David T. Ozar

The concept of basic healt.h care has grown steadily in importance in recent years as more and more of those who reflect on the issue of a right to health care conclude that we need to distinguish between kinds of health care to which people do have a right and others to which they do not have a right. There is little consensus on where to draw this line. But there does seem to be general agreement that, if this distinction is valid, it is so because some kinds of health care are less important, less essential, less something than others, and because the right to health care (if there is such a thing) extends only to those kinds of health care that are more important, more essential, more whatever-it-is. A number of authors have used the term 'basic' to represent this something and this is the term which I shall use. In this article, I shall offer a theory of what we mean by basic health care. I shall do this by developing, in Section 1 of the paper, a general theory of kinds of needs. In Section 2 I will give a brief account of the special moral significance of the levels of need which I designate as basic. In Sections 3-4 1 shall try to identify, in the context of the health care resources available in our society, the health care needs which fall into the previously developed categories of basic need.

In this paper I clarify the distinction between actions performed under a social rule and a mere pattern of behavior through an examination of two distinctive features of actions performed under a social rule. Developing an argument proposed by H.L.A. Hart in The Concept of Law, I first argue that, where a social rule exists, there nonconformity/conformity to the pattern of behavior set down in the rule count as good reasons for criticism/commendation of actions covered by the rule. Secondly I argue that, where a social rule exists, nonconformity/conformity to the pattern set down in the rule must be taken account of (at the risk of self-contradiction) in judging actions covered by the rule commendable or subject to criticism. This in turn means that, where a social rule exists, there can be no genuine exceptions to the rule because the notion of a genuine exception to a social rule makes no sense.