The main recurring question in the comments on the Separation of Health and State Debate: What do we owe the deserving sick?

Garett Harmon writes:

Specifically, I feel like you sort of sidestepped the issue of what to
do about people that require healthcare through no fault of their own.
I know that personal responsibility plays a big role, but I didn’t get
a clear idea of what you thought should happen to people who were born
with disabilities.

Josh K asks:

It seemed to me like the crux of the debate was whether or not we, as
wealthy able bodied people, have any moral obligation to those who are
less fortunate than ourselves. Do you think we have a duty to the
deserving poor? Why or why not?

Like David Balan (much to my surprise), I think that the distinction between the deserving and undeserving poor is important.  Forcing people to help the undeserving poor seems clearly wrong to me.  Forcing people to help the deserving poor is a harder case.

In the end, though, my attack on what I call the Family Analogy undermines any legally enforceable obligation to help strangers, regardless of how deserving they are.  If it should be legally permissible to turn your back on the parents who gave you life, then it should be legally permissible to turn your back on complete strangers, however awful and undeserved their plight.  It might be wrong to refuse to help, but you’re within your rights to do so.

Another way of thinking about it: If someone is sick and/or indigent due to their own irresponsible behavior, it’s fair to turn them down with, “I’m sorry you’re in trouble, but it’s really your own fault.”  If someone is sick and/or indigent despite exemplary behavior, it’s fair to turn them down with, “It’s terrible that you’re in trouble through no fault of your own.  But you’re not in trouble through any fault of mine, either.”

Nathan Goldschlag asks:

I asked a question to you Bryan, and I do not think I had
articulated my point or question well. I had asked about what social
safety net you may support, if any, and how you feel about the roll of

What I was really getting at was whether or not you believe in ANY
involuntary contribution via the use of force to support the destitute.
If not, do you believe that your view is in any way dependent upon
altruism filling the gap, and that many of the destitute will in the
end be taken care of by the voluntary contributions of the community?

Few moral principles can be known with complete certainty.  Whatever you think about involuntary charity, however, it’s got to be less justified as voluntary charity becomes more abundant.  Using coercion when there’s no other way to get the job done is less objectionable than using coercion when there are other ways to get the job done.

Nathan adds:

Do you subscribe to the idea that the welfare state crowds out private charity in a large way?

I do, but I’ve got to admit that private charity hasn’t done much to eliminate dire poverty in the Third World – and I can’t blame the largely non-existent international welfare state for the problem.  Private charity is a realistic substitute for our welfare state, but not a realistic solution for global poverty.