The UK government’s new ten-year-plan to transform the NHS includes a focus on preventing ill health rather than treating illness. But to what extent should people depend on the state to help them make healthy decisions?

Some think any kind of nudge in that direction is symptomatic of a “nanny state” overstepping its boundaries. Others might argue that nanny knows best, or that governments should do whatever works best both economically and to keep people healthy.

Either way, if a country like the UK wants to keep providing free (or at least tax-payer funded) and universal healthcare, rather than charging every patient for their specific needs, its choices are limited.

Take obesity for example, which is estimated to cost the NHS around £12.6 billion a year – more than 5% of its total budget.

In 2022, 28.7% of adults in the UK had obesity, compared to 10.9% in France, 14.3% in Denmark and 22% in Belgium. (In the US, it was 42.8%.)

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