[mibbitier]

One thing I've never understood, is why a seemingly large number of Americans don't seem to see the similarity between public fire protection, and a public health service.

Aren't these two things pretty essential for civilisation?

[po]

In some places, fire protection is apparently up for debate. This family had their house burn down because they failed to pay the $75 tax. It's only fair after all:

http://news.yahoo.com/blogs/sideshow/tennessee-family-home-b...

I think it's even been given the unfortunate name 'pay to spray'. Fire prevention is just as much up for debate amongst people of a certain ideological bent as healthcare. It's the next logical step. Of course, most people don't want to live in that world which is why we have compulsory payments. Those who see them as a positive thing will probably always have to tolerate those who complain about how unfair they are.

[gaius]

Flip it around tho', they were asking firefighters to quite literally risk their lives for them, when they weren't even community-spirited enough to contribute towards the common good. Unless you have the plague, a doctor doesn't take nearly the same personal risk as a firefighter.

[po]

Sure, that's true and I think people who don't pay the taxes that support the firemen should be ashamed of themselves and forced to pay. Similarly, I think firemen should be trained well and paid for the risk they are taking on.

That being said, humans are not very good at reasoning about risk. Fire is a life-destroying event disproportionate to the perceived risk. It can wipe a family out and has secondary impacts to the community in general. I think we should accept that. We don't have to periodically let someone's home burn to the ground to serve as a lesson to others.

[poppysan]

firefighters have many mundane tasks as well. Doctors are exosed to viuses that could be widespread if they fail to do their job properly. Id argue that they are exposed to dangers they can bring home to the kids, which in my opinion make it just as, if not more dangerous.

[Torgo]

It wasn't about ideology, it was a CITY fire department that for a fee (not tax) would provide fire protection service inside the county but outside the areas it has legal jurisdiction to tax. Some places in the USA do not have county-wide fire service because they are that poor, or are particularly remote.

[yummyfajitas]

Epidemic prevention certainly is, in the same way fire protection is - both a fire and an epidemic can rage out of control and kill lots of people. They are public goods because they have large positive externalities.

Both are also dirt cheap (i.e., single-digit percentages of government spending) and very few people oppose their public provision. So why bring them up?

[prodigal_erik]

It's hard to reconcile with the idealized version of the http://en.wikipedia.org/wiki/Night-watchman_state that does nothing more than enforce the non-aggression principle. I suppose one could consider arson (not accidents) as a form of aggression they must be prepared for, but I find this an obvious public good the night-watchman state doesn't account for very well.

[scottlilly]

They don't see the similarity because they are, in fact, different.

If my house catches on fire, and someone doesn't put it out, there is a reasonable chance it will spread to other houses. So it's a societal issue - at least at the local scale. As a societal issue, it makes sense for each member to be forced to pay for it.

If I break my leg, there is no increased chance that my neighbor will break his leg. So it's a personal issue. My neighbor receives no benefit from my leg being repaired, and is not harmed if isn't repaired. So why should he be forced to pay for it?

If you want to say that public health care should exist to provide vaccinations, in order to prevent the spread of disease to others in society, that would be a reasonable argument.

[rdtsc]

> If I break my leg, there is no increased chance that my neighbor will break his leg. So it's a personal issue.

But is not a just personal issue. If you break your leg and don't have insurance, you could lose your house over medical bills. The bank will reposes and will write down losses over your mortgage. If your lot starts to look like crap the value of his house will be affected as well. If you have a wife and kids, your kids might end up having to go to school in a crappy part of town. So it might affect their education.

Just by breaking your leg could affect a lot more people than you first suspect. Of course if you had government provided insurance you would not have the risk of spreading this as much.

This idea that we are so independent and individualistic works perhaps in some kind of a romanticized world where you live in a compound in the woods that is self sufficient and you don't have to to worry or care about the outside world either bothering your or owing them anything.

[cgmorton]

This argues equally well for completely supporting the family indefinitely for any reason. The only difference between paying medical bills and paying for the whole lifestyle is a matter of cost, and medical bills can be really expensive.

Doesn't it bother you that an even-handed application of this principle leads to absurdity?

[rdtsc]

I see it as a continuum.

But actually it maybe be true that in some cases it is more beneficial overall to the society to just support the family for a while if say the breadwinner breaks a leg. That is better than a bankruptcy, loss of house, loss of job.

> Doesn't it bother you that an even-handed application of this principle leads to absurdity?

It doesn't because this has to be applied to a certain degree. Absolutely no safety net is not good, but it is not possible of feasible to just hand out money either.

[confluence]

You forgot second order effects. Leg gets fixed - you get back to work - goods and services are rendered, taxed, consumed and saved.

Your neighbor benefits by having an individual in whom society has invested millions in to train and care for back at work instead of being dead. That's a waste of money.

Humans are worth saving simply because we invest so much in them.

[cgmorton]

But then you can easily, heck trivially, argue that people should be forced to exercise or to eat a particular diet that makes them more productive. Look, more goods and services are rendered! It's a public situation!

People should be forced to live within 5 miles of work, because they're not being productive during their commute. Also, HackerNews and reddit should be forcibly taken down because of their contribution to idleness at work.

[confluence]

You forget about second order effects once again - HN/reddit facilitate low latency, high scale, high signal communication between millions of people everyday - that's a net positive.

In terms of diet, we tax cigarettes, alcohol and drugs (indirectly) - food that is net negative on society should have their negative externality priced via taxes.

It's pointless banning them (e.g. enforced diets) - see prohibition - leave it legal and tax to cover costs.

[wwwtyro]

> Aren't these two things pretty essential for civilisation?

Isn't that also true of food?

[mibbitier]

Not really the same IMHO.

Giving people access to healthcare and fire protection doesn't create any bad incentives. You can't 'use' healthcare for monetary gain.

Giving people food, money etc, gives people incentives to not bother working.

Also I would say that a national health service ensures that the public is 'healthy'. Which affects us all, as diseases are transmitted etc. Just as the fire services ensures fires don't spread and burn down all the houses.

The same isn't true of giving people food.

[randallsquared]

Well, there's no limit to how much healthcare you can use, though. Hanson[1] suggests Americans already buy too much healthcare, and in the US, healthcare still costs most people something through copays, etc. So, I think it's quite arguable that giving people free healthcare can create bad incentives, if not limited some other way.

I also am not sure it makes sense to lump together healthcare (which includes a lot of long-term preventative care like vaccines and lifestyle advice) and fire protection (which is mostly emergency damage control). A better analogy might be if the government provided free fire insurance covering everything citizens own -- actually, the US does this sort of thing with hurricanes and floods, so there's a fairly exact analogy, and it seems clear that it does create bad incentives to build and rebuild in hurricane-prone and low-lying areas.

[1] http://hanson.gmu.edu/CutMed.htm

[king_jester]

> Giving people food, money etc, gives people incentives to not bother working.

I find this kind of attitude totally bizarre. People do not stop having output just because they have food security. The notion that giving away food is bad because of work is a very capitalistic idea that actually serves to perpetuate hunger and starvation.

[mibbitier]

Giving people food and welfare, makes them dependent on the state. Once you're dependent, you have no incentive to progress through your own hard work.

Giving handouts does far more harm than good. It keeps people down.

[eli_gottlieb]

Once you're dependent, you have no incentive to progress through your own hard work.

You mean, except for all the good incentives like achievement, mastery, purpose, learning, and contribution to a community that actual successful professionals are motivated by, rather than the motive against starvation that you seem to believe is the only reason anyone gets up in the morning?

[eli_gottlieb]

Giving people food, money etc, gives people incentives to not bother working.

Well yeah, but according to this kind of economistic thinking, paying a guy $40/hour instead of $20/hour encourages him to work half as many hours. Giving people anything for any reason, including as trade/payment, can always be construed as encouraging less work-ethic.

And likewise, withholding anything or inflicting any suffering or punishment can always be construed as encouraging work-ethic.

[jonathanleane]

http://en.wikipedia.org/wiki/Supplemental_Nutrition_Assistan...