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University of California - San Diego
Culture, Art, & Technology
Gerald Doppelt

1. Libertarian Perspective (Sade)Against Universal Healthcare a. Are all men, women, and children entitled to receive a certain basic level of healthcare, independently of their ability to pay for it as individuals on the market? Does our society have a moral duty and obligation to provide all men and women with a means of good health? b. Sade believes that healthcare is not entitled, and there is no moral duty on the part of society and the government. Regards healthcare as a commodity that some people on a competitive market produce in which the provider decides what will be charged, and of which consumers will purchase. He believes the right distribution of healthcare is the natural distribution that arise from the market. i. The market distribution is the one that maximizes individual liberty and freedom. c. The idea that there is a right to healthcare is: i. Logically absurd 1. The very concept of a right makes a right a freedom of action, a freedom from other people interfering with the right (same as Thompson). Thus, a right is not an entitlement to have anything provided for us. 2. He claims that the right to healthcare is a contradiction of terms, in that the definition of “right” and “healthcare” are illogical. 3. There is no sense of a right to healthcare in terms of an entitlement, but in terms of a right to BUY healthcare, which is a freedom of action in the libertarian perspective. 4. However, the concept of a right does not seem to exclude an entitlement (E.G. the right to education, which is provided by the government to all children for free.) 5. With healthcare, is it more like public education, where everyone has a right to a certain level of it (supports, the moral duty to provide) or is it like a commodity (a car, vacation, or home) that can be distributed by the market? 6. E.G. The distribution of emergency care is taken for granted in many societies. In our society, there is a right in terms of an entitlement to emergency healthcare. ii. Medically impossible 1. Health itself can’t be distributed because health is a function of genetic inheritance, lifestyle choices, etc. Sure, you can’t guarantee that everybody is as healthy as everybody else, but the debate is not over a right to health, but a right to entitlement to a minimum amount of healthcare. iii. Morally indefensible 1. The idea that there is a right to healthcare in terms of a duty of a society to provide is morally indefensible because all basic rights should be identified as liberties (freedoms of interference). 2. The more regulation on the part of the government, the less individual liberty. When you make money, you should be able to decide what you do with your money. Does the government have the right to tax the people? Yes, because even in the most libertarian form of governments, sacrifices and laws must be made in order to enforce the rights. An entire legal framework is made to protect one’s rights. a. In the libertarian concept, the state should only have one job to protect the rights of society. However, once states involve themselves and regulate healthcare distribution, it is wrong to do so. It is an unlawful redistribution of property (money) because it attacks our individual liberty of property. 2. The difference between Kitcher and Saad is the difference between the rights defended, autonomy and liberty. a. Kitcher’s argument to autonomy does not negate individual liberty, but is often outmatched by other values like autonomy, which requires certain services (healthcare) independent of the ability to pay. b. Saad, like other libertarians, focus outright on the sole concept of the libertarian right, in that governments cannot redistribute healthcare in the expense of attacking the people’s right to property (money) c. E.G. Abusiness owner should have the right to control who is hired and promoted. i. If you do that, you are violating the law, according to Saad, in that it violates the civil rights act. That says, as an employer, you are not entitled to discrimination. 3. Weinstein and Stason a. The right distribution to healthcare is the most efficient, based on cost-benefit analysis, whatever distribution maximizes the benefits per capita. How much money do we spend per capita on healthcare, and what are the benefits? This is the economic standpoint, where they bring in terms of longevity, and breakdown health in terms of benefits. i. The numerification of our healthcare in our country allows us to easily compare our healthcare to that of other countries’. ii. Many different names, such as rational theory, systems theory, etc. b. Weinstein brings up the problem of efficiency and maximizing benefit for what we pay, and completely ignores values and rights that Kitcher and Sade discuss. c. E.G. The condition of hypertension is a national problem, producing disabling events. This can cause decrease productivity, and is absorbed in expensive he
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