Tuesday, March 21, 2006

Single Payer, Justice and Rawls

Ever notice how the opponents of single payer health care all have health insurance? Not just any health insurance, either. Most of them have excellent health insurance, the $5 co-pay for your brain surgery health insurance. I suspect that this renders their opposition more than a bit cynical. After all, if your personal situation is not going to be improved by a change in health care financing, and may even be worsened, it is difficult to look objectively at the various proposals.

Health care is a justice issue. I don’t mean justice in the legal sense, but in the moral sense. How are we to distribute the benefits and burdens of society in a just manner? The benefits and burdens in this case being health vs. illness, access vs. no access, and paying for your own care vs. paying for someone else’s care. At the risk of mangling the philosophy of the greatest political philosopher of our time, John Rawls, I’d like to invoke his philosophy in the health care financing debate.

Rawls famously described the “original position” as the starting point for creating a just political system. In the original position, people do not know where they stand in society; they do not know their race, sex or religious preference; they do not know if they are rich or poor. It is only by starting from this “veiled” position that people can create a political system that fairly distributes the benefits and burdens of society. For example, if you do not know if you are Black, you are hardly likely to create laws that discriminate against African-Americans.

Similarly, the health care financing debate should start from an “original position”. What health care financing system would we create if we did not know whether we had health insurance or not. I daresay that opponents of single payer would be rethinking their opposition if they did not know if they were to learn that they were about to permanently lose their health insurance.


Blogger Flea said...


Your thoughts are interesting and provocative, though wrong at least wrt single-payer. Your other stuff is real good. I like it a lot!

Welcome to the blogosphere. I'm adding you to my blogroll.



4:50 PM  
Blogger Chris said...

I think I read in Matthew's blog that a liberal is a conservative who has been recently hospitalized!


5:35 PM  

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