Health Care: A Moral Imperative

The political culture in North America is often at odds with our religious faith. Particularly in the United States, our emphasis on rugged individualism at times makes us forget the Old Testament admonitions for justice and the New Testament teachings of Jesus Christ. One of the places where this excessive individualism plays out is in the arena of health care.

Hard-working, middle-class Americans—including a substantial number of Banner readers—are but a single illness away from bankruptcy. Those who have lost their jobs, whose hours have been cut to part-time, or who have gone into business for themselves are especially vulnerable. This vulnerability is inconsistent with the values found in Scripture, which seems to suggest access to health care for all people, regardless of income.

Too often our knowledge of health care is based on myths, misconceptions, and partial truths about the American and Canadian systems. These myths include the notion that the U.S. has the finest health care system in the world. In fact, the World Health Organization states that the U.S. is behind 30 other countries in quality of health care.

Another misconception is that change would be too expensive. There is ample evidence that it would, in fact, cost less. Presently the U.S. health care system costs about double that of other industrialized countries, all of whom provide better care. One primary reason for this is administrative costs. Currently over 31 percent of every health care dollar in the U.S. is spent on paperwork and overhead, far more than in other industrialized countries. A national one-payer health care system could save enough on administration costs to ensure access to care for all Americans.

People also express the fear that with national health insurance the government would make people’s medical decisions. But experience shows that in a publicly financed health care system, medical decisions are, as they should be, left to the doctor and the patient.

A Moral Imperative
The debate over health care reform has not been treated as the great moral crusade that it is, according to renowned ethicist David Gushee. A strong case can be made to extend quality health care to 50 million Americans who do not currently have it. Why a moral imperative? In the U.S., an estimated 50,000 people die of treatable diseases each year because they did not have health insurance. Gushee suggests that Jesus’ call to love our neighbor as ourselves means we need to care about these people.

And what does the Lord require of us? “To act justly and to love mercy and to walk humbly with [our] God,” says the prophet Micah. In addition, Proverbs 31:8 instructs us to “speak up for those who cannot speak for themselves, for the rights of all who are destitute.” Think how much time Jesus spent healing the sick. Health care reform must rest on a foundation of biblical values that affirm each person’s life as a sacred gift from the Creator.

The government’s God-given task is to correct and prevent injustice (Ps. 72). It is immoral for the government, the church, or individuals to look the other way when there is injustice. Would God be pleased with us allowing his children to suffer because of an ideological struggle about who has responsibility for caring for the needy?

As Steven Brill reported in Time magazine, the system of paying for health care in the U.S. is broken (“Bitter Pill: Why Medical Bills Are Killing Us,” March 4, 2013). Health care costs in the U.S. have grown at a rate five times that of the gross national product (GNP). Sixty-two percent of bankruptcies are caused by or are related to medical bills. Drug prices in the U.S are, on average, 50 percent higher than in other developed nations. So we need to control drug costs. The U.S. can lower the qualifying age for Medicare, which is far more efficient than private insurance. We need to insist that hospital managers be paid a more reasonable salary, and that hospitals make a more reasonable profit. The evidence is that a single-payer publicly funded system can provide quality care for all at half the price of private insurance companies.

The Role of the Government
John Calvin freely spoke of the government’s obligation to ensure that the basic needs (he called them “rights”) of the poor are met, both in terms of basic provisions and in terms of basic health care. Calvin argued that the diaconate of the church should work closely with the civil government in these areas, and he insisted that the government of Geneva should establish a governmentally supported hospital for the poor.

The legislators, the president of the U.S., and the judges who created the Affordable Care Act do not fall under the category of “the principalities and powers of darkness.” They are the authorities ordained by God to govern, the ones to whom citizens owe obedience, love, and service. When Christians need to oppose civil authority, we need to do so in obedience to the Word of God, exemplifying the sacrificial service of Christ toward our neighbor in all that we do, and so witnessing in word and deed to the gospel. That does not mean we need to compromise our convictions about what is best for the country we live in with respect to health care or any other issue, nor does it mean we should submit to the government when it commands us to disobey God. But it does suggest that we do these things in a spirit of love and humility, not in a spirit of cultural warfare.

In contrast with the U.S. health care system, the Canadian system is based on the belief that all “necessary hospital and physician services” will be provided to the citizens by the government. The majority of Canadian citizens take out supplementary insurance policies, comparable to persons on Medicare in the U.S. Physicians in Canada are usually reimbursed by the government at a negotiated fee-for-services rate. Canada spends about 12 percent of its gross domestic product (GDP) on health care. A 2010 Health Affairs study found that doctors in Ontario spent $22,000 each year dealing with the single-payer agency, compared to the $83,000 doctors in the U.S. spent dealing with multiple insurance companies.

Whatever its shortcomings, the Affordable Care Act in the U.S. is an attempt to provide health care to the poor. Those who oppose it should turn their attention to providing an alternative that provides access to health care for all, regardless of income. Meanwhile, the private, for-profit health insurance companies continue to divert funds to drug ads, salespersons, lobbyists, and huge executive salaries. In addition, they distribute more than $12 billion a year to shareholders. The U.S. General Accounting Office has concluded that a single-payer health care system would save the U.S. about $400 billion a year. Those funds would cover the cost of providing access to health care for most of the people who are currently uninsured, and thereby save thousands of lives.

There is no doubt that many Christians in the U.S. and Canada obtain superb medical care. The question is, can we have a system in which that superb medical care is available to all? As Christians, we’re always called to care about what is best for all people, not just what’s best for ourselves.

Related link:

The Complexities of Health Care (The Banner)

Health Care Reform (Office of Social Justice)

Web Questions:

1. The authors assert that Scripture seems to suggest access to health care for all people, regardless of income. What passages/biblical teachings might lead us to that conclusion? Do you find them persuasive?
2. What are some of the “myths” about U.S. health care, according to the authors? Do you believe they are myths?
3. Do people have the right to quality health care? Is it a moral imperative for us to extend health care to all, regardless of their ability to pay for it? If so, how should we go about doing that?
4. What should the government’s role be in seeing that health care is distributed equitably? Is “Obamacare” an acceptable way of doing so? Why or why not?
5. Should we, our congregations, and/or our denomination involve ourselves in this issue? Why or why not? If so, how?