“People don’t get what they deserve, they just get what they get.” That is a quote from Dr. Gregory House, a fictional character played by actor Hugh Laurie. And while Dr. House is known for being abrasive, blunt, and generally misanthropic, he is a genius at diagnostic medicine, as well as occasionally making some pretty astute philosophical points.
I think about this quote from a TV show that’s been off the air for well over a decade a lot, because the concept of what people do and don’t deserve comes up a lot in discussions of public policy. I am frequently confronted with some variant of the argument that “everyone deserves an education” or, less charitably, “if you oppose universal, government-funded health care, you are basically saying poor people deserve to die.”
In the course of these discussions, I’ve come to realize that I don’t really know what people mean by the word “deserve,” and I suspect that neither do they. I’ve become increasingly interested in the way our understanding of language informs our public discourse, and how much communication is hindered by the fact that we as a society often use the same words to mean different things. Much ink has been spilled debating the appropriate definition of words like “racism,” which some people argue refers to personal prejudice and others understand as a system of power structures. To my knowledge, however, no one has given the word “deserves” the attention that it, well, deserves.
In my view, “deserve” is one of those weaselly sort of terms that sounds reasonable as long as you don’t take the time to actually think about it. In fact, what I believe the word is doing is disguising a personal preference for an objective claim about reality. What, really, is the difference between saying that you deserve something, and simply expressing a wish that it were so? Actually, I do believe that such a distinction exists, but it’s one that gets overlooked in everyday usage.
Appeal to a Standard
Normative terms like “should,” “ought,” and “deserves” are different from simple desires in that they appeal to some sort of standard. Every use of the word “should,” for example, contains an implied “if-then” statement. If you want to lose weight, then you should eat less and exercise more. If you want to be a good Christian, then you should remember the Sabbath day and keep it holy. If you want to conform to broader society’s moral and ethical standards, then you should honor your agreements, keep your word, and treat others with respect and kindness. But to say that you should eat less and exercise more in the abstract, without appeal to a standard such as a desirable state of health or appearance, is meaningless. If you tell a person that he should do something without providing further context, he’s likely to offer the quite reasonable retort: “why should I?”
The word “deserve” has the same problem. It you are claiming that person deserves something, you are implicitly appealing to a standard of justice. “Criminals deserve to be punished;” “Victims deserve compensation for their losses;” “Lenders deserve to be repaid” and so on. The implication in these statements is of an explicit or implicit contract that must be honored, and what people deserve is any cheating or reneging on the deal should be prevented or reversed to the extent possible. But again, the use of the word “deserve” in the abstract, without reference to a standard of justice, is largely meaningless and raises innumerable questions about what is actually meant.
Let’s take, for example, the claim with which I am often confronted that “sick people deserve access to health care.” Without any further analysis, this sounds like a perfectly defensible claim. It is bad for illnesses go untreated or for patients to needlessly suffer, and only the most sadistic and uncaring person would assert that any individual deserves to suffer such a fate by virtue of their character or their circumstances. But vague platitudes are of little use when it comes to public policy. What claim is actually being made by this statement? What exactly does it mean to have access to health care? In one sense, everyone does have access to health care. Anyone can walk into an emergency room and receive whatever care they require and can afford. Granted, emergency medicine is far from ideal, but it does exist in cases of extremity. Does this “count” as access to health care? In most people’s estimation, I would expect not.
This raises the question: does deserving something mean that you are not obligated to pay for it? Must others provide you with health care (which is a scarce resource like any other) for free? To this, most people retort that health care need not necessarily be free as long as it is affordable. But the definition of “affordable” varies wildly depending on the person in question. For some people, any price higher than zero for medical care would not be affordable. For others, the threshold for affordability could reach into the thousands or even millions of dollars. It’s hard to see how what you deserve can be based on your income rather than on your moral characteristics or your intrinsic worth as a human being, but even if we accept this sliding scale of pricing, the problem of giving people what they deserve has not been remotely solved.
How Much Health Care?
I once asked a young woman who insisted that health care is a human right the following question: “how much health care?” Health care, of course, is not a single good, but the collective name for thousands of different products and services. Asking for free health care is like asking for free technology; it can mean anything from a Band-Aid to state-of-the-art brain surgery. To this question, the woman replied “as much as they need.” But this answer falls to pieces the second it is examined. There are some patients for whom all the health care in the entire world will not be enough to satisfy their needs. Sad as it is, some patients will die no matter how much intervention is provided, and some will suffer from chronic, incurable symptoms for the rest of their lives. What does it mean, then, to say that they deserve as much health care as they need, when that amount is functionally infinite? Should every specialist on the planet be rushed to their bedside to consult on the case? Should every medical researcher drop what they are doing to tackle this one difficult case? This is obviously impossible, even without considering that there are many thousands of such patients, each demonstrating the status as a deserving individual.
Even in a less extreme case, we can see the flaw in such reasoning. If I have a brain tumor that requires surgery, then I presumably deserve to get the surgery at a price I can afford. But not all brain surgeons are of equal quality. Do I deserve to have the best brain surgeon in the world operate on me, or only a comparatively mediocre surgeon? If I deserve the best, then presumably other people do too. How are these conflicting claims resolved given that there is only one “best” brain surgeon in the world, and that his time is finite? If not, and a lesser surgeon would do, why do some people deserve better surgeons than others? On what are these claims based?
We can conduct the same analysis for other services people claim they deserve, such as housing, food, and education. How do you decide what someone deserves, at what price, and in what quantity? You can see how attempting to dole out public services on a deserts-based system raises impossible problems, practical as well as philosophical.
I have many friends and family members who I consider to be fine, upstanding people. If you asked me whether they deserved to have more money, bigger homes, more leisure time, and greater happiness, I would probably say yes. But the fact that I, in my subjective opinion, consider them to be deserving of greater luxury than they are currently experiencing does not answer the question of how these things are going to be provided and by whom. In reality, my statement does not amount to anything more than an idle wish. The reason for this is that people don’t get what they deserve, they just get what they get. It’s okay to fantasize about the world we’d like to see, but fantasy is no basis on which to craft public policy.