Opportunity and Health Care: Criticisms and Suggestions

Abstract

orman Daniels' proposal to distribute health care on the basis of fair equality of opportunity, is, in this writer's opinion, unworkable. His concepts of species-typical activity and normal opportunity range are unclear; so is the relationship between them. His view that justice accords disease a better claim on the health dollar than other causes of death, pain, and disability, commits him unknowingly to indefensible positions on particular sorts of health care, such as the care of the aging and of pregnant women. Daniels' concept of opportunity is so inclusive, his notion of balancing opportunities so vague, that his theory loses systematic power. I offer a different account from Daniels' concerning why health care needs are objective and of special importance. I also argue for a voucher system which levels out class inequalities and which finances current medical practices more or less uncritically, but allows for change through a diversity of insurance plans available to consumers. This system is just, and more practical than rating health care needs by impact on opportunity.

Priority Setting from the Lens of Justice in Existing Health Care Industry of Pakistan

“…In addition Norman Daniels also supports Rawlsian principle that proposes the distribution of health care facilities on the basis of fair equality of opportunity [8]. Moreover Bilal has only head injury and has more chances of survival compared to Raza so we can assume that Bilal can live a full life so maximizing principle is also in favor of giving priority to him [9].…”

Fair Equality of Opportunity Critically Reexamined: The Family and the Sustainability of Health Care Systems

“…Daniels for his part located the support of health care with the support of fair equality of opportunity (Daniels, 1981). Others, however, recognizing the major moral, financial, and policy difficulties involved in attempting to ensure equality in access to health care or the realization of equality of opportunity through health care, placed health care within the difference principle, so that inequalities in access to health care would be morally acceptable if they redounded to the benefit of the least-well-off class (Stern, 1983). In the cases of regarding health care as integral to liberty as well as integral to the pursuit of fair equality of opportunity, the view taken was that, just as social-democratic states should not tolerate inequalities in basic civil liberties or in fair equality of opportunity, equality in the provision of health care would need to be achieved.…”

Just health: replies and further thoughts

“…Schramme has company here, for others13 14 have long ago also challenged my focus on opportunity to the exclusion of other reasons for thinking health is important, and I have replied that for purposes of justice, the relation between health and opportunity is central (pp49–50),9 though other values, such as beneficence or compassion, may come into play in cases where opportunity cannot be an issue. My concern here is Schramme’s argument for his claim.…”