Governments usually exert some intentional influence on mortality, as well as on
Governments usually exert some intentional influence on mortality, as well as on the two other drivers of population change, fertility and migration. If effective, these policies may impact the every day lives of individuals and families profoundly. The policies will also have an impact on the growth rate of the population, the eventual size of the population, and the age and ethnic composition of the population. The motivation of government may be economic or it may be based on values ranging from compassion to hatred.
What are the best practices around policy design?[1]
Let’s begin with
1. No discrimination or coercion. Can we agree that our government should work for the welfare of all ethnic and social classes, and all age groups? And can we agree that our government should not control our behaviour too closely?
Regarding coercion and control, it may not be easy to agree on exactly where the government crosses the line. For example, during the COVID-19 pandemic, a significant minority of people felt that the government had no right to mandate vaccination against COVID-19, and that employers, universities, airlines, and other entities had no right to require vaccination.
Regarding discrimination, during the COVID-19 pandemic in Canada and the United States, there were not enough vaccines, at first, to treat all who wanted to be vaccinated. There were not enough hospital beds to treat all who were sick. In terms of vaccine delivery, older adults, people with pre-existing conditions, and other vulnerable groups were prioritized. But in terms of admission to hospital and care of the sick, it was the other way around. In Canada, residents of long-term care facilities were often not taken to hospital. The early, panic-stricken days of the pandemic saw many long-term care residents all but abandoned by staff. In the United States, patients from long-term care were discharged from hospital back into long-term care facilities while still infectious and unwell. Laura Appleman (2021) reports on this and also the inappropriate use of trial vaccines, even quack medications in long-term care facilities, as well as the neglect of psychiatric patients and people with developmental disabilities living in institutions.
Once we determine that a policy does not violate Human Rights, we examine the policy for its likely effectiveness, using the following guidelines:
2. Target the ultimate goal as closely as you can. Identify the ultimate goal or the root cause of the problem you are trying to address. Is the proposed policy the most direct way to achieve your ultimate goal? For example, perhaps the ultimate goal of the policy is to reduce deaths from COVID-19 virus, but the policy focuses on the sanitization of surfaces. Since surfaces are not a major conduit of COVID-19 transmission, this policy will not be very effective at reducing deaths from COVID-19.
3. Target the binding constraint. A successful policy addresses the most critical bottleneck, the most press