Rawls and Locke on health care

The argument from the original position propounded by John Rawls is based on the idea of justice as the means of dealing out benefits to all individuals that are fair and unbiased (Rawls, 1999). This position approximates the equality of position that is ascribed to individuals in the United States Constitution by declaring that decisions should be made behind a cloud of ignorance. This ignorance removed from the individual knowledge about their class and predictions about their future place in society.

Therefore, without any concrete knowledge of where they will end up in society, unbiased decisions can be made concerning the benefits that should be distributed to each (1999). Since the original position, as a thought experiment, is applied only to such benefits that are considered basic needs of humans, this theory might be applied to governmental efforts at securing the welfare of its citizens.

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The distribution of “primary social goods” would be concerned with the way health care is offered to its citizens, and the theory developed by Rawls would be a very effective method of securing the health of these individuals. In guaranteeing a complete scheme of benefits regarding these primary social goods, the view that all persons are equal and therefore equally entitled to these benefits is of immense help in determining how the benefits are to be distributed. In the United States health care situation, this method would drive a more socialist system of health care (Rawls, 1999).

However, Rawls’ idea of the original position would take this equality further, in that it would allow the policy makers to be less biased in their attitude toward health care. It would remove barriers that many people now face in trying to secure good health care. This would be the case because those policy makers would not be certain of their place in society and consequently how easily they (as individuals within the state) would be able to purchase expensive policies.

Therefore, since they acknowledge the possibility that they might fall among the group of those who cannot afford their own health care, they would be more likely to institute policies that treat all persons equally and allow everyone to access the best health care regardless of the social class or position (Rawls, 1999). Rawls also goes further to describe justice as permitting economic inequalities only to the extent that those who are the least well off in a society are still able to claim the highest benefits possible.

Therefore, the capitalistic model of the United States society may be permitted according to Rawls’ view, but only on the condition that these primary social goods (such as health care) are freely granted to the poor despite their lack of financial means. According to this, the issue of money should be divorced from health care, and all hospitals, clinic and other medical centers taken care of by the state. The only criterion that should be considered when it comes to the decision of granting the best quality health care to an individual is the presence of an illness.

In such a case, no one need be concerned that their social status prevents them from being seen by a specialist or being granted an expensive medical operation that will save their lives. Rawls’ view places the burden of responsibility for the health of an individual squarely upon the shoulders of the United States government (Rawls, 1999). The Lockean concept differs from the view point granted by Rawls, as his idea of social justice appeals to the state of nature theory of the social contract (Locke, 2004).

The civil society established in the Lockean view point grants to the government only limited powers and in which citizens are entitled to property. This entitlement to property is the area in which the Lockean view has the potential to be in opposition to heath care granted freely to all. The pursuit of property implies that hard work goes into the gaining of wealth, and those who have done this work are likely to consider themselves entitled to the benefits that such wealth can purchase.

An extension of this idea is that such persons are also likely tacitly to consider themselves more entitled to what their wealth can buy than those persons who may also have worked hard but who have accrued less wealth (2004). In applying this concept to the distribution of health care, it becomes clear that the Lockean concept that derives from the state-of-nature view point seeks a health care system that responds to the inequalities of wealth that exist within the United States.

Such as health care system offer the best care to those who are most able to pay for it, and marginalizes the poor because of their inability to afford health care. In fact, Locke’s view of the states as having limited powers ensures that it is unable to interfere in the affairs of individuals regarding their property. In his own words, no state has the power arbitrarily to “dispose of the estates of the subjects” (Locke, 2004, p. 48). Therefore, in a Lockean state, no universal health care could be guaranteed and equality would be very difficult to achieve.

The government would have no power to compel health care facilities to offer its services to all, as it would have no method of compensating the personnel and ensuring the continued operation of the facility. The reason for this is that the Lockean perspective grants the government no power to levy taxes, as that would amount to disposing of individuals’ estates without their permission. All persons’ health would be left up to their ability to pay for treatment, and this describes a health care system that is similar to the one now in existence in the United States.