Graduation Year

Fall 2012

Document Type

Open Access Senior Thesis

Degree Name

Bachelor of Arts


Philosophy, Politics, and Economics (PPE)

Reader 1

Paul Hurley

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Rights Information

© 2012 Sarah R. Robinson


Despite already having the most expensive healthcare system in the world, the U.S. is facing rapidly rising costs, a growing population not covered by health insurance, and outcomes that are no better, and frequently worse, than those seen in the majority of developed nations with universal healthcare. Popular justifications of keeping the state out of healthcare appeal to protecting individual liberty; those who assert that there is a universal right to healthcare usually fail to address this claim. This paper describes the kinds of obligations in healthcare that are consistent with, if not demanded by, theories of justice that emphasize liberty. I give three different perspectives on liberty, and compare their relationship with healthcare obligations. First, I examine a plausible account of liberty, based on the condition of equal freedom, given by Immanuel Kant and Arthur Ripstein, and show how this account necessitates a system of universal public healthcare. Second, I grant the specifically libertarian approach to liberty through inviolable self-ownership, which seeks to limit the abilities of the state – using a reasonable interpretation of the Lockean proviso, as given by left-libertarians such as Peter Vallentyne, Hillel Steiner, and Michael Otsuka, this approach undoubtedly brings about increased equality in a society, which would have positive implications for healthcare access. Third, I grant furthermore the right-libertarian limited reading of the proviso, and demonstrate that even with Robert Nozick’s unhindered rules for property ownership, right-libertarianism properly understood obligates the state to act in many important aspects of healthcare.