Here in the Untied States, people have decided that the elderly are entitled to a modest level of retirement income and health care, and the young to an education, at public expense. Those who want the government to be “smaller” often argue that these services should be delivered in a different way, with the government financing the benefits but the private sector providing them. But they dare not overtly challenge the right to receive these universal entitlements, so universally popular are they with the American people. In other developed societies, those with “bigger” governments, additional human needs are also considered the responsibility of society as a whole, rather than of each individual person or family. In those societies, for example, virtually everyone receives government-funded health care, not just the elderly. One example is Canada, right next door. Government-funded housing is also more common in other places.
While the United States does not provide universal food, clothing, and health care via government programs, however, few Americans are willing to see people in their own communities starve for lack of food, freeze to death for lack of shelter, or die or become crippled by readily preventable diseases and easily treated injuries. The American compromise has been to assume that most non-elderly people will buy food, housing and health care for themselves, but for the government to provide for those who do not have the means to afford them. Means-tested benefits are thus a substitute for universal benefits, and a way to avoid deprivation at, theoretically, a lower public cost.