March 25, 2010

The Rawlsian Agreement for Health Care

I guess I haven't been drinking often enough to keep posting, but I thought I'd get back to it and try to give a few weekly words of attempted wisdom. One thing I have been doing lately is listening to a lot of The Skeptics Guide to the Universe , and I have become completely enamored with and recommend to everyone....or at least the few people who will read this. I mean where else can you find out about stories of somewhat reputable scientists saying that the universe is stopping the large hadron collider by it being sabotaged through time travel.

Now that I have plugged my favorite podcast, I guess I'll start my blog by creating the idea of the Rawlsian agreement. John Rawls came up with an idea that he thinks would be universally usable to create justice. I'm going to skip the rest of the importance parts of his theory of justice and concentrate on the two principles of justice as fairness, but if your interested you can find them here under the heading of number 4.These principles govern inequalities in a system and say that 1. For any inequality there has to be a fair an equal chance to obtain that inequality for everyone, what is call the fair equality of opportunity. 2. That any inequality be to the advantage of the 'least' members of society, the difference principle. Justice as fairness seems unfeasible at a social level, but I think it would work well for a setting up a system of health care.

      It may seem that this would only work with a public system but it doesn't mean I'm totally against a private option in some cases, all cases in fact, with the exception of cases where people would refuse to let someone ahead of them even if would be for the betterment of society, kind of a Rawlsian agreement for making things unequal. For example most people with a minor injury would let someone go ahead of them in the hospital line for 100 dollars or so, but no one would move back in the waiting list for a new heart or kidney for that amount of money. It might be argued that, that person may move back for 1 000 000 dollars, even if it did put them at a much greater risk of death or serious debilitation. That may be true the money may be too good to turn down, but I find that the 1 000 000 dollar situation would be unethical in a way that society in Canada at least agrees with. No one can pay 1 000 000 dollars to kill someone else, but they could pay 100 dollars to move ahead of them in line. I hope that example makes the idea consistent with societies ethics and understandable.

A whole medical system could be set up like this, made up with Rawlsian agreements with limits. This system would be two tiered, but set up for all the inequalities to be to the advantage to those in the second tier. I understand this would take a lot of work to set up, but it would end up being universal health care that was helped by the rich subsidizing the care for the poor, a real trickle down effect.

I'm interested in what people think of the Rawlsian agreement and what problems this system would have, hope to get some response with this and I'll try to continue to blog more often.

Thanks for reading,

The Moral Skeptic