The consumption ethic in contrast views work as merely a means to the end of personal consumption, with no intrinsic value to distinguish it from other sources of income that allow for enjoyment of the same consumer goods-private charity, government welfare, or capital gains derived from the passive ownership of assets that generate profits, rents, or interest. The work ethic views membership in a community as entailing a reciprocal obligation to contribute through personal effort-whether paid or unpaid-to the community’s flourishing, rather than exploiting others by free-riding on their efforts. Underlying this disconnect in thinking about the welfare state is a debate between two moral systems, which might be called the work ethic and the consumption ethic. Medicare may be administered by the government, but it is a program of, by, and for the working people who pay for and receive it. Along with citizens of other modern democracies, they see a profound moral and political difference between non-contributory social assistance paid out of general tax revenues (“welfare”) and contributory social insurance funded by payroll taxes or premiums (“earned benefits”), even if both kinds of programs involve government spending. People pay the taxes they can afford and receive the benefits they need. To both groups, then, money is money, whatever its source. The socialist obsesses over moral justification but embraces a framework in which all are equally deserving of public support. The market fundamentalist evaluates public programs on the starkly utilitarian basis of how much monetary value flows to whom, without regard to moral justification. With its supercilious mockery, the overclass intelligentsia revealed an inability to distinguish between social assistance and social insurance, which both market fundamentalists on the right and socialists on the left regard as interchangeable for ideological reasons. On the right, George Mason economist Tyler Cowen called the remark, “The funniest sentence I read today.” On the left, Slate’s Timothy Noah announced his initiative “to combat the pernicious and big-babyish meme that Medicare lies beyond government control and must remain so.” Bob Inglis during the 2009 health care debate, pundits across the political spectrum seized on it to symbolize the lamentable ignorance of ordinary people in general and populist conservatives in particular. When an angry constituent made the declaration at a town hall meeting convened by Rep. There are two kinds of people: those who want politicians to “keep your government hands off my Medicare,” and those who think that’s the dumbest thing they’ve ever heard.
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