If He Refuses to Buy Health Insurance, Should we "Let Him Die"?
Or: Dworkin and Ron Paul
I've been jousting with some web liberals off and on about the "let him die!" outburst at the recent Republican debate. Of course the enthusiasm for needless death was appalling...but some Dems have been breathlessly going on about how barbaric it is to let people who can't afford insurance to suffer without adequate care. That, of course, is an entirely different point. I don't know what to say about the case of voluntary non-insurance...but I do know that it's worth thinking about...and that the answer is not obvious. This has provoked anger from some of my liberal interlocutors...but today Julian Sanchez notes that Ronald Dworkin seems to conclude something similar. I frequently get told that I'm "not really a liberal" (as if that were a horrific judgment to live with); nobody can say that about Dworkin.
Or: Dworkin and Ron Paul
I've been jousting with some web liberals off and on about the "let him die!" outburst at the recent Republican debate. Of course the enthusiasm for needless death was appalling...but some Dems have been breathlessly going on about how barbaric it is to let people who can't afford insurance to suffer without adequate care. That, of course, is an entirely different point. I don't know what to say about the case of voluntary non-insurance...but I do know that it's worth thinking about...and that the answer is not obvious. This has provoked anger from some of my liberal interlocutors...but today Julian Sanchez notes that Ronald Dworkin seems to conclude something similar. I frequently get told that I'm "not really a liberal" (as if that were a horrific judgment to live with); nobody can say that about Dworkin.
posted by Winston Smith at
8:40 PM
3 Comments:
Winston,
If you're saying that the moral reasoning is not absurd on its face, I agree with you. And I further agree that Blitzer's question as it was posed included the conditions that the man was of sufficient means and health beforehand to purchase insurance.
The problem with comparison to Dworkin is that the real-world conditions in which we're making policy bear so little resemblance to his required conditions for let-him-die justice that Ron Paul's position and Dworkin's have only a superficial resemblance. Several of the commenters at Sanchez's site point this out.
It bears a striking resemblance to the contention that hypothetical ticking time bomb scenarios are appropriate criteria around which to construct torture laws.
As you have stated repeatedly, and correctly IMO, extreme cases are useful for philosophical discussion and perhaps as moral bounding exercises. But they're a lousy way to make law.
Also, consider this further difficulty in the case at hand: in each case of seeking treatment, not only would a provider have to confirm whether or not the person had insurance, but if not, whether they had made a good faith effort given their financial circumstances and pre-existing conditions. How the hell could they determine that? And what would the criteria be? And who gets to decide what those criteria are?
So while the Ron Pauls of the world can make cogent cases from a strictly hypothetical point of view, their attempts to argue policy on that basis seem to me to be an attempt to shoehorn messy real-world scenarios into a narrow, fetishistic obsession with individualism.
Wolf Blitzer actually happened to give Paul the paradigmatic case for his ideology. And the fact that that is the most plausible case for Paul's ideology doesn't make it generalizable to our real-world situation, which is what policy-making is all about.
I think I agree with everything you say here LC.
But, as you note, thinking about abstract, highly-rarified thought experiments can give us touchstones for answering questions...and, I'd say, for making policy.
I don't want to draw any clear policy conclusions from any of this...just some abstract principle like: there has to be some point at which the government ceases to try to save us from our own stupidity.
Indeed. Although determining that point is the hard part.
I'm reminded of your post a month or two ago about the illegality of suicide. I actually found it convincing and I think it changed my mind on the issue.
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