progressivism, individualism, and the public ... - Telmarc Group
progressivism, individualism, and the public ... - Telmarc Group
progressivism, individualism, and the public ... - Telmarc Group
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The <strong>Telmarc</strong> <strong>Group</strong><br />
PROGRESSIVISM, INDIVIDUALISM, AND THE PUBLIC<br />
INTELLECTUAL<br />
individuals in <strong>the</strong> society. This approach to Contractarianism is one related to individuals<br />
in a non-bargaining environment establishing between <strong>and</strong> amongst <strong>the</strong>mselves a<br />
“contract” to govern <strong>the</strong>ir society.<br />
There are two elements contained herein. The first is <strong>the</strong> essence of a contract, <strong>and</strong> in fact<br />
a form of social contract between <strong>the</strong> members of society <strong>and</strong> amongst <strong>the</strong>m as a whole.<br />
The second element is that of a view towards man as a constrained <strong>and</strong> unconstrained<br />
view of human nature. The unconstrained view states that man, individually <strong>and</strong> in<br />
concert, has <strong>the</strong> capabilities of feeling o<strong>the</strong>r people’s needs as more important than his<br />
own, <strong>and</strong> <strong>the</strong>refore we all act impartially, even when <strong>the</strong> individuals own interest are at<br />
stake. The constrained view is to make <strong>the</strong> best of <strong>the</strong> possibilities which exist within <strong>the</strong><br />
constraint.<br />
For example, <strong>the</strong> constrained view of health care is one which would state that if it costs a<br />
certain amount to provide <strong>the</strong> service, an <strong>the</strong>re is a portion of <strong>the</strong> society not able to<br />
purchase <strong>the</strong> service, <strong>the</strong>n <strong>the</strong>re is no overriding need to provide it if such a provision is<br />
uneconomical <strong>and</strong> places a significant burden on <strong>the</strong> o<strong>the</strong>r member of society. The<br />
unconstrained view, as a form of socialism, states that if <strong>the</strong>re is <strong>the</strong> least of us in want<br />
for whatever <strong>the</strong> telecommunications revolution has in store, <strong>the</strong>n <strong>the</strong>y should have<br />
access to it at whatever cost. One can see that <strong>the</strong> current trend in Health care is such an<br />
unconstrained view.<br />
Rawls approach to this contract is one wherein <strong>the</strong> individuals in <strong>the</strong> society collect<br />
<strong>the</strong>mselves as individuals, <strong>and</strong> agree to a plan for <strong>the</strong> operations of that society.<br />
First Principle of Justice: each person shall have equal rights <strong>and</strong> access to <strong>the</strong> greatest<br />
set of equal fundamental personal liberties.<br />
Second Principle of Justice: social <strong>and</strong> economic inequalities are to be arranged so that<br />
<strong>the</strong>y both, (i) provide <strong>the</strong> greatest benefit to <strong>the</strong> least advantaged., <strong>and</strong> (ii) attached to<br />
positions available to each individual under conditions of fair equality of opportunity.<br />
Now let us see how this may be <strong>and</strong> is being applied to health care.<br />
In <strong>the</strong> recent paper entitled Principles for allocation of scarce medical interventions, by<br />
Govind Persad, Alan Wer<strong>the</strong>imer, <strong>and</strong> Ezekiel J Emanuel (Rham Emanuel's bro<strong>the</strong>r <strong>and</strong><br />
health care advisor to <strong>the</strong> current President) <strong>the</strong> authors, all apparently Government<br />
employees develop a suggested plan to ration health care. They state:<br />
"Principles must be ordered lexically: less important principles should come into play<br />
only when more important ones are fulfilled. Rawls himself agreed that lexical priority<br />
was inappropriate when distributing specific resources in society, though appropriate for<br />
ordering <strong>the</strong> principles of basic social justice that shape <strong>the</strong> distribution of basic rights,<br />
opportunities, <strong>and</strong> income. As an alternative, balancing priority to <strong>the</strong> worst-off against<br />
maximizing benefits has won wide support in discussions of allocative local justice. As<br />
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