Is this biased reporting?

[Occhidiangela]

When handing out donor hearts, does it make sense - is it 'just' - to always give it to the highest bidder? 

I don't think so, I'd like to see the basis be "first come first serve" but I'd like to modify that with age, or other criterion where one can. But it is tricky, and it is very hard to be "fair" from all perspectives.

Should I spend that heart on an 80 year old, or on a 17 year old? Where in that choice, hard as it is, lies the greater good? How about a mother, 32, three kids versus a single man of 40? Who between them is more 'deserving' of that heart? What criterion is used? The "get on the list" approach is probably as fair as it can be made, but the matter of access and "who you know" presents the loophole of a greased palm ensuring that the 50 year old fashion queen gets that heart ahead of a "fair" schedule.

Is the 'worth' of a wealthy entrepreneur really calculable in that sense?  Can policy be justified on that basis in a democratic society? 

No, but people who make decisions can be bought in any society. No matter how many rules we right, people are corruptible.

Certainly America is a meritocracy of sorts, but its foundations rely on a certain populist egalitarianism.  One person, one vote has implications beyond the ballot box.

More importantly is the 14th ammendment, Equal Protection Under The Law, but the Jacksonian version of democratic principles in a republic certainly connotes a trace of egalitarianism.

Right to life is not conditional on one's means.

Agreed.

This principle is what separates the liberal democratic state from oligarchy.  If we attempt to defend liberal democratic structures on utilitarian grounds we end up with a mess.  Simply put, we don't think about our rights, about our constitutional entitlements, in utilitarian terms.  My rights do not exist as a means to the betterment of the whole; my rights are mine alone, as a condition of my citizenship.  If the general betterment of the whole is some kind of a positive externality, then all the better.

Getting back to the modified golden rule, my absolute freedom/rights are bounded by yours (and all other fellow citizens freedoms/rights. That doesn't answer the mail on "when things are scarce, how do we prioritize?" Given a finite amount of doctor/medical man hours in a week, how indeed does allocation of care get fairly apportioned?

Finally, if not some deontological liberal constitution-based model, then who is the judge?  How do we determine 'merit' when it comes to the provision of health care?

You set up a rule, and after the usual process, via voting or consensus building, abide by that rule. But merit is the wrong word, here, rather necessity or "fair share."

In capitalist society, the fallback is wealth, and wealth alone cannot be the arbiter of 'deservedness' in protecting the right to life.  Sure, I'll accept that the surgeon has greater utility-based importance to society than the professional welder - but on what basis do we make such calculations, and who is the calculator?  The deeper implications of such reasoning can become very troubling.
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Well, without the welder, the hospital never got built, so the trauma patient died for lack of a place for the doctor to treat him. :lol: Kidding aside, if the rules apply about 90% of the time, and are pretty fair, the occasional excess found by the exploitation of loopholes and the bribability of the "custodians of the rules" probably meet, to my sense of fairness, the good enough standard for Imperfectable Man. If I'm the guy waiting for the heart on one of those 10% cases, and it never shows up thanks to the beauty queen posited above, then

It sucks to be me.

Life isn't fair, we can only make it "pretty fair."

PS: Thanks for "deontological" as a fine 64 dollar word for the day. :D

Occhi