Norman Daniels' proposal to distribute health care on the basis of fair equality of opportunity is, in this writer's opinion, unworkable. His concepts of species-typical activity and normal opportunity range are unclear; so is the relationship between them. His view that justice accords disease a better claim on the health dollar than other causes of death, pain and disability, commits him unknowingly to the indefensible positions on particular sorts of health issues, such as the care of the aging and of (...) pregnant women. Daniels' concept of opportunity is so inclusive, his notion of balancing opportunities so vague, that his theory loses systematic power. I offer a different account from Daniels' concerning why health care needs are objective and of special importance. I also argue for a voucher system which levels out class inequalities and which finances current medical practices more or less uncritically, but allows for change through a diversity of insurance plans available to consumers. This system is just, and more practical than rating health care needs by impact on opportunity. Keywords: justice, right to health care, equality, opportunity CiteULike Connotea Del.icio.us What's this? (shrink)

The narrator of the Notes is opposed to determinism, rationality, and socialism. He is also a severe neurotic. The solution to the neurosis, missed in personal life by the narrator, is love. But love also bears on the theoretical positions just discussed. For love is what the socialist programs lack (thinks Dostoevsky). And love is incompatible with a calculating attitude toward personal relations. Dostoevsky and his narrator, while making a telling case against the over-calculated life, mistakenly identify calculation with rationality. (...) Similarly, a manipulative strain in socialism is mistakenly taken to presuppose, And stem from, a belief in determinism. But Dostoevsky's true quarrel would appear to lie not with the deterministic tendency of socialist theory but with its tendency to ignore factors in human nature he thinks important. The narrator's personal disaster occurs through his belief in his incapacity to change his life. But, pace Dostoevsky, this does not show the harm of believing in determinism: it shows the danger of counting oneself out too soon. (shrink)