INTRODUCTION

Socialism is dead, though many of its academic proponents take no notice of its demise. With its death, private property in the means of production is not generally in dispute, and the action in political philosophy centers on the justification of the welfare state. The heart of the welfare state is social insurance programs, such as government managed and subsidized health insurance, retirement pensions, and unemployment insurance. The arguments about health insurance will arguably be among the most ferocious, difficult, and important of the welfare-state debates: Ferocious, because proposals to alter government managed or subsidized health care strike at people's fears and concerns in a way matched by few other proposals. Difficult, because people can often not even conceive of a (genuine) market alternative to the status quo in health insurance, and there is no real existing alternative to hold up as a model. Important, because if an intellectually solid case for market health insurance can be established, then supporters of the welfare state should be on the defensive, since social health insurance is an institution central to their vision of the just or good society.

Suppose one wishes to argue for market health insurance. How should this be done? Two strategies come to mind, which can be used here or in political philosophy when comparing market institutions with welfarestate institutions. First, one can argue that the normative principles and viewpoints used by defenders of the welfare state—e.g., egalitarianism, communitarianism—are mistaken. This method accepts the opponents' view that their principles, if correct, would provide good reasons for supporting certain institutions, and focuses attention on problems with the principles.