Questions 1-6: From Chapter Introduction

1. The chapter introduction includes a host of statistics. Is there one that you found surprising? If so, why? If not, why not?

2. Of the three major theories of justicelibertarian, utilitarian, and egalitarianwhich one(s) might possibly endorse a healthcare system that includes some citizen rights to healthcare, and which one(s) would not endorse a right to healthcare?

3. Why is it more demanding upon a society if everyone has apositive right to healthcare? (Frame your answer in moral, not economic, terms. In other words, what is the feature of a right (especially a positive right) that makes it stronger than other moral claims?Hint: Think correlativity)

4. Give definitions of 'microallocation' and 'macroallocation.'

5. Explain the QALY criterion for healthcare rationing. Do you think it is morally justified? Why or why not?

6. Give a concrete example (real or fictional) of a situation in which the 'social value' of one person over another ought to be taken into account in deciding allocation of a scarce resource.(if you, personally, do not believe this should ever occur, then take the perspective of someone else who could plausibly make this argument.)

Questions 7-9: From Jason Brennan Lectures on Rawls and Nozick:

7. What does Rawls say against the argument that some people deserve more than others because they work harder?

8. What is it about being behind the 'veil of ignorance' in the 'original position' that Rawls thought would lead us to choose principles of justice that would allow economic inequality only if they maximize the wellbeing of the least advantaged group?

9. You can answer this question with a simple yes or no: According to Professor Brennan, does Nozick think that the inequality we are actually experiencing in the U.S. economy justified by entitlement theory?

Questions 10-15: From Daniels article, Engelhardt article, and my Lecture:

10. Daniels explains the Libertarian complaint that the right to health care would make a 'bottomless pit" of medical needs (p. 738). How does Daniel's proposal for a right to health care that is 'system-relative' and limited in scope purport to meet this Libertarian worry?

11. Explain what it means to say that some medical services have a 'high opportunity cost'? Give an example of an opportunity cost in this context. (Discussed in my lecture at 28:00 and textbook, p. 742.)

12. Explain why, in the context of Daniels' conception of a system-relative right to health care, infertility would not be covered in the basic tier of entitlements.

13. Engelhardt maintains that it is impossible to provide the best possible health care for all and contain health care costs. Do you think Daniels is claiming that these two policy goals (as stated by Engelhardt) can be met within a tiered system-relative set of entitlements?

14. With respect to establishing a single-tier healthcare system, Engelhardt makes the libertarian claim that the redistribution of private resources (in order to fund the system) is coercive. Explain that argument. In other words, why do libertarians think that redistribution is coercive?

15. Daniels and Engelhardt make two opposing claims about 'the natural lottery.' Daniels gives a Rawlsian argument, according to which many of the health misfortunes of life suffered by some people are undeserved and a fair-minded society has a duty to help restore their health. Engelhardt claims that the misfortunes of life are not 'unfair' and they can impose no duty on another person to help the unfortunate. People with such competing views seem to be at an impasse. So, let's try something else. Some would say that perhaps 'fairness' and 'entitlement' are not the best standards for measuring how the problem of access to healthcare is to be solved. Suggest a different way of framing the problem that invokes a different moral principle(s), or a solution that does not rely on a discussion of rights.

Bonus question:

Recall the topic on confidentiality and the Tarasoff case. In Professor Robertson's lecture he talked about the 'line-drawing problem' between morality and the law. So, for example, utilitarianism morally requires us to choose those actions that bring about the greatest overall net good. But the law does not require this kind of individual responsibility (the legal principle of nonfeasance). Instead, legislation comes up with policies that promote the good (and are implemented through taxation and redistribution), which take the affirmative duty off of individuals to be responsible for the evils of the world. Explain how this applies to the problem of allocation of healthcare resources.