Public Welfare as a Public Power

When talking about public health, Ripstein writes the following: "The state's mandate to protect public health follows from its mandate to see to its own preservation.” (261) The state’s provision of national defense and public health “are required to sustain a rightful condition.” (260) If this is the basis for whether or not a government should provide a service, should public welfare not be included?

Taking cues from Jacksón and Kyla’s posts, the abundance of roads means very little without the means of using them – if you don’t have a car and can’t afford the bus, the worth of liberty provided by the roads is limited to the pace of your gait. Other “public powers” provided by the government, such as the hospitals that are essential to public health, are similarly out of reach because if you can’t afford a car or the bus, you likely can’t afford the monthly payment on an insurance plan, much less the deductible on an ambulance ride. In this situation, you are likely to be reliant on whatever private charity exists (free clinics and a means to get there). Thus, you are still at the whims of someone else, and therefore not free.

The point of the extrapolation of the example here is that without the means to take advantage of the public powers provided by the government, I would imagine that many would feel significantly disenfranchised. Therefore, shouldn’t public welfare count as a public power? The least well-off in this scenario, if they are enough in number (and I would imagine they would be, since the system makes no attempt to correct for inheritance), would be a threat to destabilizing the system. So, “to see to its own preservation,” shouldn’t the government adopt the difference principle and fair equality of opportunity? Or at the very least, free buses and hospitals?