Justice

What are the arguments for and against a universal health care system?

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It's a really big question, and I'm not going to pretend to offer an adequate answer. It's hard to argue with the idea that it would be a good thing if everyone had decent health care. That said, not everyone thinks that it's legitimate for the State to try to bring it about. (I don't share this view, but that's an aside, not an argument.) But suppose, for argument's sake, that we agree: it's fitting for the State to step in and help ensure that everyone is covered. We can still ask what the most effective way to get close to that goal actually is, and here we run into questions of fact. Perhaps some variation on, say, the Canadian system is the best way to go. Perhaps some largely market-based scheme, with subsidies and/or credits for the less well-off will produce the best result. Or perhaps some innovative market/State solution is what's called for. These are questions that philosophical thinking can't settle by itself. Insofar as they're part of the "arguments for and against," they'll call for the expertise of economists, political scientists, health care professionals and a lot of other people with various kinds of empirical knowledge.

I bring this up partly because I come from a country with a State-run health system (Canada) but I now live in one where the market mostly rules (USA). People with an ideological commitment to free-markets often assume far ahead of the evidence that a government-run system can't work well. People who think that what we actually have in the USA works badly for too many people may have unrealistically rosy beliefs about what it's like in countries with State-run systems. My first suggestion would be for everyone to put slogans like "socialized medicine" or "G*d d*mned HMOs" aside (I know you very sensibly didn't offer any such rhetoric) and ask hard questions about what will actually work.

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