The Scope of Hobbes' Social Contract

In Leviathan, Hobbes describes the state of nature where all people believe themselves to be the best and smartest. “For such is the nature of men, that howsoever they may acknowledge others to be more witty, or more eloquent, or more learned; yet the will hardly believe there be many so wise as themselves” (75). However, because of their vulnerability to others, people in the state of nature decide to form a commonwealth and surrender certain freedoms and rights. Some of these freedoms could include things like stealing from other men, because doing so would eventually lead back to the state of nature as all men steal from others and everyone is constantly suspicious of others.

Essential to Hobbes' theory of this formation of a commonwealth is the idea that all men have equal status in the state of nature and thus are all equal. It is unclear what scope Hobbes intended this theory to encompass. Did he think that all of human kind was equal? Or perhaps he intended it only applicable to men, and not women.  Additionally, considering the historical and social context of his time, it is unclear whether he intended it to include people of color-- men or women. 

When Hobbes was writing about this commonwealth, it was common knowledge that white men believed themselves to be the smartest, as well as superior to nonwhites and women in almost every way. Because they believed their people (white men) to be the smartest and most superior, they believed that it was their destiny to conquer or control other "lesser" peoples (people of color and women). It seems that if Hobbes' theory for the formation of a commonwealth was ever enacted, it was done so in a perverse way. When forming a commonwealth, there is said to be "peace without subjection" (107). This derives from the fact that all people involved have consented to sacrificing their freedoms for the commonwealth, and thus consented to the sovereign who guarantees their security. In reality, it seems that many "lesser" people sacrificed freedoms for the commonwealth without the benefit of a sovereign guaranteeing their security. 

Hobbes' social contract and commonwealth built upon a principle of inequality between the people involved would seem to be inconsistent with the laws of nature that Hobbes' pushes for throughout Leviathan. Therefore, it is of critical importance to examine his writing and intended scope with a critical eye. Because if he meant for his social contract to exclude women and people of color, there is reason to question his theory from the very start. As a side note, one may argue that Hobbes only meant his theory to be theoretical, and thus this historical context is irrelevant. However, considering that he wrote this during the English Civil War, which centered on dissatisfaction with the King, and dedicated considerable attention to the idea of an illegitimate sovereign, it does not seem likely that he intended the theory to be completely theoretical. 

Hobbes and the Transition from the State of Nature to a Commonwealth

"Anu and Bel called by name me, Hammurabi, the exalted prince, who feared God, to bring about the rule of righteousness in the land, to destroy the wicked and the evil-doers; so that the strong should not harm the weak." - Hammurabi, The Code of Hammurabi

Hobbes' Leviathan describes a commonwealth - a government where men give up certain freedoms in exchange for security - as the savior from the state of nature. It is difficult for us in the 21st century to imagine a world in the state of nature; barring a handful of remote islands, nearly every square acre of land is claimed by some government, no matter how unstable it may be. The commonwealth exists to avoid the Darwinian survival-of-the-fittest brutality that accompanies the state of nature. Hammurabi's Code of Laws is a prime example of an ancient civilization forming a commonwealth to avoid the state of nature.

The transfer of rights that comes along with leaving the state of nature is a value judgment. In this judgment, the person evaluates preserving their own unabridged liberty versus giving up a degree of liberty for security. This established contract can take place with an oath of fealty, being born into a country, or as a result of conquest. The extension from this theory is that if a government does not protect its citizens security, it has failed its end of the bargain. As such, a government like Pol Pot's Cambodia would be illegitimate.

Hobbes' outlook on the state of mankind is entrenched in strong misanthropy. In other words, Hobbes assumes that mankind is necessarily depraved and needs an overseer to control and restrict personal freedoms. Hobbes' reasoning can be extended to cover more than a mere commonwealth. Most authoritarian regimes would agree with Hobbes when restricting their constituents liberties, including the right to privacy, the right to travel, and the right to bear arms. The stark contrast between Hobbes and other more philanthropic philosophers ought to be answered as a question of degree: "to what extent should society give up freedom for security?"

Token and Type Property Rights according to Pogge

Token and Type Property Rights according to Pogge

Today, the term "right to property" is used broadly to apply to a myriad of political issues, but Pogge not only shows the difference between token property rights and type property rights. When Locke defends the right to property, he is talking about the right to token property. Abraham Lincoln describes the right to token property as the most obvious right: "[even the] ant, who has toiled and dragged a crumb to his nest, will furiously defend the fruit of his labor, against whatever robber assails him." The debate over token property rights surfaces in questions regarding tax policy and eminent domain. This blog post will focus on the right to property and how it plays into Pogge's debate on patents.

The right to token property is very different from the right to type property. The right to type property says that if a person invents a product, be it a drug, new iPhone, or book franchise, the government guarantees that no one will copy their work and diminish their profits. The right to type property typically around patents and copyright. Continuing Lincoln's parable, the first ant to drag the crumb to its nest does not have the monopoly on all crumbs.

Pogge points out that the right to token property and the right to type property not only are not identical, but they can conflict. Suppose I am the first person to add ketchup to my scrambled eggs. I like the idea so much that I patent ketchup with scrambled eggs, and I now have the type property rights over the dish. If someone else - knowingly or not - copies my idea, their scrambled eggs with ketchup - token property - gets taken away.

The distinction between type and token property rights comes into Pogge's analysis when Pogge analyzes the GBD (Global Burden of Disease) on the world, particularly on developing countries. Pogge argues that the GBD would be lower if some drug companies lost their monopoly on certain drugs. In theory, Pogge's argument that a monopoly chases away some buyers from the market is sound. The quantity of customers in the market at the optimal monopoly price is lower than the quantity of customers in the market at a competitive market price. The deadweight loss - these customers and their money - as well as the loss of the positive externality - the inoculation effects of a drug on a population - is a problem.

The takeaway from Pogge's analysis is as follows: In choosing to break up the monopoly, one makes a value judgment. This judgment is between the type property rights of the company versus the societal good that comes with breaking up the monopoly. Pogge understands that nullifying patent laws - choosing the societal good over the type property rights - diminishes the incentive for companies to continue innovating. After all, companies, such as Pfizer, spend a great deal of money brainstorming, testing, and manufacturing their products. If another company shortcuts the innovative process, they skirt the costs that accompany failure. As such, the greater economic benefit follows the spinoff company that pirates the original company's work. Pogge does present alternatives, the aptly named "push" and "pull" alternatives, but both of these plans, as Pogge admits, have their drawbacks.

The Pogge Pull

Pogge presents a fascinating and well thought out proposal for inducing a dramatic yet plausible shift in the current incentive scheme of our global health care system when it comes to alleviating the Global Burden of Disease (GDB). I want to focus on the implications of his distinction between “pull” programs and “full-pull” programs.

Pogge advocates for a “full-pull” program over a “pull” program on page 21, arguing that “pull” programs - or prizes - have “four serious drawbacks.” The four argument against prizes are:

1. Politicians, Bureaucrats, and experts play a substantial role in deciding which diseases ought to be researched, how to specify the remedy to be aimed for, and how large a reward should be offered for a remedy meeting these specifications.”
2. Prizes Involve excess specificity
3. Funding is haphazard, case-by-case, and subject to arbitrary political factors
4. The “last-mile” problem: prizes pull innovators to inventions but not implementation

Pogge then argues that a “GBD” patent, or “full-pull” solution avoids these serious drawbacks and is therefore superior. Because I agree with the moral imperative to bring about change in a broken and misdirected health care system, I think it is economically and politically flawed to choose the “full-pull” program over the “pull” program.

Both pull and full-pull programs have the potential to form the backbone behind Pogge’s Public Good Strategy which requires three components:

1. Open Access to intellectual results of R&D

2. Alternative Incentives - Rather than the existing incentives to treat affluent diseases, increase diseases among the poor, and monopolize the results of research with patents, we should create incentives to achieve results, not customers.

3. Some sort of reliable funding mechanism.

In the last decade, use of prizes to solve social problems has skyrocketed and created massive success. The XPrize foundation, beginning in 2004, placed a $10 million prize to usher in a new era of private space travel (http://ansari.xprize.org/), a $7 million to transform the lives of low-literate adults (http://adultliteracy.xprize.org/), a $20 million prize to create recyclable Co2 products (http://carbon.xprize.org/), and others. Following the success of some of these programs, McKinsey and Co. drafted a report outlining what it takes to create a successful prize for social benefit (http://www.mckinseyonsociety.com/downloads/reports/Social-Innovation/And_the_winner_is.pdf). Notably, as many institutions and government agencies have experimented with prizes over the years, successful prizes - while varying in their implementation - share similar features in their design. Page 37 of the McKinsey report has a diagram outlining when a prize should be used as a tool for social change. It states that there must be a “clear, achievable goal,” many “solvers” who are able to compete for the prize, and the solvers must be “willing to accept the outcome of risk.” While the pull-program would work as a prize, the full-pull program structures a grant as a fee for the provision of an existing good or service from an established supplier. The full-pull would fall into the branch of “Fee/Contract” - suggesting it would be optimal if there weren’t many companies able to compete for the prize. The report stated that their “survey of prize administrators found that they consider ‘specifying the goal or mission’ to be one of the most difficult aspects of effective prize-giving” and “a good prize will not seek to do all the work itself, but to lay the groundwork for further impact by generating new ideas, innovations, capital and interest in a topic” (McKinsey 39). The specificity of a prize’s goal is paramount to its success and - importantly - it shouldn’t seek to solve the problem in its entirety, rather, it should seek to remove essential bottlenecks in the existing market of problem solving.

Here is why a full-pull system will not work and why a more comprehensive pull-system will:

• Prizes have achievable, unambiguous, time-restricted goals.

While Pogge states that pharmaceutical companies and governments will need to collaborate with fleets of experts to determine what the best ways to measure reduction in GBD are, I find it difficult to believe we are capable of quantifying the necessary metrics, assigning appropriate payouts, and maintaining the system in the long run. Pogge argue that prizes are inferior to the full-pull system because they solve the “last-mile” problem (Drawback #4). Prizes however can reward outcomes just as easily as it can reward outputs (implementation vs. inventions/new drugs). Pogge argues that a full-pull program “simply rewards what works in proportion to how well it works” (22). While this might sound nice - if only we could reward everything that works in proportion to how well it works - it seems more like a pipe dream - or at least an asymptotic goal - than a feasible reality. Essentially, we would need to be able to find a perfect, measurable index for every disease we wanted to cure. Even programs with lofty ideas, such as No Child Left Behind or Race to the Top - aimed at improving public education - often fall short of their ideal goals because the metrics used to decide the allocation of funds and determine success are deeply flawed (standardized testing).  It seems the full pull solution is the creation of a GBD stock market - where companies and governments gamble on the growth and spread of disease - rather than a proven prize structured system. Pogge states that companies would only be rewarded based on how much they changed the projected disease growth - yet, we are terrible at accurately and consistently predicting disease (our predictions are only as good as our numbers that go into it (http://www.economist.com/blogs/economist-explains/2015/02/economist-explains-3). Diseases are especially hard to target and predict because they are affected by and defined by nearly every lifestyle variable in existence - diet, environment, medicine, knowledge, genetics, and pure chance. There never was a clear answer to what happens when more than one company claim to be solving the same disease: if company A patented a drug curing diarrhea and company B patented a drug curing diarrhea and they operate in the same region - how do we allocate funds to each company? What if one of the drugs doesn’t actually work (but we don’t know if it is company A’s or company B’s? While the full-pull program solves for one market failure, it creates the potential for a free-rider problem - where companies have incentives to maximize their perceived involvement in curing a disease (as measured by some collaborative metric) while another company actually cures a disease in the short term. Thus, prizes are superior because they require specificity to avoid gaming, inspire innovation, and have some sort of time-based result. They shouldn’t seek the solve the problem wholesale, rather, they should hone in on and provide funding to eliminate barriers to larger change (ie. a prize to find a drug to cure an unprofitable, yet deadly disease). In fact, while Pogge claims the ebb and flow of politics can hamper success in Drawback #3, the haphazard nature of prizes is essential to their success. Further, Pogge never gives a strong argument for why the full-pull system isn’t susceptible to the whims and lobbying of politics (Drawback #1). In reality, most prizes (like the XPrize), aren’t at all subject to political whims - they have been consistently backed for the past decade. In fact, these problems need to be case-by-case. Entrenching a large, full-scale system without specific end goals or time periods is a direct formulation for duplicating the existing system, even with good intentions. Do you really think - in an industry ranked #1 for lobbying since 1998 (https://www.opensecrets.org/lobby/top.php?indexType=i)  - that the few competitors there are won’t fight tooth and nail to game the system? The longer the system is promised to stay around, the larger the incentive to game it and entrench political lobbies. Case-by-case prizes actually circumvent that problem by changing the rules. Also, failed prize designs quickly evaporate into history while successful ones lead innovation. Under the “full-pull” scheme, we would need to continually, evolve, duck tape, and lobby a singular, one-size-fits-all model to meet the quickly evolving and contemporary demands of the GBD.

While the full-pull system sounds nice in theory, the pull system might be better in implementation. Regardless, funding and enforcement of both systems on a large scale are most likely better than status quo.

A pull, then push prize program: The best of both worlds?

     In processing Pogge’s comparison of push and pull programs both designed to incentivize potential medical innovators within the broader, public-good strategy, I want to avoid the kind of false dichotomy that Pogge warns of in his discussion of the argument from beneficial consequences (p. 8, bottom). I think that considering the push and pull methods only in isolation from each other is too binary. By combining the two approaches, in a pull, then push program, an optimal combination of the advantages of each can be harnessed, and some disadvantages of each method implemented alone can be shed. 

     This hybrid program’s first stage would be a pull that rewards all potential innovators able to achieve meaningful progress on an important medical innovation. Then, the reward for any potential innovator deemed to have made significant progress would be a commitment to push the innovator’s continued work as – hopefully – that innovator’s promising early results come to fruition. 

     In this hybrid program, the pull approach’s clear incentive to achieve early success would be present, and assuming that the program judged meaningful progress accurately, a lot of failed research efforts could be weeded out without being paid for. However, the push that rewards success would not have to be as large as the purse offered by normal pull programs because the innovators competing for this hybrid program’s prize would have less risk of failure than they would have if they were competing in a normal pull program for two key reasons: 1) Reward-worthy solutions would be less elusive and more obtainable since partial solutions and progress are accepted and 2) Competition with other innovators would be less cutthroat because the hybrid program would almost certainly have to accept a variety of different medical innovations as “meaningful progress” towards a final solution. 

     Skeptics might criticize the potential for non-productively vague or partial innovative solutions to be rewarded by such a program, but I would respond by pointing out that this hybrid program’s openness in its initial pull phase could be an important positive for a reason not mentioned by Pogge: Each innovator, knowing that multiple different partial solutions are acceptable, and that no single person or party is being held accountable for solving the entire problem might be encouraged to specialize, concentrating his efforts on a more tangible (but necessarily still meaningful) segment of the problem. By pulling multiple innovators that each solve a different part of the problem, this hybrid program may be able to facilitate extremely productive collaboration in the latter push phase.

Justifying the plan

Thomas Pogges’ Intellectual Property Rights and Access to Essential Medicines breaks down the complex issue revolving around the pharmaceutical business and their effect on the health of poor humans around the globe. This paper outlines the “full-pull plan”, which creates a free market system for affordable essential healthcare that serves everyone. However, there are limitations, especially in its implementation. Since the resolution is multi-stepped, I would like to first focus on the complexities of justifying the plan to affluent citizens and their representatives.

I do believe that we should implement the plan, if possible, but only after there is a certain level of economic development in the countries of the world. In page 35, Pogges says that if all the countries in the world opt into this program, it would take 0.1% of the World’s GDP. The way these statistics are phrased almost  make it seem like 0.1% of GDP is a small number when it truly isn’t. If less countries participate, naturally the amount that every country has to contribute increases. The paper mentions how if US does not participate in this program, the amount that other countries would have to pay will hike. The plan heavily relies on the participation of all sovereign states, which is quite bureaucratic and hard because every country has different interests. While there is a moral imperative to solve this injustice, the utility derives from the long run protection from potentially deadly virus like SARS and MERS are not enough of an incentive for taxpayers to want to participate in this project. There is a higher opportunity cost for a country to wealthier countries merely due to the fact that they will be proportionally charged more for the cause. Pogges might argue that the leaders representing the citizens will act upon the greater good. But as mentioned in a previous section of the paper, the respective leaders of the countries are different. Additionally, some might be more corrupt than others, and some countries —especially undeveloped nations— have high tax evasion rates. Hence there has to be short term utility that affluent countries can derive because a sense of moral good is not a sustainable argument.

While I was reading this paper, I was also wondering when this plan would be implemented. I think it is more fitting to implement the plan after there is a certain level of development in all countries in order maximize the impact of the plan. For instance, the United Nation’s Millennium Goals exist in order to reduce the amount of poverty by using indicators with quantifiable metrics. I think that it would make more sense to develop nations first economically and give them the infrastructure to implement a plan like this. Because the plan is construed under the assumption that the positive effect is going to be the same, even though the same action might have a different reaction in every nation. In order to make this paper stronger, the timing of the project should be explained because the paper criminalizes the current system and makes it seem like implementing this plan will solve all problems when it has its limitations. 

Pogge's Appeal to Morality

In his article, Pogge argues that the current system of intellectual property rights and patents after the TRIPS agreement is “morally deeply problematic” (2).  Pogge asserts in his article that everyone has a moral obligation to do what is in their power to work to eradicate the global burden of disease (GBD) that afflicts a majority of poorer countries. In order to correct the current morally corrupt structure, Pogge suggests creating a GBD patent that incentivizes big pharma to facilitate the access of life-saving drugs to the world’s poor. The GBD patent reorients the incentives of pharmaceutical companies by rewarding them only if their medicines favorably impact the GBD. Pharmaceutical companies would then be more likely to promote generic versions of their drug and sell them at lower-than-market prices in order to create this greater impact. Pogge explains that each country would contribute to the price of this reward, with the more affluent countries covering more of the cost. In short, his plan ultimately relies on the taxpayers of affluent nations to cover a majority of the costs for the GBD patent.

Pogge’s argument for morality is unconvincing as he neglects to sufficiently argue for the moral necessity that demands that the affluent should cover the costs of GBD patents in order to benefit the poor.  I do not believe that Pogge adequately explains why the affluent taxpayers should contribute to his plan. He explains that the wealthy will support his idea because it would bring them lower drug prices and access to medicines that typically afflict poorer regions as well as the “morally compelling” interest of avoiding mortality and morbidity in poorer countries (36).  To demonstrate his argument for morality, Pogge appeals to our sense of moral intuition in the example of giving a small amount of money to save the life of a total stranger. Yes, it would be very nice of us to help this total stranger.  However, what moral obligation do we have to the total stranger in need? Pogge neglects to decode if and why there is a moral obligation for the affluent to help the poor. In his conclusion, Pogge briefly solicits the idea that we must support his plan “as it is necessary for rendering minimally just the rules of the world economy considered as one scheme” (38). To Pogge, it is our moral obligation to help those in need in order to provide minimal justice (i.e. not make any situation worse) to those a part of the world economic system. I believe that this point more clearly defines Pogge’s argument for morality and would like him to expand upon this point to further support his argument.