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Self interest is the most compelling of all motivations. The most effective way of changing behaviour is to reward (or penalize). This rule applies equally to individuals as to groups, including governments and government departments. If a course of action makes any branch of government richer—or less poor—it seems logical that such action should be endorsed.
Accordingly, it makes sense to assume that economic data related to injury prevention should be highly persuasive in influencing the decisions of health departments. There are now a growing number of cost-benefit reports from various countries, including the US, Canada, and Australia. In spite of their limitations, all reports agree that overwhelming savings follow from relatively inexpensive injury prevention strategies. Nevertheless, few governments have responded accordingly. Why not? What possible explanations can there be for their failing to act in the national self interest?
To my way of thinking, the answer is simple. The branch of government that benefits most from a reduction in injuries is that which pays for the care of the victims. Yet, the range of options open to health departments alone, that is, without the help of colleagues in transport or product safety, for example, is limited. Thus, we face a paradox: transport would have to spend more money to achieve greater safety, but health would be the main beneficiary. In an enlightened society, this is how government should operate, with each department operating for the collective good. Unfortunately we can only conclude that so little is spent on more safety measures, such as enforcing speed limits, because such enlightenment is missing.