Is Charging Immigrants and Tourists for NHS A&E Services Fair?

The UK government's plan to make migrants pay for treatment at accident and emergency departments in England immediately whipped up a storm of moral outrage. The move, which is an extension of the NHS charging strategy and is intended to clampdown on abuse of the country's social security system, will apparently enable the government to recoup some much needed money.

While nobody will be turned away from accident and emergency departments who is experiencing an emergency, but there will be a charge. The announcement comes just days before EU restrictions on migrants from Bulgaria and Romania travelling to the UK are dropped.

Lord Howe, the Health Minister, stresses the measure is to be implemented to make sure the system is "fair to the hardworking British taxpayers who fund it". But what does Howe mean by "fair" and why are so many people upset and enraged at the new system?

Could it be that the government and the people who disagree with the policy have two different definitions of fair? IBTimes UK attempts to uncover if it is possible to resolve the moral melee with an ingenious thought experiment.

The Original Position

The concept of fairness seems to come up every day. In fact, it seems hard to get away from it. It is not "fair" that a lazy worker gets a promotion, while a hard-working employee does not. It is not "fair" that a bad football team beats their opponents with a fluke goal. And it is not "fair" when someone pushes to the front of a queue. It seems easy enough to point out instances where something has or has not been fair, but it is much harder to explain what we mean by the term.

The problem is we often come up with subjective definitions of what is "fair". Maybe this is why TV talent competitions are so popular – everyone has their own opinion on whether a contestant should be booted off the show or not and whether such a loss would be "fair" or not.

But institutions and societies cannot be run according to subjective moral opinions. We really need to figure out an objective measure of fairness. John Rawls, an American philosopher, was able to come up with just that.

Rawls, writing in A Theory of Justice, says if you want to resolve an issue of fairness or justice, imagine you are under a "veil of ignorance". That is, how would you like the situation to be resolved it you were ignorant of your own role in it.

Rawls dubbed this state the "original position". So, imagine you do not know your, gender, sex, religion, age or any definitive characteristic that could bias you – including whether you are a migrant or not. However, you are armed with general facts. In this state of physical ignorance, do you think it is fair for migrants to be charged at accident and emergency departments or not?