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Should governments save people from themselves? Do governments have the right to influence citizens' behavior related to smoking tobacco, eating too much, not saving enough, drinking alcohol, or taking marijuana-or does this create a nanny state, leading to infantilization, demotivation, and breaches in individual autonomy? Looking at examples from both sides of the Atlantic and around the world, Government Paternalism examines the justifications for, and the prevalence of, government involvement and considers when intervention might or might not be acceptable. Building on developments in philosophy, behavioral economics, and psychology, Julian Le Grand and Bill New explore the roles, boundaries, and responsibilities of the government and its citizens.Le Grand and New investigate specific policy areas, including smoking, saving for pensions, and assisted suicide. They discuss legal restrictions on risky behavior, taxation of harmful activities, and subsidies for beneficial activities. And they pay particular attention to "e;nudge"e; or libertarian paternalist proposals that try to change the context in which individuals make decisions so that they make the right ones. Le Grand and New argue that individuals often display "e;reasoning failure"e;: an inability to achieve the ends that they set themselves. Such instances are ideal for paternalistic interventions-for though such interventions might impinge on autonomy, the impact can be outweighed by an improvement in well-being.Government Paternalism rigorously considers whether the state should guide citizen decision making in positive ways and if so, how this should be achieved.
How can we ensure high-quality public services such as health care and education? Governments spend huge amounts of public money on public services such as health, education, and social care, and yet the services that are actually delivered are often low quality, inefficiently run, unresponsive to their users, and inequitable in their distribution. In this book, Julian Le Grand argues that the best solution is to offer choice to users and to encourage competition among providers. Le Grand has just completed a period as policy advisor working within the British government at the highest levels, and from this he has gained evidence to support his earlier theoretical work and has experienced the political reality of putting public policy theory into practice. He examines four ways of delivering public services: trust; targets and performance management; "e;voice"e;; and choice and competition. He argues that, although all of these have their merits, in most situations policies that rely on extending choice and competition among providers have the most potential for delivering high-quality, efficient, responsive, and equitable services. But it is important that the relevant policies be appropriately designed, and this book provides a detailed discussion of the principal features that these policies should have in the context of health care and education. It concludes with a discussion of the politics of choice.
Discussing economics and applied philosophy, this book explores economic approaches to equity. Grants to local governments, income taxation and health care are considered in relation to equity and the changes in economic welfare measured.
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