Sean Donaghue-Johnston

In this essay, I explore John Stuart Mill’s theory of government and its application to the issue of health care reform. In particular, I ask whether Mill’s theory of government would justify or condemn the creation of a public health-insurance option. Although Mill’s deep distrust of governmental authority would seem to align him with Republicans, Tea Partiers, libertarians, and others, who cast the public option as a “government takeover” of “our” health care system, I argue that Mill offers good reasons for seriously considering some form of government-operated health insurance. For Mill theorizes government as having a positive as well as a negative role to play in people’s lives, and he explicitly endorses “public options” in different areas of life. According to his theory of government, a public health-insurance option would be just as long as it would meet the following two conditions: (1) it would not invade the “reserved territory” of individual liberty; and (2) “the case of expediency is strong.” I argue that a public option would in fact meet both of these conditions, and that Mill would have likely endorsed it as an effective solution to the current health care crisis in the United States.

According to John Rawls, the liberalism of John Stuart Mill is “comprehensive” and not “political” because it promotes the idea of individuality as a more or less universal conception of the good. Rawls’s political liberalism, in contrast, does not promote any one particular conception of the good over others. Instead, it aims to guarantee for citizens the capacity for a conception of the good. I argue, however, that Mill’s liberalism is “comprehensive” because power is ubiquitous, i.e., because there are social and “nonpolitical” forms of power that political liberalism is not equipped to deal with. It is impossible to guarantee the capacity fora conception of the good without providing a point of resistance to the social and nonpolitical deployment of power. Thus, if liberalism is going to be able to guarantee the capacity for a conception of the good, it must become “political” in aim but “comprehensive” in scope.