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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

Chapter 3

Morals and Health Policy

James A. Morone


The individualistic model of american politics
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


The individualistic model of american politics1
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


Considerations of the community in american politics
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


Divergence within the puritan tradition
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”


Divergence within the puritan tradition1
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


Morality politics in practice case of school health clinics 1
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


Morality politics in practice case of school health clinics 2
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


Morality politics in practice obesity debate 1
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”


Morality politics in practice obesity debate 2
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


Morality politics in practice obesity debate 21
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


Chapter 3 summary
Chapter 3 Summary

  • American political history often viewed through the lens of individualism, community, or, in the case of this study, morality


Chapter 3 summary1
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


Chapter 3 summary2
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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