SlateStarCodex has a blockbuster post (with a follow-up highlighting comments) on the topic. I posted the following comment:

What’s missing in these comments is the historical religious context of our educational and healthcare systems. In the Christian West, care for the sick and education of youth were traditionally under the purview of the Church and family. Thus, our hospitals generally had “Presbyterian” or “Jewish” in their names, or otherwise were named after some Catholic saint. Children went to either explicitly parochial schools, or to public schools which were essentially generic Protestant Christian, a legacy of our nerdy Puritan forebears.

This system was dismantled in America over the last century. In America this dismantling was mostly unintentional, while in Bismarck’s Germany this was an intentional front in the Kulturkampf (“culture war”). Instead, the now post-Christian West relies on the market and the state. In America, the replacement generally takes the form of a hybrid between the two, either as a “nonprofit” or a publicly-funded private corporation. This monstrous hybrid is the result of an unwitting collaboration between conservative liberals and progressive liberals. This basic story has repeated itself throughout all aspects of our secularizing society, but the shift has been most drastic in healthcare and education. To quote Patrick Deneen, “Both the left and the right effectively enact a pincer movement in which local associations and groups are engulfed by an expanding state and by the market, each moving toward singularity in each realm: one state and one market.”

The miserable results we are witnessing in healthcare and education should make us question whether this shift was justified. While the market and the state are sufficient for ensuring animal welfare, they are by their nature insufficient for the education and care of human beings. The education system must necessarily involve itself with instilling moral values in future generations. The instilling of moral values in future citizens and voters, besides being needed to maintain order in the classroom, is a primary justification for public education funding and truancy laws. (Vocational training for future units in the labor force is of course another purpose of our schools, but we rely on schools for much more than this.) This task is essentially a religious one, and so both the amoral market and ostensibly religiously-neutral state are poorly suited to it. Our public schools’ failures in English and mathematics betray deeper failures in moral education, especially among inner city schools where classroom order is precarious at best.

The healthcare system must also necessarily make decisions requiring moral calculus, in order to utilize scarce resources while honoring human dignity. For example, our society is at ease putting down pets with terminal illness, both to minimize their pain and our expenses. In contrast, most of us believe that human life, even if filled with pain and suffering, may be worth prolonging, even at taxpayers’ expense. This belief is fundamentally religious, following our moral intuitions that human life has value and meaningfulness beyond one’s ability to experience pleasure and avoid pain. Because our healthcare system’s basic task is to operationalize this religious belief, its objective cannot be implemented optimally by institutions that are blind to religious terms in any utility function. And because our current healthcare system lacks the language to discuss thorny moral issues, it limits itself to purely financial considerations (the market) or to political considerations (majority vote + lobbyists), both of which are deeply problematic.

The market and the state are not only unable to recognize the religious ends of healthcare and education, but also the religious means by which they ought to be provided. Teaching and healing are both labors of love, because they are directed at human persons who are worthy of love. These jobs are thus utterly unlike teaching computers via machine learning or fixing engines at the car shop. While most individual teachers, school counselors, nurses, and doctors are certainly motivated by love for those under their care, this is not enough. The entities they work for must also be institutionally bound by love. This is however very difficult for our impersonal corporate and state bureaucracies. Corporate bureaucracies are driven by shareholder profit, while state bureaucracies are driven by aversion to change and accountability. The empathic gap between those who deliver education and healthcare and those in charge of administration leads to frustration among the former. Well-administered schools and hospitals must have love-oriented administrators and administrative systems. Love necessarily depends upon a sense of binding. This sense of binding is nothing other than religion, derived from the Latin religare, which means “to bind fast.”