UNIVERSAL HEALTH CARE AND ENFORCED BENEFICENCE

Abstract

I examine Allen Buchanan’s arguments for enforced beneficence andexpress a number of worries concerning his attempt to justify coercive distributivepolicies that guarantee (basic) health care services for all citizens. The centralobjection questions whether, given Buchanan’s own stipulation of universallyinstantiatedattitudes of moral beneficence amongst all society members, hisarguments from, first, the coordination problem and, second, the assuranceproblem successfully establish a justification of enforced contribution. I defendalternative, non-coercive, responses to the aforementioned problems and show thata particular kind of institution (an “information service”) provides all citizens withthe sufficient and reliable epistemic resources so that they can effectively help thesick and needy. I notice that Buchanan’s difficulties with justifying coercion can beregarded as providing indirect support for the view that developing a justice-basedconception of moral health care rights remains, pace Buchanan, an important taskto be completed.