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Culture War Roundup for the week of March 4, 2024

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That is a brilliant analysis. Trying to put it in my own words so that I can steal it, I realise that there is a British NHS way of framing it.

The three founding principles of the NHS are that: one, it is funded out of general taxation; two, free at the point of use; three, treatment is based on clinical need, regardless of the ability to pay. The fourth principle was silent; one didn't say out loud. The NHS didn't ask why the patient needed treatment. No-one was refused treatment because their illness was their own stupid fault.

There have always been worrywart who feared that the silence wouldn't hold. Treating liver disease and type II diabetes is expensive. Why is the tax payer on the hook for peoples' drunkenness and gluttony? The question gets asked and used to justify the government intervening in peoples lives, making alcohol harder to get to spare peoples livers, and making fatty food harder to get in the hope of shrinking their waist lines. Both to save the NHS money. Both current UK public policy.

The previous paragraph is very British. An alternative response to the very same question, uses the issue to justify cutting the funding to the NHS. Fund treatment for illnesses that strike at random, but stop subsidizing bad lifestyle choices.

I'm struggling to find the right words to describe this framework,...

Me too. Here is my attempt:

  • tight budget paternalism The government has the obligation to raise taxes to pay for rescuing people from the bad consequences of unwise choices AND the power to limit peoples choices by punishing expensively bad choices, with the aim of discouraging them.

  • no budget freedom The government protects people from others who would tell them: No! Bansturbators tolerate this in return for not having to pay for rescuing people from the consequences of their own bad choices.

  • budget busting freedom The government has the obligation to raise taxes to pay for rescuing people from the bad consequences of unwise choices. Bad choices multiply and get worse until the money runs out.

Another attempt:

When there are potentially bad choices that can be made, do you

Limit the ability to make such choices

Allow them to make such choices (and to suffer the consequences)

Support them in making such choices

I'm keen to get some mention of budget or money into the short name.

Why? I reckon that the way that Support fails is that the proponents come up with a plan. The plan is good in itself, but costs ten times what is politically feasible. The plan goes ahead anyway, with 10% of the funding that it really needs. Fails badly :-(

A good comment reminds us of Scott's epic critique of addiction research. Perhaps we don't have affordable answers to addiction, and Suport has a good plan that requires 100 times the politically feasible funding. Gets 1% of the funding it needs; fails very badly.