Kevin, MD links to a lively debate between Graham and Panda, now joined by California Medicine Man and Medskool, about the merits and meaning of social justice. Graham believes that Panda doesn’t understand the concept, so he offers the following:

Social justice, as I understand, is about equality. Distributing shared, scarce public resources as equitably as possible.

But that explanation highlights the problem with making policy based on such a diaphanous concept. As a matter of practical reality, absolute equality is impossible to achieve among human beings. Some people have natural advantages. Some people are smarter, taller, better looking (ad infinitum) than others.

So, facing the impossibility of achieving absolute equality, you have to settle for material equality. Since the Constitution already renders us (more or less) equal under the law, that leaves us with the “scarce public resources” to which Graham refers. But what consitutes a “public” resource?

Single-payer advocates would have us believe that health care is a “public” resource. That’s what they mean when they say people have a “right” to it. But, this particular resource is comprised of the labor of physicians and other providers of care.

So, in order for health care to be “distributed,” it first has to be taken from the people who “own” the labor. And, if a physician’s labor is “distributed” against his will in ways that he doesn’t choose himself, his “equality” under the law has been violated. He is, in fact, a slave.

This is just one example of how the pursuit of “social justice” can (and will) go off the rails. Such conflicts between equality under the law and equitable distribution of resources are inevitable when the people defining “equality” are different from the people who own the resources.

If you really want “social justice” and “equality,” the invisible (unbiased and impossible to bribe)  hand of the free market is a better bet.


In her comments on this topic, Nurse K links to a Thomas Sowell piece that succinctly explains why “social justice” is so problematic as a policy goal. Here’s the money quote.

Lofty talk about “social justice” or “fairness” boils down to greatly expanded powers for politicians, since those pretty words have no concrete definition. They are a blank check for creating disparities in power that dwarf disparities in income–and are far more dangerous.



More interesting commentary on social justice from Robert Center and James Gaulte. And Nurse K has some additional thoughts.

Comments 5

  1. Marc Brown wrote:

    You keep going round the same track. The debate comes down to those who see healthcare as a vital public service and those who don’t.

    As for ‘the invisible (unbiased and impossible to bribe) hand of the free market’ – what planet are you living on? Planet Enron, where market traders have reinvented the laws of nature in a never-never land? I know pantomime is seasonal but you’re not Peter Pan.

    Posted 07 Jan 2008 at 7:11 am
  2. drmatt wrote:

    If you really want “social justice? and “equality,? the invisible (unbiased and impossible to bribe) hand of the free market is a better bet.

    Your joking right? never have more people in the history of the world been killed accept in the name of profit, which is what drives “free market” you have to be kidding, or you absolutely haven’t the faintest clue of what social justice is. Free market is about distributing rescources to the largest number of people who can afford it, this doesnt even deserve to be in the same sentence as justice.

    As far as taking the labor of the doctors, they dont have to work here, they dont have to become doctors, here are some other examples; military, fire, police, politicians, school teachers, tax collectors, space explorers, etc. etc. etc.

    Posted 07 Jan 2008 at 7:31 am
  3. Catron wrote:

    Marc,drmatt—I notice that your responses have one thing in common (beyond the tired and irrelevant Lefty memes): neither addresses (in any serious way) a single substantive point made in my post. Très intéressant, non?

    Posted 07 Jan 2008 at 7:59 am
  4. Nurse K wrote:

    Social justice is a very broad term with no particular meaning, and only the political left would even put it in the same idea as health care.

    Here is everything you’ll ever need to know about what Nurse K thinks about “social justice.”

    Posted 07 Jan 2008 at 11:13 am
  5. Matt Horn wrote:

    Perhaps one should read “Theory of Moral Sentiments” before one dismisses it?

    Posted 07 Jan 2008 at 6:40 pm

Trackbacks & Pingbacks 2

  1. From Trusted.MD Network on 07 Jan 2008 at 10:10 am

    Retainer Medicine,Social Justice and the importance of framing the debate…

    In the not too distant past, but well before the current generation of medical students and house officers were born, a person might go to a physician with some medical problem and be charged for the medical services and then pay for the service eithe…

  2. From Trusted.MD Network on 19 Apr 2010 at 1:52 pm

    Social Justice and the Framing of the Healthcare Debate about fairness and individual freedom…

    Two years ago, I published a blog commentary about what I now call the”social justice revolution” in medicine. I wrote about about what-not too long ago-was a simple two person transaction between physician and patient and some aspects of the path ta…

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