A luck egalitarian account of distributive justice in health care

Abstract

In this thesis I develop a Luck Egalitarian account of distributive justice in health care, broadly based on Ronald Dworkin’s broader theory of distributive justice. I contrast this account with other theories of distributive justice in health care. I argue that the alternative theories do not fare well in part because they cannot balance the intuition that we ought to spare no expense to aid someone if they need it with the contrasting intuition that people do not have to sacrifice all that they value to aid others. This leads these theories to either imply that we should commit all our resources to the provision of health care (the bottomless pit objection) or to argue that health care should not be publicly provided. In the process of developing this account I engage with several major criticisms of luck egalitarianism more generally and show how these criticisms can be overcome. In particular I engage with an intuitional dispute between the claim “that it is immoral to deny someone medical treatment on the grounds of cost” and that “on a societal level, health care prioritisation is necessary if we are to enjoy a life worth living, and maintaining this sort of life is morally acceptable”. I argue that Luck Egalitarianism provides us with the resources to resolve this dispute.