ABSTRACT
It may or may not be true that there is a growing resistance to such ideas of solidarity and social justice in Western societies: that those who pay taxes are increasingly reluctant to pay to provide for the needs of others who may not contribute themselves, or who may contribute too little in tax to pay for their own medical needs. For those who share this anti-solidaristic attitude, no doubt the non-contributors (who would include the old, or at least the less affluent among them) are seen as a burden, a drag on the ability of the taxpayers to pursue their own aims, using their own resources. If this were a matter of sociological fact, then it would certainly be more and more unwelcome, given an ageing population, to sustain the NHS in its present form. But the question that concerns us here is one about the interpretation of this alleged sociological fact. Is the perception of the old as a burden a mere expression of selfishness, and a rather short-sighted selfishness at that, since all of those who are now young and healthy will, if they are lucky, one day be old themselves and quite possibly frail and in need of medical care? Or is it a perception of a genuine injustice done to the young and healthy by the need to provide for those who are old and frail? Only if the latter interpretation is correct is there a crisis facing the moral foundation of the NHS and one that is attributable to an ageing population.
