Enforced Beneficence How to Get Health Care

¶ … Veatch compares two principles of distributive justice as applied to health care, namely maximum principle and egalitarian principle. Describe briefly his characterizations of these principles. Which principle does he prefer for health care distribution and why?

Veatch (1994) characterizes these principles in terms of fairness, i.e. justice, and autonomy (p. 694), discovering between the two the differences inherent in their individual assessments of health care through the lens of the max-min principle and the egalitarian principle. The min-max principle rests on the maximum good (utilitarian) for the most people with the minimum negative consequences, while the egalitarian principle rests on the sense of all things and people being equal and therefore on the same footing and deserving of the same amount of care.

Veatch prefers this principle: "The principle of justice for health care could...be stated as follows: People have a right to needed health care to provide an opportunity for a level of health equal as far as possible to the health of other people." This is essentially the egalitarian principle because it is based on the need for equal rights under the protection and guarantee of the law.

Veatch prefers the egalitarian principle because he wants all to share equally in the costs and impact of the health care. He wants to see that health care should be for everyone and not just for a select few or those who can afford it. Thus the state should take over for how this health care is divided out among the people. Since not all the people can pay, the state has to intervene and make everything equal. This is the justice that Veatch talks about needing in the health care policy.

2.The claim that everyone is entitled to some minimal level of health is implausible according to Buchanan. Why? What does he mean by "enforced beneficence" as applied to health care? How does it work?

Buchanan talks about the principle of "enforced beneficence" when he describes that by taking money from the people in order that the state might then provide for the good of all is a matter of enforcing the good or the beneficence as it is called. Buchanan uses this idea as a way to support his argument for why it is implausible to expect that all should be entitled to some minimal level of health care: entitlements and rights are not the issue: the issue is morality and what is to be done for the good of people. Rights and entitlements are not where the problem is but they actually create the problem. In this sense, it is up to the authoritarian state to take away the rights of people from the discussion and make the discussion about what is the greater good -- individual rights or the beneficence of the whole. This is the relation between the two.