Health insurance coverage for incarcerated citizens is generally acceptable by Western standards. However, it creates internal tensions with the prevailing justifications for public healthcare. In particular, a conceptualization of medical care as a source of autonomy enhancement does not align with the decreased autonomy of incarceration and the needs-based conceptualization of medical care in cases of imprisonment; and rejecting responsibility as a criterion for assigning medical care conflicts with the use of responsibility as a criterion for assigning punishment. The recent introduction of sofosbuvir in Germany provides a particularly instructive illustration of such tensions. It requires searching for a refined reflective equilibrium regarding the scope, limits, and justifications of publicly guaranteed care.
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DOI 10.1017/s0963180120000596
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References found in this work BETA

Justice, Health, and Healthcare.Norman Daniels - 2001 - American Journal of Bioethics 1 (2):2 – 16.
XI.—The Ascription of Responsibility and Rights.H. L. A. Hart - 1949 - Proceedings of the Aristotelian Society 49 (1):171-194.
The Ascription of Responsibility and Rithts.H. L. A. Hart - 1949 - Proceedings of the Aristotelian Society 49:171.

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