So governmental power is used to insure freedoms. Traditionally, civic organizations are used to fulfill "public responsibilities" We have groups dedicated to local infrastructure improvement, fostering leadership skills in children, making sure people have eye care, giving healthcare to the poor -- the list goes on and on.

This is changing as more and more politicians and voters want the government to do the good things that civic organizations used to do. But we still have a long way to go to the point where we view government as the tool to handle all of our moral civic duties for us. There is a strong feeling that centralized governmental planning leads to waste, corruption, inefficiencies and the politicization of service delivery.

Education, I was told, was institutionalized after WWI as a way to make sure that soldiers had basic literacy and math skills. So this movement was a part of national defense, not some collective civic duty. (I understand education has a much more storied background. I abbreviate here)

* Are there Americans that feel education should not be a public service?

* Are you saying that healthcare is seen as a public responsibility but not one that needs to be delivered by 'Government?'

There is a large section of the population which believes that education is being done so poorly as to need re-vamping completely -- getting back to the days where the goals were set but the methods were left open to each school. I'm one of these people. I'm all for the national goal of education as being required for war-fighting and citizenship. The current system, however, looks to have quite a few flaws. I'm all for iterating and re-factoring.

Healthcare, or taking care of the sick, has traditionally been seen as a church-related activity in the States. This began to change in the 1930s when FDR enacted legislation to help people in their retirement (although the initial age of benefits was also the average death age, so on average nobody saw these benefits unless they lived longer than most)

You have to remember that in the States, multiple religions and cultures each took care of things like healthcare locally with hundreds of different solutions. There are hundreds of charity hospitals, for instance. In that manner, healthcare is considered a personal moral responsibility, not a public repsonsibility. Public responsibilities are those I owe the state -- voting, armed service, jury duty, etc. Moral responsibilities are those I owe a particular person based on my moral compass -- gifts to the homeless, charities (the U.S. leads the world in charities), etc.

The U.S. is beginning to believe that all of these moral responsibilities must/should be delivered by government. That takes away any personal involvement or critical thinking of mine and lets the government simply "write the check" for whatever moral ills we all agree on. I'm against this and view it as a step backwards -- replacing a distributed, intelligent, self-optimizing system with a rigid centralized one. But this is clearly the direction we've been going over the last 70 years and I would expect it to continue.

I meant, do you consider that there are things that are a public responsibility, things a society owes to its individual members, that are not The Governments place to provide?

I think you answered no. These things should be personal not public.

In a multicultural, multi-ethnic, multi-religious secular environment, personal mores and values should extend quite a ways from the minimum amount that we can all agree on. Traditionally communities have addressed moral issues through the use of volunteer-based civic groups.

I like this idea because the majority is not forcing it's definition of morality onto the minority. It also does not involve going to a local or national politician to make a moral case why charity money should be spent one way or another. It does not promote "one size fits all" solutions that are supposed to be applicable in wildly varying conditions. In addition, it seems that politicians can get elected simply on the moral persuasion of their arguments instead of their practicality, which is leading us to make promises we can never afford to pay for.

I'm for doing something about healthcare, for instance, because I think the buying and selling of health services is not happening in anything like a free market. Most people don't have anything to do with the cost of healthcare (other than paying insurance premiums), and there is virtually no shopping around for services. So the buyer doesn't use his own money, there is no open pricing, and there is no competition on price or quality. In addition, if a company developed a pill that cost a million dollars but let you live to be 150? It's obvious that there are multiple, legitimate players involved that each should have an equal say.

So please don't take my response as "there's nothing wrong." It's broken, but not everything that is broken needs an immediate, rubber-stamp solution. We work best in complicated environments by setting goals, iterating, re-factoring, trying different solutions -- all things that centralized solutions do not offer.

Moreover, we believe that almost everything the government does, it does poorly. Schools would be a great case in point.

We believe that almost everything the government does, it does poorly

There is definitely some truth in that in a general sense. But it seems to me that it is really a technical side issue in this particular case. The efficiency costs/gains are debatable. Even if you think you see an answer, it's marginal. It largely depends on what you consider the 'output' of a healthcare system. If you take traditional public health indicators such as life expectancy at birth, rates of various avoidable deaths & such, as the output of healthcare systems, private health systems are generally 'less efficient.'

What I mean to suggest with the above line is that a lot of practical pieces of general world views & rules of thumb (Government should not provide services because it is inefficient) are taken to specific contexts regardless of their validity in these cases.

That's why I always find it very hard to believe that anti public health arguments are truly decided on technical grounds. This is a moral not a technical issue.

We believe that health care is not a right but a privilege.

I'm not sure if you were being sarcastic. But it does seem closer to the point. In other words, I have no duty to ensure you have healthcare. I have a duty to ensure you are not murdered, but not that you don't die from diabetes.

If you take what seems to be a current debate in US politics, it seems very fundamental & moral rather then technical: Assume the responsibility or try to enable more healthcare without assuming the responsibility.

I think most would probably agree that regardless of the tax regime & regardless of price of medical care (within possible levels), some people will be left without. Many people in fact.

Short of assuming responsibility for health, you are debating ways of getting the number of uninsured from 17% to 12% or 10% or some moral equivalent. Some people will be left out. But that's ok because they chose that or made a dumb mistake or had a fighting chance.

Also, I always try to resolve arguments on practical grounds first. For instance, I feel that moral stances on drug laws are irrelevant, because the facts show that drug laws don't stop drug use, cause violent crime and many deaths of dealers/distributors, policemen and civilians. So even if you accept that drug use is immoral, just like with alcohol before it the laws still should not be on the books.

A law that has almost entirely negative effects is not a good law no matter what the moral justification.

OK. How about measuring various health care systems against themselves? What I am putting forward is that given that we are talking about improvement in the types of metrics used to compare health care systems, the US system would improve it's output by being public to an extent.

Various implementations are possible from direct government ownership of hospitals to means-tested health care subsidies & everything in between. Obviously crappy implementation has the ability to make things worse. But within the realm of the currently probable, steps taken in that direction would probably lead to an improved result.

But again, that's a purely technical line of argument. I think that in this case the rule of thumb economic liberalism is wrong. I'm reasonable happy to let economists bash that one out. But I do think that in the absense of an overwhelming victory for one of the practical debates, the moral argument here is very strong.

practical grounds

That's an area worthy of discussion in itself. Even if you do believe that drug use is deeply immoral, but see that the consequences of prohibition on are so severe, it'd be very rational to let it slide. But then, I wonder what I would think if I did understand drug use to be deeply immoral in the same sense as rape or murder is immoral. Would I allow legalised rape if the long term if the consequences of prohibiting it were as severe as the drug case. I dn't know how to answer that. (*Most would say no to a purely utilitarian approach http://www.nysun.com/arts/putting-practice-into-ethics/69595...)

For me that particular issue is all about practical. It's hard for me to see any justification for drug prohibition on moral grounds, just the opposite. It's an infringement on liberties. So there have to be net benefit reasons. But I would consider the flipside. In Australia (where I live) Alcohol & gambling are legal. Certain communities (usually extremely remote communities) here have severe social problems linked to abuse of these. Very severe. Some have decided that Alcohol prohibition (like dry counties in the states) are necessary to get the situation under control.

Even though I think individuals should have the right to consume alcohol, in these circumstances the prohibition creates large net gain for the community. I'm OK with that.

Of course there are gray areas. What if rape laws decreased rape by 10%, but increased other forms of violent crime double that?

But in general, if a law's overwhelming result is negative, like our drug and gambling prohibitions, there's no point to them no matter how moral they may be. The money and effort would be much better spent on prevention and rehabilitation.

Unless your communities that are so afflicted are much different than ours, I expect prohibition won't work much better for you than it does for us. People are going to get what they want. Demand for vices seems to be inelastic the world over.

People disagree with you instinctively. It seems that we have Deontological tendencies by nature. Mostly people do not find utilitarian arguments compelling. You have to weight the scales very far in favour of utility before people will violate a principle.

the dry communities

It's an extreme case. These are mostly very small very isolated (like 2 days drive to a store) communities. Generally self imposed by direct democracy or community elders/leaders. I don't know if it works. I don't know if it helps. But that is besides what I was saying. Assuming it's a net gain, I approve.

*It's interesting that we arrived here from the public health care questions. I'm actually surprised that someone open to a 100% practical outcome argument would be so against public healthcare. I expected more fundamental objections: despite the net loss..

Anyway, most people are instinctive deontologists. From the above link:

"the minority of subjects who did consider that it would be right to push the stranger off the footbridge {Right from a utilitarian/net-good perspective} took longer to reach their judgment, and had more activity in the parts of their brains associated with cognitive activity, than those who said that it would be wrong to push the stranger off the footbridge{Right from a deontological perspecitve}"

You seem to be a good example. Instinctively/emotionally a deontologist, rationally a utilitarian. A torn man. (;

I think that those who go with a utilitarian approach think harder about the decision, but that might be just because it makes the decision harder. You need to work out consequences. It's a stretch to say it makes it smarter.

But when you get right down to the root of your stack of 'whys,' you generally hit a principle at some stage. When your trying to rationalise morals, that is. Even Bentham the old time 'extremist' utilitarian had 'the principle of equal consideration.'

Your Constitution & other fundamental documents that you sited earlier are essentially principals (held to be self evident, no?). If you are going to try & rationalise your ethics, most strategies can be deciding on what level to define you principles, define them somehow then apply. Most people instinctively do it at the same sort of level as the law. Some mostly pretty bookish characters go to a slightly higher level.

In that respect, the US founding documents (which I am always surprised to hear quoted & treated in the way that they are) conform to that. Confucius as an example goes to a slightly lower level.

Oh and quit talking for all Americans.

Fires can wreak havoc upon many beyond the fire's point of origin. It's also unprofitable to run a fire department, so given the public benefit, the public foots the bill for keeping a fire department.

Health care isn't the same in that it can be a very profitable business, but because profits are tied to consumption of goods (e.g., medicine) and services (e.g., operations), the industry has incentives to promote overconsumption of both. Meanwhile, the health insurance industry has incentives to deny coverage as much as possible in the name of profit. You might think this would cause the health care industry to operate efficiently, but health care is complex and not easily overseen, and even if the health care industry ran efficiently, the health insurance industry would still have incentives to deny coverage past the efficient rate.

But the effects of letting people who genuinely need treatment go untreated are nevertheless much like fires. Not only does it stand an excellent chance of reducing their productivity and overall employment prospects, the consequences it can have for a family can likewise be disastrous. That doesn't do them any good and it certainly doesn't do our economy any good. So while the health industries might be quite profitable, the net benefit to society is considerably less than if the profit incentives were properly aligned to maximize health instead of consumption and lack of coverage.

But, you know, some folks just have to be sacrificed on the altar of the completely free market, in the name of their own good.

It's not up to the public to protect people from all of the bad things that can befall them. It's up to the public to ensure that people are not impeded when trying to help themselves.

Thus even most of us who are against public health care are in favor of reforms. Tort reforms, ending the perverse incentives.

Interestingly, most of our health problems in the U.S. seem to be due to political pressure caused by lobbying. Read In Defense of Food for a good review as to why our diet has shifted to where it is, and why it's almost certainly the problem. It illustrates that government cannot be counted on to ensure public health.

In most cases, someone else's fire has no (direct) effect on you either, so I'm not sure what the relevance of that assertion is. Nor am I talking about the spread of disease, but rather the socioeconomic effects of having an untreated medical condition, which may not affect you very much, but which can have serious effects for a family and their ability to contribute to the economy. See Gladwell's The Moral-Hazard Myth: http://www.newyorker.com/archive/2005/08/29/050829fa_fact and Uninsured in America, a book which Gladwell cites in the article.

I'm also not sure how you got the impression that I think the public should "protect people from all of the bad things that can befall them." What I believe is that an entity capable of making a credible threat on the public's behalf must ensure that market incentives are properly aligned with the public good, when they are demonstrably not in alignment. That entity tends to be the government. If there's another entity that can do the job more effectively, that's great. I don't entertain any sort of dogma about the "proper" role of the government.

I don't see how tort reform counters the inefficiencies of the health industries.

And diet certainly is a problem. But I'm not sure how the fact that there is a cultural basis to many of our health problems bears upon the problem of misaligned market incentives in the health industry. No one is saying that government is the sole force in ensuring the public health. People who think the government might have a role to play typically don't think that individual judgment goes out the window.

Tort reform and caps on payouts for malpractice suits are necessary. Every time someone wins a $50m suit because a doctor accidentally amputated their pinky, the costs are passed back onto the rest of us.

I'm all for aligning incentives, but that does not necessitate public health care.

Tort reform is a solution to a completely different problem than what I've been talking about, so again, I fail to see the relevance.

We clearly disagree on what would improve the public health, and our disagreement clearly stems from ideological differences which haven't surfaced here. That's fine, but nothing that we've been doing amounts to an actual debate over the issue in question.

We also consider preventing sex with children to be a legitimate function of the government, while preventing sex with adults is a matter of personal privacy.

There are many aspects of children's wellbeing that the public does not concern itself with including to an extent child health.

BTW, the paedophilia laws are not really analogous. Sex with children is prohibited because it is considered rape. A child is considered unable to consent so it is non consensual. Non consensual sex is prohibited with adults too.

There may be administrative differences between specific government programs in education and health care, but there is little public opposition to either one.

Education is seen as a right in The States. Everyone gets to (has to) go to school.