Monday, 15 October 2012

The Utilitarian Cost of Free Healthcare

Oregon Health Plan is state funded healthcare, and with euthanasia legal in the state, the local government are finding interesting ways of cutting from the budget in this time of financial crisis.

The OHP no longer covers medication that slows the growth of cancer, but they do offer euthanasia in its place. The reason: price. 

If you've ever learned about the five transplant patients of any other thought experiment that tried to test the claims of utilitarianism against our moral intuitions, you might have heard them be described as 'exaggerations', or 'extreme examples', but the reality of State funded healthcare, such as the OHP, or the NHS, is they do operate on some, occasionally quite distributing, utilitarian principles. They have to. As Dr Walter Shaffer of Oregon put it, "We can't do everything for everyone." There are always more patients than resources and choices have to be made. Value judgements have to be made about what helps the greatest number, and indeed what makes the greatest number happy (after all, why help a cancer patient that has low chance if you can help a cancer patient that has a high chance?)

In the UK euthanasia isn't yet legal, but there are back-door euthanasia programs like the Liverpool Care Pathway, an NHS program where those who are 'dying' can have their medication, food and water withdrawn, hastening the process of death. Professor Patrick Pullicino recently came forward with information about thousands of elderly patients killed on the NHS prematurely every year because they've been diagnosed as terminal.  Why are the elderly picked on? Well, even if they aren't actually dying, they soon will be, right? Why waste resources?

Most good people turn up their nose at the five transplant patients. To treat life as non-sacred for the benefit of others is a disguising idea. Even if the 'others' are a larger and preferable group. Yet in real life, are we OK with a bit of utilitarianism or what?

While a Libertarian, and some conservatives, would happily argue that there are private healthcare options that'd solve this problem, it's the supporters of State healthcare that strike up my curiosity. Is this the cost they happily pay for free health care for all most? 


  1. I've enjoyed your posts so far, but for this I don't see the problem.

    Our public resources can't provide everything for everyone. We can't fund PHDs to all students, but we can reasonably afford basic education for all, like wise we can't afford expensive or rare treatments that only help a few but we can afford basic (cost effective) health care for all.

    If you get a rare form of cancer and you happen to be rich, great spend your money privately; it’s perhaps a fare reward for the contributions you may have made for society.

    But if you have curable conditions with no insurance or money in a purely private system, that is the death sentence you seem so horrified by.

    1. thank you for reading. :)

      that precisely is the problem. its a system which carries with it death sentances just from the flaws in that system. this is made all the worse for two reasons a) the system is generally believed to be better than it is/its flaws have not been elucidated for most and b) there are legitimate alternatives to consider, which would not be flawed in this way.

      I think one can make the argument that lots of people dying, or even less, should be avoided without needing to consider rights or entitlements.