by Mario Rizzo
The healthcare debate is bringing out some interesting ideas. Consider what the philosopher Peter Singer (Princeton) had to say in the New York Times:
“The death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities. We can accommodate that difference by calculating the number of life-years saved, rather than simply the number of lives saved. If a teenager can be expected to live another 70 years, saving her life counts as a gain of 70 life-years, whereas if a person of 85 can be expected to live another 5 years, then saving the 85-year-old will count as a gain of only 5 life-years. That suggests that saving one teenager is equivalent to saving 14 85-year-olds. These are, of course, generic teenagers and generic 85-year-olds. It’s easy to say, “What if the teenager is a violent criminal and the 85-year-old is still working productively?” But just as emergency rooms should leave criminal justice to the courts and treat assailants and victims alike, so decisions about the allocation of health care resources should be kept separate from judgments about the moral character or social value of individuals.”
If the provision of and payment for healthcare were purely a matter of government policy then ideas like this might make sense.
However, having a unique hierarchy of values (aka “priorities”) is a feature of primitive tribes and comprehensive social planning. In a liberal society or “catallaxy” there are fundamental abstract rules (property, free contract, etc.) within which individuals and organizations of civil society establish their own priorities. I blogged on this general idea in a post, “The Unity of the People.”
Contrast what F.A. Hayek had to say about ideas of the kind Singer is promoting:
“…the conception of a ‘value to society’ is sometimes carelessly used even by economists… there is strictly speaking no such thing and the expression implies [a] sort of anthropomorphism or personification of society…Services can have value only to particular people (or an organization), and any particular service will have very different values for different members of society. To regard them differently is to treat society not as a spontaneous order of free men but as an organization whose members are all made to serve a single hierarchy of ends (Law, Legislation and Liberty, vol. 2., p.75).
“A free society is a pluralistic society without a common hierarchy of particular ends.” (Id., 109).
I have been fascinated for a long time by the advocacy of left-liberals of pluralism in the realm of ideas, but not in the realm of action. They seem to think of freedom as a matter of pure intellect alone. In my view, acting and thinking are two-sides of the same coin. We are not pure intellect. If we were, we wouldn’t care about healthcare.