The provisions governing membership on the commission, Abram and Wolf add, mandated that commissioners have diverse backgrounds and represent a variety of ethical viewpoints. Though making agreement more difficult to achieve, this same diversity contributes to the persuasive power of any consensus emerging from such a group. The more dissimilar their backgrounds and viewpoints, the more likely it is that positions on which they achieve consensus (or even well-grounded compromise) will be endorsed by legislators and public.

Yet stressing consensus for strategic reasons may weaken the substantive power or coherence of a group's recommendations. Consider, for example, criticisms of the President's Commission's volume on access to health care. Ronald Bayer, in a well-documented review of the commission's deliberations on this matter, identifies and sharply criticizes the "kinds of compromises that were necessary to bring the Commission's work [on this topic] to a successful conclusion" (Bayer, 1984, p. 314). Agreement between the commission's staff, who favored the language of rights, and most commissioners and the staffs executive director, who did not, required replacing the notion of a right to health care with the weaker notion of a societal obligation to provide access to care. This was, to Bayer's mind, an unfortunate concession. "The concept of positive or social welfare rights," he argues, has emerged in recent American history as the most potent political language for those seeking to make claims against a nonegalitarian social structure. By explicitly rejecting the concept of a right to health care, thus breaking with recent public discourse on this matter, the commission deprived those poorly served by the current health care system of a language with which to express their discontent. In so doing, the commission implicitly adopted a perspective that views social change as the consequence of the recognition of moral obligations by the socially powerful, rather than as a result of demands pressed from below as a matter of right (Bayer, 1984, p. 320).

This charge has been echoed by John Arras, who argues that the commission's "retreat from the right to health care" represents "a significant retrenchment of our public commitment to provide health care for the needy" (Arras, 1984, p. 322).

In a different but related vein, Baruch Brody criticizes the commission's work on access to health care for failing to come to grips with underlying philosophical questions about distributive justice. "The Commission," he maintains, "needed to delve more deeply into the philosophical issues in order to show the extent to which we lack an appropriate social policy about access because we lack a social consensus about distributive justice" (Brody, 1989, p. 376f). A number of deep and divisive philosophical questions were papered over in the interests of maintaining a strategic consensus. Yet this served no purpose and may even have hampered subsequent



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