Preface

Summary

This book is about justice in the design of a health-care system. The term ‘health care’ is used broadly to include personal medical services, preventive medical and public health measures, including health and safety regulation, and certain social support services for the chronically ill or disabled. So a health-care system involves a diverse set of institutions which have a major impact on the level and distribution of our welfare. A theory of justice articulates the general principles which should govern this system. It is not merely a catalog of its features we think in advance to be just. To find such principles of justice for health care we must address questions such as these:

What kind of a social good is health care? What are its functions and do these make it different from other commodities?

Are there social obligations to provide health care?

What inequalities in its distribution are morally acceptable?

What limits do provider autonomy and individual liberties of physicians or patients place on the just distribution of health care?

A theory of justice for health care is not just the fare of philosophers and political theorists. It concerns us all. Quite simply, distributive justice concerns who ought to get what. How our health-care institutions distribute various goods and services has a direct bearing on our welfare, and all of us take an interest in comparing how well off we are with how well off we ought to be.