I still remember the day I went in to my heart surgery rotation to find that all heart and vascular surgeries for the day were cancelled, because someone in a serious car wreck had used up all the blood.

It doesn't only hurt yourself. Mandating seatbelts reduces the population's overall risk of injury. When you have a society that has a public fallback for health insurance, reducing the amount of serious injuries has a beneficial impact on lowering the cost of providing healthcare to society.

If this is the rationale, why do countries with public health insurance fallback not also have mandatory BMI or tobacco/alcohol limits, given the much much higher fatality rates of cardiovascular disease and cancer versus automobile accidents?

There may not be hard limits on tobacco or alcohol use but they do tend to have very high "sin" taxes on those items. Those who use the most pay the most. It is imperfect but probably the best we can do without going full surveillance state in people's homes.

Because we live in an imperfect world and it takes time for public opinion to adapt to change.

Also, we do have BAC limits for driving, and public intoxication prohibitions.

Are you claiming that in a perfect world we would have legal limits on BMI, and totally ban alcohol and tobacco?

Of course not. I’m saying that complex situations yield inconsistent results, and that way we solve one problem may not be exactly the same way we solve a different problem, even though they may look superficially similar.

This is a common and dangerous misconception. Wearing a seatbelt causes you to be a projectile that bounces around the car, into other people. YouTube "not wearing a seatbelt" and you'll never not wear one again when others are in the car.

Those videos are the equivalent of the DARE junk of the 90s but for cars. You should wear a seat-belt because it improves your own survivability not because some scare tactic told you to.

It doesn't have to be one or the other. Wear it to protect yourself and others.

> If Covid were an STD there would be huge social pressure on

HIV/AIDS was that.

https://en.m.wikipedia.org/wiki/HIV/AIDS

Similar in some ways, but also very different. HIV/AIDS had a much higher mortality.

Covid-19 is interesting in that it's on the margin for death rates, and its long-term health effects are more varied and subtle than those for, say, polio.

Strictly speaking seat belts improve the ability of drivers to stay seated and in control during emergency maneuvers. This factor can have an impact on other drivers.

> Not wearing a seatbelt hurts yourself only.

And yet people in many countries reject it.

If a significant amount of people already makes a bad choice at this point where it affects themselves we cannot expect these people to make good choices to protect others.

Are you paying extra for all the people who need to clean up your body in the accident you get into? And to bring the coroner out just to verify your time of death. And all the lost time of the other people on the road delayed because you died or were seriously injured when you didn't have to be. We all pay these costs with higher insurance and higher taxes. These costs are a drag on society. Just like smokers, people who don't wear seatbelts should pay more for insurance. Likewise, they should pay more in taxes because they cost more.

Because the average person has a very bad understanding of risk and consequences?

Also, the laws aren't solely about the wearer; not wearing seatbelts at scale has societal costs.

Can you please elaborate what is so difficult to understand about the concept that when you drive fast and crash you get thrown out the windshield and possibly die? What does it mean to you that this understanding already fails?

It's a constant minor annoyance weighed against a fairly rare, hypothetical risk.

People ride motorcycles despite vastly higher death and injury rates than cars, cause it's fun. (I did for awhile and might start doing so again one day.)

I'm not disagreeing with you I don't think? I agree that it's a really stupid thing to not wear a seatbelt. I just think it's important to consider how to solve these problems without throwing up our hands and saying "people are irredeemably stupid" because that doesn't really do much good for anyone.

>Because the average person has a very bad understanding of risk and consequences?

When it comes to things that are defined by social consensus (like whether or not one should wear a seat-belt, or smoke indoors, etc) like the hypothetical "average person" is always correct by definition.