Health care reform poses numerous challenges. A core challenge is to make health care more efficient and effective without causing more harm than benefit. Additionally, those fashioning health-care policy must encourage patients to exercise caution and restraint when expending scarce resources; restrict the ability of politicians to advance their careers by promising alluring but costly entitlements, many of which they will not be able to deliver; face the demographic challenges of an aging population; and avoid regulations that create significant inefficiencies (...) and restrict access to health care. Given such real-world challenges, how should health care be reformed in the United States or elsewhere? This number of The Journal of Medicine and Philosophy examines many of the complex issues that must be considered in reforming a health-care system. (shrink)

In an attempt to respond effectively to the COVID-19 pandemic, policy makers and scientific experts who advise them have aspired to present a unified front. Leveraging the authority of science, they have at times portrayed politically favored COVID interventions, such as lockdowns, as strongly grounded in scientific evidence—even to the point of claiming that enacting such interventions is simply a matter of “following the science.” Strictly speaking, all such claims are false, since facts alone never yield moral-political conclusions. More importantly, (...) attempts to present a unified front have led to a number of other actions and statements by scientists and policy makers that erode the authority of science. These include actions and statements that: (1) mislead the public about epidemiological matters such as mortality rates, cause of death determinations, and computerized modeling, or fail to correct mainstream media sources that interpret such concepts in misleading ways; (2) incorporate moral-political opinions into ostensible statements of fact; and (3) misrepresent or misuse scientific expertise. The fundamental thesis of the paper is not primarily that such actions and statements have proliferated during the COVID-19 epidemic (though I think they have), but rather that they are unscientific and that presenting them as science undermines the authority of science. In the moral-political realm, the great power of science and the source of its authority derives from its agnosticism about fundamental moral-political claims. Science, for instance, has no built-in presumption that we should respect life, promote freedom, or practice toleration; nor does it tell us which of these values to prioritize when values conflict. Because of this agnosticism, science is recognized across a broad diversity perspectives as morally and politically impartial, and authoritative within its proper sphere. When it is infused with partisan bias, it loses that authority. (shrink)