On his health policy blog this morning, John Goodman asks whether there’s a moral case for the Affordable Care Act. The whole thing is worth reading. Some excerpts:

Search the world’s ethical codes and you will have a hard time finding any that are consistent with a health reform that:
Gives people in health insurance exchanges up to 10 times as much federal subsidy as people at the same income level getting insurance at work.
Forces young people to pay two or three times the real cost of their insurance in order to subsidize older people who have more income and more assets.
Takes from low-income seniors in order to provide subsidized health insurance for non-seniors who have higher incomes.
Takes from people who use tanning salons and people who need crutches and wheelchairs and pacemakers and gives to … well …. who knows?

One’s first thought might be to point to the late John Rawls, author of A Theory of Justice, right? Goodman thinks of that. He writes:

Some might point to John Rawls and his theory of justice. Because of a quirky assumption, Rawls concludes that a just society is one organized to maximize the wellbeing of the least well off. As an economist, I can assure you that doesn’t mean socialism. In fact, if you consider the least well off indefinitely into the future (and it’s impossible to justify excluding them), Rawls’ theory implies an extreme form of capitalism — one that maximizes economic growth. Minus the quirky assumption, Rawls’ theory implies garden variety utilitarianism of the type embedded in neoclassical welfare economics.