Medical Need, Equality, and Uncertainty

Bioethics 30 (8):588-596 (2016)

L. Chad Horne
Franklin and Marshall College
Many hold that distributing healthcare according to medical need is a requirement of equality. Most egalitarians believe, however, that people ought to be equal on the whole, by some overall measure of well-being or life-prospects; it would be a massive coincidence if distributing healthcare according to medical need turned out to be an effective way of promoting equality overall. I argue that distributing healthcare according to medical need is important for reducing individuals' uncertainty surrounding their future medical needs. In other words, distributing healthcare according to medical need is a natural feature of healthcare insurance; it is about indemnity, not equality.
Keywords healthcare  distributive justice  health insurance  medical need  equality  political philosophy  medical necessity
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DOI 10.1111/bioe.12257
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