曾导致其他一些意料之外的效果。

But the New York ban on serving soda in paper cups larger than 16 ounces – three times the old standard size – would hardly be a draconian clampdown. It would not prevent anyone slurping their way through 24 ounces of Coca-Cola while watching a film or having a meal. He would merely face the inconvenience of buying two cups.

但纽约禁止售卖单杯容量大于16盎司（这是旧式标准杯容量的三倍）的纸杯装汽水，这项禁令很难算严厉，不会阻止任何人在看电影或吃饭时咕咚喝下24盎司可口可乐，他们只需要忍受买两杯的不方便。

Mr Bloomberg’s plan is thus a “nudge” proposal of the kind now favoured by psychologists and behavioural economists. It does not impose a ban on an activity – it simply adjusts the environment to give people incentives to make better and healthier choices.

因此，布隆伯格的方案正是心理学家和行为经济学家如今热捧的“轻敲”型方案。这种方案不禁止某项活动，只是调整环境，激励人们做出更好、更健康的选择。

Little measures such as changing a cup size sound absurd, but they can be very effective. “We are exquisitely sensitive to environment,” says Theresa Marteau, head of the Behaviour and Health Research Unit at Cambridge university. “We are just like rats – energy misers and cognitive misers. If there is a shortcut, we will take it.”

更改饮料杯容量等小举措虽然听上去荒唐，但可能非常有效。“我们对环境极为敏感。”剑桥大学(Cambridge University)行为与健康研究中心(Behaviour and Health Research Unit)主管泰雷扎•马尔托(Theresa Marteau)表示，“我们像老鼠一样——是精力吝啬者(energy miser)和认知吝啬者(cognitive miser)。如果有捷径，我们就会抄近道。”

Nudges are less blunt than laws, since they still permit people some discretion – they merely try to guide them. Mr Cameron’s coalition is keen on the approach, declaring in 2010: “Our government will be a much smarter one, shunning bureaucratic levers . . . and finding intelligent ways to encourage, support and enable people to make better choices for themselves.”

“轻敲”型方案不像法律那样生硬，因为这种方案仍然为人们留出一些自由——只是试图去引导人们罢了。卡梅伦的联合政府热衷于采取这种方案，曾在2010年宣称：“我们的政府将是一个聪明得多的政府，回避官僚手段……并寻找明智的方法，鼓励、支持和帮助人们做出对自己而言更好的选择。”

The minimum price per unit for alcohol was more of a lever than a nudge. The idea was to curb the UK tendency toward binge drinking by barring supermarkets from heavily discounting alcohol. It would not have encouraged people to stop buying booze cheaply – it would have prevented them.

为酒精饮料设定最低单价，更像是一种官僚手段而非“轻敲”型方案。该政策的理念是，禁止超市以高折扣出售酒精饮料，从而遏制英国人的豪饮倾向。这种政策不会起到鼓励人们停止购买廉价酒的作用——而是会阻止人们购买廉价酒。

You need a very good reason to intervene so forcefully in people’s choices, especially when it amounts to a regressive income tax. It puts alcohol firmly in the same category as cigarettes, a pernicious form of good that a government will tax not only to raise revenues, but actively to curb its consumption.

我们需要非常充分的理由，才能如此强势地干预人们的选择，特别是当这样做的效果等同于征收累退所得税时。这种政策毫不留情地将酒精饮料与香烟划为同类，即一种要被政府征税的有害商品，政府对这种商品征税，不仅是为了提高财政收入，也是为了主动控制其消费量。

I still think the idea was justified. Even a law-abiding drunk drowning his sorrows at home imposes health costs on others – as does the person who contracts type 2 diabetes by ingesting too much sugar. New York City incurs an estimated $4.7bn in annual costs due to obesity, much of it paid by public programmes such as Medicare and Medicaid.

我仍然认为，这种理念是有道理的。即便是一位遵纪守法、只是在家里借酒消愁的醉汉，也会给他人造成医疗费用的负担——就像因摄入糖分过多而患上二型糖尿病的人一样。据估计，纽约市每年发生由肥胖导致的成本47亿美元，其中大部分由美国联邦医疗保险计划(Medicare)和美国联邦医疗补助计划(Medicaid)等公共项目埋单。

With obesity, the social cost more or less stops there, apart from bad parental influence on children. With drunkenness, it often goes further – alcoholism triggers crime, and turns accident and emergency departments in UK hospitals into bedlams.

除了肥胖父母对子女的不良影响外，肥胖的社会成本差不多仅此而已。但醉酒的影响往往更加广泛——酗酒引发犯罪，并让英国医院的事故与急救部门乱成一团。

Liberty and social equality mean that governments should adopt the lightest methods possible to address such social ills – they should label and advertise before nudging and banning. But both Mr Bloomberg and Mr Cameron struck a fair balance – or they at least tried.

自由和社会平等意味着，政府应当使用尽可能温和的方法解决此类社会痼疾——在推行“轻敲”型方案和颁布禁令之前，政府应当进行说明和宣传。不过，布隆伯格和卡梅伦都已平衡得不错——或者说，至少他们努力了。