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Notes -
Is a strong central authority necessary to deter the catastrophe of health and fertility?
Consider that if America wanted to reduce its obesity epidemic it would likely have to implement draconian actions like high taxation or outright bans on certain food types, reduced workplace stress conditions, incentivizing longer breastfeeding times and reducing female employment to reduce stressed mothers. If it wanted to maintain or increase its fertility rate it would need to deter or ban women from higher education, teach pro-motherhood material in public school, possibly ban certain types of media…
Any action that has a real effect on the ever-increasing problems of obesity and fertility would be essentially off the table. Our capitalism worship and our political climate forbids it. It is unlikely that there will be a magic bullet for fertility that does not include reducing female education/employment and producing natal propaganda. A state like China, however, can snap their finger and introduce policies that will certainly reduce obesity and increase fertility.
No, but some kind of positive governance is required, rather than an incompetent or malicious one.
Take obesity, for example. People get fat when they ingest more calories than they burn - this isn't rocket science. Having cheap, calorie-dense food everywhere makes it nearly impossible to keep a good calorie balance without going hungry, or without planning and measuring your food (which most people don't and won't do). So a good place to start would be to not subsidize corn, and thus high-fructose corn syrup. Instead, incentivize the cultivation of tasty vegetables (as opposed to good-looking ones, e.g. sherry tomatoes vs. the large ones at the supermarket) and low-calorie fruit, like strawberries.
For fertility, notice that you can't have TFR > 2.1 if families don't have more than 2 kids on average. So, what are the barriers? High housing prices are the first to tackle, in the places that people actually want to live. This is also not rocket science - build more. It doesn't even matter how or what, if housing stock will increase then the prices will decrease. Couples detached from their family will have almost no spare time - so young kids should be in some kind of schooling for 6 days a week (or 5-and-a-half, like here in Israel) to give parents time to make more kids.
Giving birth should not cost the parents money - cost is a very obvious disincentive. Instead, compensate the hospital directly for each birth and charge the parents nothing (again, this is what we do in Israel. The result is that the maternity ward is one of the nicest places in the hospital, as hospitals compete to get as many mothers as they can. Sort of a voucher system). Car seat laws in Europe and the US are just insane, creating a hard barrier at 2 kids per family with a normal car, or spacing the kids out too much so that at least 1 doesn't need a safety seat.
Most of this requires less government restrictions, some of it is just moving things around, but you don't really need to get big-brother on your populace.
To take this one step further, why don't we see all big-brother actions under the lens of just another tax?
They have financial and non-financial costs based on how people respond to them; so it should be possible to put a price on them.
When the tax on children is too high, people stop having them.
When the tax on an industry is too high, no innovation occurs.
When the tax on men is too high, they lie flat.
All of these choices have consequences imposing real financial costs.
It's almost like there's a moral hazard when creating these taxes or something, where the people imposing them because "it sounds like a good idea, safety is everyone's responsibility" either don't get (or can't be) resisted effectively enough to stop them. And when the full effects of hollowing out the country's labor class take effect, you're either retired (thus insulated from the problems you caused) or dead from old age. Unfortunately, we can't fine the dead and the populace has sovereign immunity when voting.
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