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Chapter 3

Chapter 3. Morals and Health Policy James A. Morone. The Individualistic Model of American Politics. Americans “born free without having to become so” Tocqueville historically relying on themselves Not a paternalistic monarch or state to attain privileges.

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Chapter 3

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  1. Chapter 3 Morals and Health Policy James A. Morone

  2. The Individualistic Model of American Politics • Americans “born free without having to become so” • Tocqueville historically relying on themselves • Not a paternalistic monarch or state to attain privileges

  3. The Individualistic Model of American Politics • Early philosophical liberalism written into U.S. Constitution and design of government institutions • Self-interest often seen to trump hard science • Presenting continual challenges to health care professionals

  4. Considerations of the “Community” in American Politics • Political historians have discerned long tradition of appeal to communal traditions and assistance • Broad public health programs launched by cities at the turn of the 20th century • New Deal-era legislation

  5. Divergence within the Puritan Tradition • Early Puritan ethos elaborated into twin moral stream in American political history • Individualistic “neo-Puritans” stressed sins of the individual, or the “other”

  6. Divergence within the Puritan Tradition • Collectively-inclined neo-Puritans chose to focus on the sins of the community • Advocating collective action to solve problems • Including those relating to public health

  7. Morality Politics in Practice:Case of School Health Clinics-1 • Public health officials by 1990s advocated opening health centers directly inside schools • Conflicted with cultural conservatives • Recommended alternative course of emphasizing individual discipline • “Just say no” anti-drug campaign

  8. Morality Politics in Practice:Case of School Health Clinics-2 • Despite opposition, clinics flourished and multiplied across country • Developed home-grown constituency of parents, students, public-health advocates • Achieved compromise with conservatives on certain issues

  9. Morality Politics in Practice:Obesity Debate-1 • Surgeon general first defined obesity as public health crisis in 2001 • Reactions focused on the individual obese • Fast-food industry came to be blamed by new breed of “muckrakers”

  10. Morality Politics in Practice:Obesity Debate-2 • Villainizing of fast-food purveyors led, in turn, to villainization of the obese • Policy options mooted include mandating high insurance premiums for the obese

  11. Morality Politics in Practice:Obesity Debate-2 • In the end: • Biggest impact of definition of obesity as public health crisis may come in the way it informs the public • Changing lifestyle choices

  12. Chapter 3 Summary • American political history often viewed through the lens of individualism, community, or, in the case of this study, morality

  13. Chapter 3 Summary • Original Puritan impulse led to divergent world views • One focusing on the sins of the individual • Or groups thereof • Other focusing on the ills of society • Social gospel

  14. Chapter 3 Summary • Morality politics can be seen at play in the cases of school health clinics and the debate over obesity in America

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