How the Tyranny of Market Forces Stunts Our Moral Imagination
Is providing healthcare for all too expensive, or is it a failure of our moral imagination to say so? What first appears as an economic reality can too quickly become an excuse for inaction.
Nicole Hassoun is a residential fellow with the Hope & Optimism Project at Cornell University and an associate professor in philosophy at Binghamton University. From 2006-2012 she was an assistant professor in philosophy at Carnegie Mellon University, affiliated with Carnegie Mellon's Program on International Relations and the University of Pittsburgh's Center for Bioethics and Health Law. In 2009-2010 she held a postdoctoral position at Stanford University and visited at the United Nation's World Institute for Development Economics Research in Helsinki. She has also been a visiting scholar at the Center for Poverty Research in Salzburg, The Franco-Swedish Program in Philosophy and Economics in Paris and the Center for Advanced Studies in Frankfurt. She has published more than fifty papers in journals like the American Philosophical Quarterly, Journal of Development Economics, The Journal of Applied Ethics, The American Journal of Bioethics, Australasian Journal of Philosophy, Public Affairs Quarterly, The European Journal of Philosophy, Environmental Ethics, the Journal of Social Philosophy, Utilitas, and Philosophy and Economics. Her first book Globalization and Global Justice: Shrinking Distance, Expanding Obligations was published with Cambridge University Press in 2012 and her manuscript Global Health Impact: Extending Access on Essential Medicines for the Poor is under contract with Oxford University Press.
Nicole Hassoun also heads the Global Health Impact project intended to extend access to medicines to the global poor (Global Health Impact). The project launched at the World Health Organization in January 2015 and has been featured on National Public Radio (New effort ranks drugmakers by impact). The Wall Street Journal (A New Index Measures Impact Pharma Has on Infectious Diseases) and Capital New York (SUNY professor indexes pharma companies' impact). The project is intended to assist policy makers in setting targets for and evaluating efforts to increase access to essential medicines. Hassoun is the author of Globalization and Global Justice: Shrinking Distance, Expanding Obligations.
NICOLE HASSOUN: Several years ago the World Health Organization declared that it wasn't cost-effective to help people get treatment for drug-resistant tuberculosis. And there was an organization called Partners in Health that simply refused to accept this claim they said we’re going to do whatever it takes to help these people. So they came up with a program for treating drug-resistant tuberculosis in some of the world’s most conflict-ridden, poorest places. And they succeeded in doing it they had very good treatment outcomes. So they thought creatively about how to come up with treatment programs that worked and as a result funding for drug resistant TB increased spectacularly, and now many people around the world have treatment. So what did they do? I think what they did is they have this virtue, which requires three things.
First, that we commit to fulfilling human rights. Second, that we think creatively or imagine ways of doing that. And finally, that we act to do so. So let me explain the virtue of creative resolve a little bit more and hopefully you’ll see why I think it’s really important. So first to have the virtue one has to question evidence against the possibility of fulfilling human rights. We can do this in many ways so we can question the source, reliability or implications of that evidence. It’s possible to acquiesce too quickly in the face of evidence that it’s impossible to help people, or to be so pigheaded that we refuse to accept the constraints of the given.
The second thing that we need to do is I think consider all of the options on the table and then use our imagination to come up with new options. Finally, we should act to fulfill human rights. And this requires a measure of grit, will or resoluteness. We can’t be inflexible and persist even when it is actually impossible to fulfill rights, but at the same time we shouldn’t be complacent about it. Since change is difficult, people who don’t think that it’s possible or desirable to fulfill human rights probably won’t try hard to do, so hope is important for the virtue of creative resolve. Hope is simply believing something that one desires is possible but not certain. Still, even when we lack a kind of hope I think we should have the virtue of creative resolve as long as there is not conclusive evidence that fulfilling human rights isn’t possible.
So the kind of hope we need is a radical hope. In the face of uncertainty we must persist and exercise our moral imaginations to help people meet their basic needs. But the reason we should have creative resolve is this: the ground for the human rights is protecting everybody’s ability to live a dignified human life, and it’s really important that we do that so we should try hard.
I think the imperative to try hard is particularly compelling given that there’s a lot of psychological evidence that people don’t try hard enough. They tend to search not far enough for solutions to problems, and many people seem to have a narrow view of possibility and feasibility, assuming tight time frames and financial constraints. When we imagine ourselves succeeding in tasks we’re often more likely to do so, perhaps because our imagination spurs a sense of agency and lets us set plans for the future and act to achieve them.
The crux of my disagreement with critics of the human right to health who think we have to ration and that the human right has to tell us how to do that is this: I don’t think that’s what the human right to health has to do or even that it should, rather I think it does something much more important for us I think it inspires us to do our best to help everyone meet their basic needs.
Okay. But if we do have to ration here’s what I think, I think creative resolve can help us do that. I think it can help us find better ways of helping more people. We can’t, though, simply build hospitals in the city rather than also in the countryside because it’s most cost-effective to do that. Everybody has a human right to health and if we think creatively enough about how to do it, we may be able to help everybody.
Okay. So there’s two sides to this virtue, on the one side we should try very hard to help people fulfill their human rights. On the other side we don’t have to try when it’s impossible or impermissible to do that. But I’m going to stress and I have been stressing the positive or commitment side of the virtue for this reason: millions of people around the world are suffering and dying every year from poverty related causes, and it’s not as if there’s millions of people trying to help them. I believe we need to try harder, try harder, try harder. I think we need to find both the resources and the political will to do this. And like Martin Luther King, we should refuse to believe that the bank of justice is bankrupt.
Is providing healthcare for all too expensive, or is it a failure of our moral imagination to say so? What first appears as an economic reality can too quickly become an excuse for inaction, says Nicole Hassoun, who heads the Global Health Impact, launched at the World Health Organization in January 2015. Maintaining a radical sense of hope in the face of so-called market forces, which set too high a price on human health, spurs the human imagination. Novel healthcare solutions have been found those willing to face economic headwinds, and they provide an example to us all. This video was filmed as part of the Los Angeles Hope Festival, a collaboration between Big Think and Hope & Optimism.
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