Equality of what in health? Distinguishing between outcome egalitarianism and gain egalitarianism

When deciding how to weigh benefits to different groups, standard economic models assume that people focus on the final distribution of utility, health or whatever. Thus, an egalitarian is assumed to be egalitarian in the outcome space. But what about egalitarianism in the gains space, such that people focus instead on how equally benefits are distributed? This paper reports on a study in which members of the public were asked to rank a number of health programmes that differed in the distribution of benefits and final outcomes in ways that enabled us to distinguish between different types of egalitarianism. The results suggest that outcome egalitarianism dominates, particularly for differences in health by social class, but a sizeable minority of respondents appear to be gain egalitarians, especially when the health differences are by sex. These results have important implications for how we think about outcome-based social welfare functions in economics

Justice, Claims and Prioritarianism: Room for Desert?

Does individual desert matter for distributive justice? Is it relevant, for purposes of justice, that the pattern of distribution of justice’s “currency” (be it well-being, resources, preference-satisfaction, capabilities, or something else) is aligned in one or another way with the pattern of individual desert? This paper examines the nexus between desert and distributive justice through the lens of individual claims. The concept of claims (specifically “claims across outcomes”) is a fruitful way to flesh out the content of distributive justice so as to be grounded in the separateness of persons. A claim is a relation between a person and a pair of outcomes. If someone is better off in one outcome than a second, she has a claim in favor of the first. If she is equally well off in the two outcomes, she has a null claim between the two. In turn, whether one outcome is more just than a second depends upon the pattern of claims between them. In prior work, I have elaborated the concept of claims across outcomes, and have used it to provide a unified defense of the Pareto and Pigou-Dalton axioms. Adding some further, plausible, axioms, we arrive at prioritarianism. Here, I consider the possibility of desert-modulated claims—whereby the strength of an individual’s claim between two outcomes is determined not only by her well-being levels in the two outcomes, and her well-being difference between them, but also by her desert. This generalization of the notion of claims suggests a new axiom of justice: Priority for the More Deserving, requiring that, as between two individuals at the same well-being level, a given increment in well-being be allocated to the more deserving one. If individual desert is intrapersonally fixed, this new axiom, together with a desert-modulated version of the Pigou-Dalton principle, and the Pareto axioms, yields a desert-modulated prioritarian account of distributive justice. Trouble arises, however, if an individual’s desert level can be different in different outcomes. In this case of intrapersonally variable desert, Priority for the More Deserving can conflict with the Pareto axioms (both Pareto indifference and strong Pareto). This conflict, I believe, is sufficient reason to abandon the proposal to make claim strength a function of individual desert on top of well-being levels and differences. If distributive justice is truly sensitive to each individual’s separate perspective—if the justice ranking of outcomes is built up from the totality of individual rankings—we should embrace the Pareto axioms as axioms of justice and reject Priority for the More Deserving. In short: desert-modulated prioritarianism is a nonstarter. Rawls was right to sever distributive justice from desert

Characterizing Welfare-egalitarian Mechanisms with Solidarity When Valuations are Private Information

In the problem of assigning indivisible goods and monetary transfers, we characterize welfare-egalitarian mechanisms (that are decision-efficient and incentive compatible) with an axiom of solidarity under preference changes and a fair ranking axiom of order preservation. This result is in line with characterizations of egalitarian rules with solidarity in other economic models. We also show that we can replace order-preservation with egalitarian-equivalence or no-envy (on the subadditive domain) and still characterize the welfare-egalitarian class. We show that, in the model we consider, the welfare-egalitarian mechanisms appear to be the best candidates to satisfy several different fairness and solidarity requirements as well as generating bounded deficits.egalitarianism, solidarity, order preservation, egalitarian-equivalence, no-envy, distributive justice, NIMBY problems, imposition of tasks, allocation of indivisible (public) goods and money, the Groves mechanisms, strategy-proofness

Experiments in Distributive Justice and Their Limits

Mark Pennington argues political systems should be decentralized in order to facilitate experimental learning about distributive justice. Pointing out the problems with Pennington's Hayekian formulation, I reframe his argument as an extension of the Millian idea of 'experiments in living.' However, the experimental case for decentralization is limited in several ways. Even if decentralization improves our knowledge about justice, it impedes the actual implementation of all conceptions of justice other than libertarianism. I conclude by arguing for the compatibility of egalitarian redistribution with the epistemic virtues of markets pointed out by Hayek

Marc Fleurbaey: Fairness, Responsibility, and Welfare

Rawls, Fairness, Responsibility, Welfare, egalitarianism / luck egalitarianism, distributive justice, compensation principle, neutrality principle, envy

In the Shadow of a Myth: Bargaining for Same-Sex Divorce

This Article explores a relatively new phenomenon in family law: same-sex divorce. The Article\u27s central claim is that parties to the first wave of same-sex divorces are not effectively bargaining against the backdrop of legal dissolution rules that would govern in the absence of an agreement. In other words, to use Robert Mnookin and Lewis Kornhauser\u27s terminology, they are not bargaining in the shadow of the law. Instead, the Article argues, many same-sex couples today bargain in the shadow of a myth that same-sex couples are egalitarian—that there are no vulnerable parties or power differentials in same-sex divorce. The Article shows how a myth of egalitarianism undermines current bargaining for same-sex divorce. First, the myth leads to what the Article calls “divorce exceptionalism,” that is, when a party claims that existing marriage dissolution rules do not apply in same-sex divorce because they were designed to remedy the nonegalitarian conditions of different-sex marriages. Divorce exceptionalism disables effective bargaining because without default legal rules there is nothing to guide the bargaining process. Second, the myth of egalitarianism eliminates key bargaining chips: under a presumption of formal equality neither party really has anything to “give” or “get” in the bargain for divorce. Finally, the myth, combined with the general fog of uncertainty regarding how courts will treat same-sex divorces, may lead to increased strategic behavior. The Article proposes a realistic solution, arguing that the legal actors who participate in same-sex divorce, including lawyers, mediators, courts, and the parties themselves, should reject divorce exceptionalism and apply ordinary divorce rules. It also proposes to protect vulnerable parties by extending to same-sex divorce the current trend toward joint-custody presumptions. The myth of egalitarianism in same-sex couples, which was quite helpful in achieving marriage equality, is now haunting the first wave of same-sex divorces and harming vulnerable parties. It is time to let it go and address the reality of same-sex relationships

Taking Risks Behind the Veil of Ignorance

A natural view in distributive ethics is that everyone's interests matter, but the interests of the relatively worse off matter more than the interests of the relatively better off. I provide a new argument for this view. The argument takes as its starting point the proposal, due to Harsanyi and Rawls, that facts about distributive ethics are discerned from individual preferences in the "original position." I draw on recent work in decision theory, along with an intuitive principle about risk-taking, to derive the view

The social welfare function and individual responsibility: Some theoretical issues and empirical evidence from health

The literature on income distribution has attempted to quantitatively analyse different degrees of inequality using a social welfare function (SWF) approach. However, it has largely ignored the source of such inequalities, and has thus failed to consider different degrees of inequity. The literature on egalitarianism has addressed issues of equity, largely in relation to individual responsibility. This paper brings these two literatures together by introducing the concept of individual responsibility into the SWF approach. The results from an empirical study of people’s preferences in relation to the distribution of health benefits are presented to illustrate how the parameter values in such a SWF might be determined

Justice and Public Health

This chapter discusses how justice applies to public health. It begins by outlining three different metrics employed in discussions of justice: resources, capabilities, and welfare. It then discusses different accounts of justice in distribution, reviewing utilitarianism, egalitarianism, prioritarianism, and sufficientarianism, as well as desert-based theories, and applies these distributive approaches to public health examples. Next, it examines the interplay between distributive justice and individual rights, such as religious rights, property rights, and rights against discrimination, by discussing examples such as mandatory treatment and screening. The chapter also examines the nexus between public health and debates concerning whose interests matter to justice (the “scope of justice”), including global justice, intergenerational justice, and environmental justice, as well as debates concerning whether justice applies to individual choices or only to institutional structures (the “site of justice”). The chapter closes with a discussion of strategies, including deliberative and aggregative democracy, for adjudicating disagreements about justice

Feminism, agency and objectivity

In this article I defend the capability approach by focusing on its built-in gender-sensitivity and on its concern with comprehensive outcomes and informationally-rich evaluation of well-being, two elements of Sen's work that are too rarely put together. I then try to show what the capability approach would have to gain by focusing on trans-positional objectivity (as Elizabeth Anderson does) and by leaving behind the narrow confines of states in favor of a more cosmopolitan stance. These preliminary discussions are followed by two more precise applications. At first, I show how a gender-sensitive capability approach that respects the criteria of trans-positional objectivity and cosmopolitanism can enhance the agency of women inhabiting third-world societies. I turn next to show how mainstream feminism can insulate itself against criticisms such as bell hooks' by switching to trans-positional objectivity in public reasoning