Health, Luck and Moral Fallacies of the Second Best

Journal of Ethics 15 (4):387-403 (2011)
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.
Keywords Egalitarianism  Health  Healthcare  Luck  Luck egalitaianism  Personal responsibility  Responsibility
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DOI 10.1007/s10892-011-9109-z
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References found in this work BETA
Health, Luck, and Justice.Shlomi Segall - 2009 - Princeton University Press.
Equality and Equal Opportunity for Welfare.Richard J. Arneson - 1989 - Philosophical Studies 56 (1):77 - 93.
What is Egalitarianism?Samuel Scheffler - 2003 - Philosophy and Public Affairs 31 (1):5–39.

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Coping with Doping.J. Angelo Corlett, Vincent Brown Jr & Kiersten Kirkland - 2013 - Journal of the Philosophy of Sport 40 (1):41-64.
Coping with Doping.J. Angelo Corlett, Vincent Brown Jr & Kiersten Kirkland - 2013 - Journal of the Philosophy of Sport 40 (1):41-64.

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