There are two discourses that are used in connection with the provision of good healthcare: a rights discourse and a beneficial design discourse. Although the logical force of these two discourses overlaps, they have distinct and incompatible implications for practical reasoning about health policy. The language of rights can be interpreted as the ground of a well-designed healthcare system stressing the values of equality and inclusion, but it has less application when dealing with questions of cost-effectiveness. This difference reflects the (...) distinction between the deontological status of rights claims and a teleological approach presupposed in the language of beneficial design. However, the value of the separateness of persons contained in the discourse of rights can impose constraints on the adoption of a simple maximizing principle when thinking about the allocation of healthcare resources within a social contract for health. Throughout these issues are discussed by reference to the work of Peter Jones. (shrink)
Is it possible to reconcile a classical liberal approach to economics with a concern for the environment? The contributors to Economics and the Environment: A Reconciliation contend that it is. But they fail to distinguish properly between classical liberalism and a widespread orthodoxy in environmental policy communities in Europe and North America to the effect that economic instruments for environmental policy need more serious attention than they have hitherto received. Once this orthodoxy is distinguished from classical liberalism, the latter is (...) seen to be implausible. In particular, the classical liberal approach fails to deal with the practical and administrative problems involved in enforcing private property rights solutions to problems of environmental protection, wrongly generalizes from the failures of U.S. environmental policy to the failure of public regulation as such, and fails to take into account the claim that nature should be accorded intrinsic value. (shrink)