Bad Luck vs. Bad Design

I think you (and Ms. McArdle) are on to something here. This is a cultural issue of a completely different kind than the culture wars. The political scientist Daniel Elazer (http://www.jcpa.org/djeindex.htm) has argued there are three political cultures in the US: traditionalist, moralistic, and individualistic. Although they intermingle throughout the country, the first is predominately in the South, the second in New England and the Upper Midwest, and the third in the West, the Heartland (MO through OH), and Mid-Atlantic (although it also finds plenty of adherence in the South and elsewhere. The moralistic political culture sees politics as a (the?) proper arena for addressing the common good and good governance issues are very important to it. People from this political culture are more likely to see the problems that arise from government actions as temporary and fixable (rather than inherent bugs in the system), and thus less problematic.

Huh?

MM, did you even read the piece, or did you paste in some boilerplate? Topic is not whether single payer is better or not, but rather whether it is a greater injustice if someone doesn’t have the ability to pay for something they want, versus they are actively denied something they want because it has been determined that it doesn’t fit cost benefit analysis.

Nor is McArdle making the question up — the question arises based on her ongoing debates with several thoughtful progressive bloggers who are themselves in favor of health care reform. If you’d like to follow that laudable example by engaging in rational discussion, do feel free.

It would be nice, MM, if you gave Ms. McArdle and/or Darwin the courtesy of reading the post before saying stuff like “X is a libertarian, and libertarians are idealogues who reject Catholic Social Teaching; ergo, I don’t need to respond to anything they write.”

If, as your rantings writings suggest, you cannot appreciate the idea that people have good faith differences of opinion about how to best achieve the common good – and that these differences of opinion can be based on legitimate moral intuitions – then there is little reason to take your arguments from ignorance seriously. Thus far, you haven’t even commented on the subject of the post, or even written anything that suggests an awareness of what the post was about.

I have little sympathy for libertarians in general, but I think the post raises an interesting question, even if I would frame it differently. I think it’s more accurate to describe the first system as a situation in which the people and their elected representatives have decided that the state will not intervene to help people, and the result will be that the poor are systematically disadvantaged. I think that may be acceptable for home insurance, where risks are relatively low, but unacceptable for a basic right like health care. In the second situation, the people and their elective representatives have evaluated the relevant trade-offs and have made some attempt to prevent the burden from falling simply on those who are already less fortunate. Both are deliberate decisions about the role of the state; neither is purely impersonal. I favor the second situation over the first, simply because I think it better reflects the preferential option for the poor. I don’t deny, though, that there are good reasons to be skeptical of the model of the benevolent bureaucrat; there are trade-offs here as in every contested area of public policy (that’s why they are contested).

While I’m not sure if there’s any point in attempting to spoon feed debate to someone, I’m mildly curious as to the result:

MM,

Would you see any difference in morality and/or justice between these two situations:

1) I am unable to afford medical coverage which would have provided unlimited chemo treatments in the event of pancreatic cancer, and so when I come down with it, I get several of the standard treatments that often work (but don’t in my case) but am not able to get a very expensive, experimental treatment which had a 5% chance of helping me.

2) A centralized government authority in a single payer country determines that cancer treatments with less than a 5% chance of success should never be funded period.

My guess is that you’d see no difference between these two situations, since I’d guess you’d take an “outcome based morality” approach to the situation and say that it really doesn’t matter why someone was denied, they result is the same.

However, I think for many people there would be a significant perceived difference between the two situations (though this might not be the case if the person had not realized that their insurance didn’t cover certain types of very expensive care — thus giving them a similar sense to the government situation.)