Health,Luck and Moral Fallacies of the Second Best |
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Authors: | Eric Cavallero |
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Institution: | (1) Southern Connecticut State University, New Haven, CT 06515, USA |
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Abstract: | Individuals who become ill as a result of personal lifestyle choices often shift the monetary costs of their healthcare needs
to the taxpaying public or to fellow members of a private insurance pool. Some argue that policies permitting such cost shifting
are unfair. Arguments for this view may seem to draw support from luck egalitarian accounts of distributive justice. This
essay argues that the luck egalitarian framework provides no such support. To allocate healthcare costs on the basis of personal
responsibility would arbitrarily and publicly burden socially detectable risk-takers while undetectable risk-takers continue
to get a free ride. That problem is unavoidable even on the assumption that distributive institutions outside the healthcare
sector are fully just. In actual, farfrom-just societies, imposing personal liability for the costs of voluntary risk taking
would be wrong for an additional reason. Doing so would tend to magnify existing distributive injustices. These conclusions
draw attention to two common ‘moral fallacies of the second best’ that can arise when applying ideal normative theory to matters
of institutional design and in real-world policy contexts. |
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