NSW Cervical Screening Program scientific director Gerry Wain said the decision was "staggeringly disappointing". "There's no dispute that Gardasil works so for the Government to knock it back on the basis that it's just going to cost too much seems so amazing," Dr Wain said. "They clearly don't value the lives and health of Australian women, especially young, poor women who can't afford to buy it but need it most."
Of course, funding the vaccine isn't the only -- or even the best* -- way to respect those values. Compare two potential solutions to this problem: (1) reduce the market price of this particular good, or (2) increase the purchasing power of the buyers. (Why not give the $460 to each individual and let her decide what to do with it?)
The latter type of solution is not even considered! But really, not being able to afford a fancy new vaccine is the least of poor people's worries. Rather than slapping on a bandaid, why don't we actually do something to alleviate poverty, say by introducing an unconditional basic income? That would do a hell of a lot more to show respect for the value of these people's lives.
The fundamental issue here concerns distributive justice: is it fair that poor people get fewer opportunities in life? Should we redistribute wealth in order to help them? If so, then go ahead and do so (and then they can buy the vaccine themselves). If not, then presumably publicly funded healthcare is wrong for all the same reasons. Either way, this policy debate is a cop-out, and a distraction from the real issues. We ought to have a real public debate about valuing "the lives and health" of the poor. This particular instance of federal funding is a proxy issue that doesn't really settle anything.
Aside: it's a familiar libertarian refrain that "liberals think the government knows how to spend your money better than you do." But we should distinguish government spending from redistribution. We can -- and arguably should -- support the latter without the former.
* = (One issue I've neglected here is that vaccination is arguably a public good, which benefits others besides the receiver by preventing the spread of infections. This could justify subsidizing the goods rather than boosting people's purchasing power. But then this is an argument from market failure, rather than the values that Dr Wain half-heartedly appeals to.)
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I notice that in this consumer society I can live at a standard equal to a person on a higher income for much less money. As a result of there being a wide range of goods with various prices and no major difference in actual quality and the potential to allocate money amongst these things.
ReplyDeleteOne could argue on a "universal income sort of basis that those other people should be paid a higher income than me (and in general those who spend more money to get the same thing) because while their monetary income would be the same that would only be a trivial sort of equality.
Also from a futurist point of view - I think while the govt cannot out-guess the market in many areas at present in the future it probably will be able to in almost all areas (due to the massive increase in computing power and modeling). At some point the sum of the actions of 6 billion people will be no match for the (eventually, maybe around 2040 or so, in theory) vastly greater computing power of the world's biggest computer.
Some egalitarians might favour payments to be made conditional on one's inability to use those resources effectively. But the result isn't an Unconditional Basic Income, by definition. And of course I'm no egalitarian...
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