As with the Aff, I see many possible avenues of argument for the Neg and this article will explore a few of them. As I mentioned previously, there are plenty of critical arguments to be made as well and hopefully I will find time to run through these in more depth in a future post. In this article, I would like to explore some conventional but hopefully compelling arguments which address, what I expect to be contrary to many Aff positions.
There is no right to health care
The basic rights define personal spheres of action, within which one is free to act without interference from others. They include rights to life, liberty, and property. The obligations they impose are negative: to refrain from violating the rights of others. Because they are metanormative and provide no guidance to ethical behavior, they can impose no positive obligations toward others. Positive obligations do exist, but only insofar as they are created by voluntary agreements made within moral territories. In the health care field, this means that there can be no rights to health services other than those attaching to voluntary agreements or contracts. There can be no right to health because health is a personal responsibility and cannot, even in principle, be provided by others.11 Legal systems that attempt to guarantee health services to some, many, or all at the expense of others, as was true of the Clintons' and most of the other health system reform proposals in 1993-1994, violate basic rights in imposing predetermined hierarchies of values on unconsenting others.
Government can not mandate UHC without coercion.
To examine the morality of the proposed health reform we must ask the following questions: What is the role of government and what are its moral bounds? Also, how do these bounds apply to the current health-care reform debate? If, in this examination, it is discovered that government has no proper authority to insure the availability of goods and services generally, then all health- care reform proposals seeking to establish the provision of health insurance should be rejected.
The uncritical acceptance of the proposition that a major purpose of government is to insure the provision of some goods or services is related to another popularly held proposition. That notion, either conscious or unconscious, is that government can miraculously generate resources to provide for people’s needs. But, how is that possible? Can government actually create material prosperity where none existed beforehand? Can it cause by fiat an increase in the number and kinds of products produced without harm? It should be self-evident that the answer to these questions is no.
Government cannot create by mandate. It relies on its power of taxation and coercion to provide material benefits to selected citizens. In order for it to provide some benefit for an individual it must impose a cost of equal or greater value either on that individual or on someone else. Nevertheless, the mythical concept that government can provide cost-free benefits continues largely on the basis of wishful thinking and covetousness.
Federally mandated UHC undermines federalism
In modern, less black and white issues such as universal health care, the federal government's attempt to induce (or coerce, in the Court's opinion) uniform legislation is essentially assimilating various ethical, political and social views into one homogenized approach to each of those topics. And of course, these national definitions are determined by the current majority and prevailing views of the times. John Calhoun, the greatest proponent of ante-bellum state sovereignty, wrote extensively on the perils of the tyranny of the majority, and saw individual state sovereignty as a way to ensure that Americans of all differing beliefs had a state in which their views prevailed.
UHC does not solve
Contrary to claims that government-imposed “universal health care” would solve America’s health care problems, it would in fact destroy American medicine and countless lives along with it. The goal of “universal health care” (a euphemism for socialized medicine) is both immoral and impractical; it violates the rights of businessmen, doctors, and patients to act on their own judgment—which, in turn, throttles their ability to produce, administer, or purchase the goods and services in question. To show this, we will first examine the nature and history of government involvement in health insurance and medicine. Then we will consider attempts in other countries and various U.S. states to solve these problems through further government programs. Finally, we will show that the only viable long-term solution to the problems in question is to convert to a fully free market in health care and health insurance.
Some Philosophical PositionsAt the heart of a philosophical framework for the Neg can be an examination of some of the ideas behind the welfare-state, caring for the needy and more importantly distributive justice, which deals with principles of a kind of egalitarianism. Recall Rawl's veil of ignorance in which resources are distributed so as to favor the least fortunate. The idealistic principles of distributive justice, while just in providing resources in accordance with situation, does not adequately address the inequalities which arise from personal choice. Certainly, unless the United States implemented a totalitarian approach to UHC, people will have the option to choose not to avail themselves of the care or they may choose a life-style that is detrimental to their own well-being. These choices could one day force them to seek the services they could have had all along and possibly avoided the need for expensive intervention (surgeries, expensive treatment regimes, etc).
Theories of redistributive justice are unfair because they do not account for personal responsibility.
Consider a simple stylized example. Smith and Jones have identical native talents and equally favorable childhood socialization experiences. Over the course of their lives, Smith chooses a life plan that gives her an expectation of a high level of income and other resources over the course of her life, whereas Jones chooses a life plan that gives her an expectation of a much lower resource level, which happens to place her among the Rawlsian worst-off class. The Rawlsian difference principle will recommend institutions such as a tax and transfer policy, which redistributes resources from a group that includes Smith to a group that includes Jones. But Jones has freely decided to pursue life goals that do not involve maximizing her resource holdings, either because given her values, prudence does not lead her to choose this form of maximization or because she chooses to pursue life goals other than those dictated by prudence (for example, she may choose to sacrifice her earnings prospects in favor of service to a worthy cause). In either case, the transfers recommended by the difference principle are unfair. The conclusion to be drawn from the discussion to this point is that neither the difference principle nor the canonical moment difference principle adequately incorporates responsiveness to individual responsibility in the theory of distributive justice.
Utilitarian redistribution of welfare favors the rich
..According to utilitarianism, you should allocate each unit of resource to the person who will get the most welfare from it. To allocate a unit of resource to someone who will get less additional welfare from it than someone else would have treats the former’s welfare as more important than the latter’s. Allocating each unit of resource to the person who gets the most welfare from it maximizes total welfare. In this way the non-favoritism ideal can motivate the aim to maximize welfare.
However, this way of thinking has unattractive implications concerning some unhealthy or disabled persons. Consider someone who is blind and, to be mobile, maintains a guide dog. Or someone who needs regular dialysis. It seems that many such persons would get less welfare from any given allocation of income than would someone bursting with health. A substantial part of a resource allocation to an unwell or disabled person may have to be spent raising her to a minimal level of welfare, which healthy persons take for granted: on buying food for the guiding dog, or on dialysis. If so, a healthy person will get more extra welfare from each additional unit of income allocated to her than would an unhealthy or disabled person. It seems that health usually generates welfare out of resources more efficiently than lack of health.
But utilitarianism treats health conditions, along with others, merely as means to more or less welfare. Thus the utilitarian aim, to allocate each unit of resource where it will produce the most welfare, will direct resources away from the unhealthy and disabled in favor of the healthy, to the extent the healthy are more efficient generators of welfare. As a result, the unhealthy and disabled achieve lower total levels of both resources and of welfare than do the healthy.
For more on Arguments and Values, click here
For links to other LD topics, click here
The Immorality of Government-Mandated Health Care
Paul A. Cleveland
November 1994, Volume: 44, Issue: 11
Sade RM. The moral foundations of health services reform: a critique of H.T.
Engelhardt, Jr. Reason Papers, No. 22, Fall 1997, 85-95
The Atlas Society
Is There a Right To Health Care
David Kelley, 1993
The End of Federal Coercion:
How the Supreme Court May Have Opened the Door for 21st-Century Federalism
July 16, 2012
Moral Health Care vs. “Universal Health Care”
The Objective Standard
Winter 2008-2009 Vol 2, No 4
Lin Zinser and Paul Hsieh
Rawls, Responsibility, and Distributive Justice
Hurley S. 2007. The ‘What’ and the ‘How’ of Distributive Justice and Health. In:
Holtug N, Lippert-Rasmussen K. Egalitarianism: New Essays on the Nature and
Value of Equality. Oxford University Press.
(Word doc can be found on the internet)
Responsibility and Distributive
Justice: An Introduction
Carl Knight and Zofia Stemplowska