UNIVERSAL HEALTH CARE AND ENFORCED BENEFICENCE

Abstract

I examine Allen Buchanan’s arguments for enforced beneficence and express a number of worries concerning his attempt to justify coercive distributive policies that guarantee (basic) health care services for all citizens. The central objection questions whether, given Buchanan’s own stipulation of universallyinstantiated attitudes of moral beneficence amongst all society members, his arguments from, first, the coordination problem and, second, the assurance problem successfully establish a justification of enforced contribution. I defend alternative, non-coercive, responses to the aforementioned problems and show that a particular kind of institution (an “information service”) provides all citizens with the sufficient and reliable epistemic resources so that they can effectively help the sick and needy. I notice that Buchanan’s difficulties with justifying coercion can be regarded as providing indirect support for the view that developing a justice-based conception of moral health care rights remains, pace Buchanan, an important task to be completed.