Advanced Search

Is it immoral for a health insurance company to refuse to cover a person with a

Is it immoral for a health insurance company to refuse to cover a person with a pre-existing condition?

Timely! I'm inclined to tinker a bit with the question.

First, I think it's a scandal that in the USA, people with pre-existing conditions often can't get health insurance. Other developed countries have figured this out; it's about time the US caught up.

However, given the way the system works at present, we might get a fix on your issue by asking this. Suppose I'm in a position to set up a not-so-large company that provides health insurance, but I'm not willing to take on the risk of insuring people with certain pre-existing conditions; I'm worried that if I do, the company will be bankrupted and then won't be able to insure anyone. (I'm not saying this is actually the case for most big health insurance companies, but bear with me.) So long as I'm upfront and honest about what I'm offering, it's not clear that I do wrong by offering my more limited product. It's in the nature of private insurance schemes that the companies are in the business of risk management. Companies that don't make appropriate risk calculations in deciding what premiums to charge and whom to insure probably aren't going to last long and arguably aren't responsible businesses.

So far, then, the fact that a company won't offer policies to people with pre-existing conditions doesn't automatically make the company itself immoral. Note the word "automatically" here. I'm not suggesting this hypothetical scenarios is a good fit for typical big insurers. But to repeat what I said at the outset, there's something very wrong with the real-world situation: the US, the world's wealthiest nation, leaves large numbers of its citizens people in this awful situation.

It's worth adding: the very idea that the market is the best way to deal with health insurance is eminently questionable, as this essay by Nobel-Prize winner Paul Krugman points out. Where to place the blame and what we do about it is not easy to sort out, but if health care reform gets bogged down in the sort of mindlessness we've seen of late, then there will be a long list of villains whose names should live in infamy.

Should business/corporations give to charity? Or should they return the profits

Should business/corporations give to charity? Or should they return the profits to shareholders, and let them decide what to do with it?

In principle, the decisions made by corporate managers are, as a matter of contract and law, supposed to reflect and be answerable to the will of the shareholders. I can't think of any compelling reason to think that corporations should give to charity. But let's be clear what's at issue here. Is it nice when they do so? Of course it is. Those who benefit from that charity (or those charities) to which a corporation might donate are certainly benefited. Do corporations have responsibilities, as a result of the benefits they gain from society? Sure they do--that's why they either pay taxes or else make other agreements with cities, states, and nations that are supposed to exact a fair exchange of the goods that are enjoyed by the corporation and the goods returned back to the community. But I can't see how or why in addition to paying their fair share (in jobs, or taxes, or whatever) in exchange for receiving the goods they receive from society, they also have some responsibility to give to charity.

Let me put the point very simply. Suppose you hire me to manage your money. Then someone else notices that I have access to all your money, and tells me that I should use some of that money to support charity. Maybe that would be OK with you, but it is hard to see that just because I control the use of a certain amount of money, I should use it to support charity. My responsibility is to you (my shareholder)--the fact that I control your money does not add some other responsibility as to how I should use that money, above and beyond the terms of my contract with you (and all, obviously, subsumed under and regulated by the laws of the land).

Suppose Big Company Inc. supports a controversial Initiative X, endorsing the

Suppose Big Company Inc. supports a controversial Initiative X, endorsing the legislation and donating millions to PACs in favor of it. I, for one, hate Initiative X, and have taking personal action (eg. protests, letters to my senator) to try and kill it. Would I be justified to boycott Big Company's products, in order to spite them for supporting Initiative X? Most people seem to think that's okay, or even commendable. But let's turn the situation around. Suppose I apply for a job at Big Company. Although I am the most qualified candidate, Big Company has heard of my actions to undermine Initiative X. They decide not to hire me, in order to spite me for my political actions. In this case, I seem to have a good reason to get angry, or even sue. From a moral perspective, are these two situations different? Or is the supposed discrepancy simply a result of our tendency to empathize with the weak (me), as opposed to the strong (Big Company).

I am not sure that the company would be legally required to hire you under the circumstances you outline. In many jurisdictions it may well be able to argue that -- qualified though you may be -- you are less suitable than other candidates because you are less likely to be loyal to the company and hence likely to be less effective at promoting its business interests. Be this as it may, there is a clearer and cleaner example of your asymmetry: while you are free not to buy from the company, it is not free not to sell to you.

What's the moral rationale for this legal asymmetry? Strong versus weak may well have something to do with it -- and, relatedly, the fact that companies selling to individuals face millions of potential customers whereas individuals buying from companies may not have many to choose from (imagine you had protested against Microsoft and Gates then refused to license you to use Windows).

A further point is that companies are artificial agents created pursuant to constitutive rules laid down by the state. These rules are known in advance and those who do not want to create or purchase a company under such conditions can refrain. This element of voluntariness makes the burdens involved more acceptable. When you consider opening a business in the US, you know beforehand that you'll have to serve people whose skin color or religion differs from your own and you know beforehand that potential customers will be free to shop elsewhere even at higher prices. This element of voluntariness is absent in the case of individuals. Rosa Parks didn't decide to be born in the US on the understanding that businesses would be free not to serve her.

Another point is economic efficiency. It would be very costly for the legal system to ensure that individuals do not boycott businesses -- and it's very much less costly, by contrast, to enforce the rule that businesses must not refuse to serve willing customers. Conversely, permitting businesses to exclude potential customers is likely to be more costly to the economy (e.g., by forcing people to drive long distances to get served) than permitting customers to boycott businesses. (To be sure, much-disliked businesses may go under, but this is a large loss to their owners, not to the economy.)

In my work there are clear inequalities between colleagues for choosing the

In my work there are clear inequalities between colleagues for choosing the holidays period and for choosing morning or evening shift. The more senior a worker is the more privileges he has. Let’s suppose that one of the senior workers decides voluntarily to give some of his privileges to another worker even though other senior workers probably will not do the same. Should the junior worker feel and express gratitude for this action? Or, as the decision could be considered as a matter of justice and more equality, it is what everybody should do, and so gratitude is not necessary, and the senior worker should not be expecting gratitude.

One relevant factor here is whether the seniority privileges you describe are unjust. If they are long-standing rules fairly administered, then they may not be. Unlike privileges based on race or gender or religion, such seniority privileges do treat everyone equally over time. Everyone is disadvantaged early in her/his tenure on the job, and everyone has an equal opportunity to be advantaged later on (but what about those who die early?). If the privileges are morally defensible in this way, then gratitude is appropriate when a more senior worker waives a privilege for the benefit of a more junior one.

Now suppose that, for some reason, the seniority system is not morally defensible after all. Even in this case a senior worker may not be morally obliged to waive her/his privileges. After all, s/he is not responsible for the flaws of the system, and s/he is also not a net beneficiary of these flaws (having presumably gone through many years of disadvantage early in her/his tenure). Once again, then, if s/he waives a privilege for the benefit of a more junior worker, gratitude would be an appropriate response.

Gratitude would not be called for (in the way you suggest) only if the system is morally flawed and the more senior person who waives a privilege for a more junior one either has contributed to the design or perpetuation of the flawed system or has been a net beneficiary from its flaws.

Here's my challenge for those who think we have the right to sell our bodies (i

Here's my challenge for those who think we have the right to sell our bodies (i.e. prostitution): Suppose Travis, a hardworking businessman who is too busy to have a romantic relationship, calls Elise, a prostitute he finds on Craigslist. Elise tells him that she would love to service him, but he'll have to wire the money in advance (she's been taken advantage of too many times). Travis complies, and the two agree to meet next Thursday night. That night Elise thinks about her career and has a change of heart. When Thursday rolls around, she comes to Travis's house and explains that she cannot go through with the act. She offers to refund the money, but Travis refuses. Travis, you see, has already invested more than the money. For one, he set aside a night for Elise that will be wasted if she leaves. And he's already accepted some risk to his reputation by contacting Elise. More importantly, Elise agreed to a contract, and contracts are not reversible on the whims of a single party. If Elise had sold...

I'm having a bit of trouble finding the argument here. Let's take a "transaction" that most of us think is just fine: accepting a proposal of marriage. If Pat agrees to marry Robin and then gets cold feet, Robin can't force the issue. But what of it?

Or take another example: I agree to buy your house. I sign the contract. And then I back out. In most jurisdictions, far as I know, you can't sue me for specific performance; you can't force me to buy the house, though there are various damages that you would be entitled to recover from me.

As things stand in most places, a contract for an act of prostitution isn't enforceable, and so Travis has no legal claim against Elise -- particularly if she gives back the money. But suppose that these sorts contracts were legal, since your issue is presumably with people who think they should be. In that case, there's still no reason to think that Travis has some sort of right to rape Elise, though depending on the legal regime, he might have a civil claim against her that would allow him to recover monetary damages.

In fact, there's a strong whiff of red herring here. All of us agree that some kinds of consensual arrangements are legitimate, and the law recognizes a good many. That means we'll always face the question of what someone is entitled to if the other party reneges on a legitimate agreement. The answer will depend on the case. It might be nothing at all; not all private agreements amount to enforceable contracts. It may be that some sort of monetary damages are in order. It might be, depending on the case, that requiring the original agreement to be kept is the remedy. It all depends. But the fact that people sometimes go back on consensual agreements tells us nothing at all about whether private acts between consenting individuals should always be permitted. In particular, someone who thinks prostitution should be legal doesn't need to be committed to the bizarre view that a prostitute who has a change of mind should be required to submit to rape.

I work in a fairly large organization where each year staff are given the

I work in a fairly large organization where each year staff are given the opportunity to nominate a colleague for a "staff achievement award". A member of staff in my office is a good candidate for nomination but no-one wants to nominate her (or anyone else) because another member of staff, who doesn't deserve nomination, desperately wants to be nominated - so to avoid an unpleasant situation the staff are not nominating anyone. I don't agree with awards such as this - not just because they cause pain to those who will not be nominated and are unfair anyway because people who do not deserve nomination will be nominated - but because I do not think that anyone deserves an award for a job well done or for being a considerate co-worker or for being exceptional in anyway. Entering competitions in order to win an award is a different matter. What is your opinion?

This sort of case is the best example of a reason why organizations should be very leery of any system of recognition or reward that has the consequence of making its members feel they are subject to invidious comparisons.

Even so, I do think that special effort and special merit also deserves special recognition. A system of nominations is supposed to bring attention to the most deserving cases, and if this system operates properly, then credit goes where credit is due. But, to be perhaps a bit too blunt, it sounds to me as if your co-workers are actually doing your best to make sure this system will not work effectively or fairly, by refusing to take part in it. By refusing to nominate your colleague, you do what is in your power to deny them the recognition they deserve. How can that be right? Instead you and your other co-workers are going to sit idly by and watch someone undeserving get that recognition, because you are unwilling to allow the system to work as it should!

Now I suspect that things have gotten to this point because you and your co-workers suspect that even if you did make an appropriate nomination, the wrong person would be rewarded. So this is a kind of passive resistance to a system you regard as unfair. If that's what's going on, then perhaps a more appropriate response would be for some representative of those who think like this to go (privately and discretely!) to whoever it is who is responsible for making these decisions, explaining to that person why there is so much reluctance to make nominations this year.

Anyway, I really think that the best way to make sure the most deserving candidate gets the appropriate recognition is to nominate that person, and have your co-workers do the same. The one who doesn't deserve it should not win by default, and might learn much of value by being denied the credit they crave. So for heaven's sake don't continue to sit on your hands. If something is broke, fix it!

We can think of a monetary system without banknotes or coins, where people would

We can think of a monetary system without banknotes or coins, where people would only have their money in banks, using it with credit cards and the like. Of course, there would be nothing in banks except for information on the amount of money each person would have. Now, I think that in this system there would exist nothing of which we could say "That is one euro" or "one dollar" (or whatever). But still it would be true that some people would have, say, one million dollars. My question is: if there is nothing which is one dollar, how can somebody have one dollar or a million dollars?

If having a dollar means having some thing or other, then no one could have a dollar if there weren't any. But bits of language of the sort "have a ___" often don't call for filling the blank with the name of a thing. If someone has a cold, or an idea or a worry or a lot of work to do, there isn't some thing they're carrying around in their nose or their head or have stored in their office.

Unlike colds and good times, dollars once were bits of stuff and mostly still are -- at least in one sense. But having a dollar has never been simply a matter of having a bit of paper. What makes the piece of paper a dollar is that the person who has it has a certain amount of economic power, so to speak (which, by the way is another example of "having" something that's not a thing.) Money is already a lot more abstract than the creased bits of cash in your wallet let on. And so in the cashless economy you're imagining, that's what having a dollar or a euro or a million such would amount to: having what we're calling, rather crudely, a certain amount of economic power; having the capacity to acquire goods, services, whatnot with a certain value.

And as you in effect point out, we're already quite comfortable with this idea. If you're anything like me, most of your financial transactions these days consist of swiping debit cards, filling in online forms and signing on various dotted lines. Most of my available cash exists only in abstract form. When I get paid, it's by way of an electronic transaction between my university and my bank. I don't even get paper notifications anymore.

Of course, somehow this doesn't stop me from ending up with pointless pocketfuls of pennies, which I'm told are worth more these days as copper than as cash!

One of my favorite rap artists used to be a drug dealer and a pimp. He is not

One of my favorite rap artists used to be a drug dealer and a pimp. He is not apologetic, but regularly brags about it. If I buy his albums, am I supporting drugs and pimping?

Perhaps, as you'd expect, it depends on what we mean.

One scenario: the artist used the profits from his musical career to underwrite drug dealing and prostitution. In that case, you're supporting drugs and pimping at least in the sense that you're helping to provide the cash that keeps it running.

Another scenario: the artist isn't dealing drugs and pimping, but his fame and the reach of his CD sales helps him encourage others to do what he used to do. In that case, your money is still supporting criminal activities, though quite a bit less directly.

I'm guessing the most likely scenario is this: far as you know, he isn't still carrying on any criminal enterprises. Far as you, he probably does mean to glorify those things, and far as you know, he probably does have at least some marginal success in encouraging others to do the things he used to do. In other words, even if he's no longer an active criminal, there's something unsavory here, and the more successful he is financially, the more that's so. But I'm also guessing that you just like his music and aren't interested in promoting drugs or pimping. Where does that leave you?

Nowhere particularly clear. On the one hand, most of us spend money that supports businesses whose practices may be undesirable even if not criminal, and many of us even know some specific cases. Corporation X sells a product I want, but contributes to causes I deplore, or engages in labor or environmental or business practices that I oppose. These days, purity isn't easy to come by. A few years ago, for better or worse, the town where I live declared itself a "nuclear free zone," meaning that they wouldn't do business with any company that had a stake in the nuclear industry. Turned out this was almost impossible to pull off without tying themselves in knots.

But there is a difference. I may buy something from a company whose practices I don't like. But when I do, I may be doing it with my nose held, so to speak -- in spite of what I don't like about them. I'm not vicariously indulging in their vices. That's where the music case seems a little different. The connections among the artist, the message and what the consumer expresses by supporting the artist seem tighter and more intimate. If someone spouts whole-heartedly misogynist lyrics, the excuse that I'm buying their records just because I like the music is a bit malodorous. Hiving off the obnoxious content from everything else and putting it in a box might be possible, but I have a feeling I'd suspect myself of bad faith.

Here's a case. Suppose that I stumbled across some artist whose language I didn't even speak. I start buying hisCDs, and then a friend who knows the language points out that what he's singing amounts to Nazi propaganda. I don't think I'd feel good about where my money went, and I don't think I'd want to put any more in the artist's coffers.

So: buying this artist's CDs isn't the worst thing you could do. But it doesn't seem entirely pure and innocent either. And the less incidental the glorification of crime to the music, the harder it is to claim that you've stayed on the unsullied side.

I work for an organization for which the buzz word "compromise" has great appeal

I work for an organization for which the buzz word "compromise" has great appeal. However, I am not a fan of compromise - I feel that it should be used as a last - very last - resort. I think that operations generally run more smoothly if the person with the better idea gets his / her way. However, in my organization almost all differences are "resolved" by compromise even where difficult people who disagree as a matter of course are involved - on the simple belief that compromise is always the best option. However, I feel that compromise can be used as a means of control, as a way of ensuring that the other person cannot win, etc. What is your opinion?

You're right that compromise can be used as a form of control. But so can being uncompromising. Compromise can sometimes impede efficiency; but sometimes it can facilitate it. From where I sit, I don't think that one can defend as a general principle either the idea that compromise or being uncompromising is better. When and where to compromise is a matter of art--or, perhaps in more philosophical terms, a matter of prudence, in the sense of practical wisdom. Much depends upon the context: what sort of people are involved, what's at stake, what the purpose and mission of the institution is, what sort of time and resource constraints one faces. There's a great deal of difference in making a decision about what to do about an imminent ICBM attack and what sort of retirement hobbies one might explore. In addition, compromise does work better, in my experience, when those involved have cultivated certain complementary habits and sensibilities. That is compromise works best when people value compromise, appreciate when to persist, when to give way, how to listen, how to argue a point in a civil and logical and sensitive way, how to be circumspect, how to see and appreciate the strengths and weakness of others in a group, how to see and appreciate one's own strengths and weaknesses, and how to be patient. I myself try to work towards consensus as much as possible. But I also recognize that there are contexts where consensus, as well as compromise, simply doesn't matter.

Is the use of torrent sites to download TV shows wrong? Or is it OK on the

Is the use of torrent sites to download TV shows wrong? Or is it OK on the grounds that it makes a stand against the invasive advertising techniques used on television?

The "invasive advertising techniques used on television" would make torrenting TV shows justifiable only if we had some sort of right to watch these shows without advertising. But I don't think we have such a right. TV shows are produced or purchased by networks at some cost, and they recoup that cost (and earn a profit) by selling time for advertisements. That you dislike or even disapprove of these advertisements doesn't give you the right to make use of their products in ways that the networks oppose. They own the shows, and thus they can determine the conditions under which they are broadcast.

If you want to take a stand against advertising, don't watch the TV shows at all. Or just buy them on DVD. That way you can pay for them without submitting yourself to those invasive advertising techniques.