THE MORAL CASE FOR UNIVERSAL HEALTH CARE
by Bob Wheeler
Earlier today Speaker of the House Paul Ryan pulled from consideration a health care reform bill that was designed to replace Obamacare. The speaker, it turns out, was unable to secure a consensus within his own party to get the bill through Congress. Obamacare remains the law of the land for the time being.
The debate surrounding the bill reflects a logical dilemma underlying the American health care system. Should the government take steps to insure that everyone has access to affordable health care? One faction of the Republicans wants to keep the government out of the picture altogether. Another faction worries about the political consequences of possibly millions of low income and high risk Americans losing their health insurance coverage.
The Republicans’ perplexity is understandable. The American healthcare system had been plagued for decades with two major problems. On the one hand there were large numbers of uninsured patients; and, on the other hand, health insurance premiums continued to rise at unacceptable rates year after year. The U.S. would spend an enormous amount of money on health care each year, but often got less results than in other countries in terms of health outcomes.
One obvious solution to the problem would have been to adopt a single-payer national health insurance plan like that of Canada and many other industrialized countries. But in the U.S. there is a strong tradition, rooted in the Constitution itself, of limiting the role of the federal government. What else was it for which our ancestors fought in the American Revolution, if not freedom? And so the Obama administration decided to take a different approach. Adopting an idea that was originally conceived by the conservative Heritage Foundation, Congress passed the Affordable Care Act, or Obamacare as it came to be known. Republicans were appalled, partly because it involved an individual mandate. The federal government was forcing people to buy something they didn’t necessarily need or want. If this wasn’t tyranny, what was it?
Obamacare was a failure. Not enough younger, healthy people signed up. Insurance premiums skyrocketed; insurers dropped out of the program. Something obviously had to be done, which brought us to the Republicans’ current dilemma: is the aim to get the government out of the health care business? Or is it to make sure that everyone has access to affordable health care?
It is important to recognize that there is a moral dimension to this question. Can we, collectively as a society, consciously leave a significant part of our population without health care? Libertarians might be inclined to say “yes”: no one is “entitled” to anything, and our freedom depends on keeping the government out of our personal business. But Christians should think twice before accepting this line of argument.
It must be remembered that we are first and foremost human beings, and that as human beings we are accountable to our Creator for our actions. And what exactly does our Creator expect from us?
The question was once put to Jesus by a Jewish legal scholar. “Teacher, what shall I do to inherit eternal life?” (Luke 10:25; NKJV). Jesus in turn asked him a question: “What is written in the law? What is your reading of it?” (v. 26). The lawyer responded by quoting Deut. 6:5 (“You shall love the Lord your God with all your heart, with all your soul, with all your strength, and with all your mind”) and Lev. 19:18 (“and ‘your neighbor as yourself.’”). Jesus commended him for having answered correctly.
But then the lawyer went on to ask a typical lawyer’s question: “And who is my neighbor?” (v. 29), and Jesus responded with His famous Parable of the Good Samaritan.
The story goes that a certain man was making his way from Jerusalem to Jericho, and was attacked by robbers who beat him severely and left him half-dead. A Jewish priest happened to come by, saw the wounded man, and ignored him, going on his way. Then a Levite, another Jewish religious official, came by, saw the same man, and also passed by.
Finally there came a Samaritan. The Samaritans were a group of people who practiced an unorthodox hybrid form of Judaism, and were looked down upon with scorn by the Jewish religious establishment in Jerusalem. This Samaritan, however, reacted differently to the situation than had the previous two passersby. We’re told that “when he saw him [the injured man], he had compassion” (v. 33). What he did next was most extraordinary. First, he dressed the man’s wounds, “pouring on oil and wine.” The oil, basically olive oil, acted as a salve; while the wine, containing alcohol, would have served as an antiseptic. Having thus administered first aid, the Samaritan then placed the injured man on his own animal (perhaps a mule or donkey) and apparently walked the rest of the way to Jericho on foot leading the four-legged ambulance along the way.
Once in Jericho the Samaritan took the victim to an inn and there personally attended to his needs. Then, when he was ready to depart the next day, he left the wounded man in the care of the innkeeper, paying the innkeeper two denarii, roughly equivalent to a working man’s wages for two days. And perhaps most extraordinarily of all, he told the innkeeper, “. . .and whatever more you spend, when I come again, I will repay you” (v. 35). Thus the Samaritan assumed the financial risk of caring for the patient – and the patient was a complete stranger!
The point of the story, of course, is that the lawyer had failed to understand what God really requires of us. The lawyer thought that the question hinged on the definition of “neighbor.” The point that Jesus wished to make, however, is that the key word is “love” – we are to love our neighbor, to be genuinely concerned for his well-being. And love never asks the question, “Do I have to?” Love responds to human need no matter where we find it. This, then, is the basic principle of the moral law. This is the responsibility that each one of us has towards God.
Some of my Libertarian friends will undoubtedly argue that this is an individual responsibility, that there is no biblical warrant for a state-run health care system, or a state-run welfare system for that matter. And up to a point this is certainly true. In the Old Testament the social safety net consisted of extended family relationships. If your second cousin was in financial trouble it was your responsibility to act as a “go’el” or kinsman-redeemer to him, and come to his aid. The New Testament church recognized itself as a spiritual brotherhood and took care of its members by practicing a form of communism (Acts 2:44; 45; 4:34,35). Nevertheless all human beings are ultimately accountable to their Creator for their behavior, and they are not permitted to do collectively as a society what they are not permitted to do as individuals. And the Bible makes it clear that God judges entire nations for their cruelty, oppression and injustice. It remains to each society to devise the practical means by which pressing human needs can be met.
If we Christians, then, believe that abortion involves the taking of innocent human life, and that physician assisted suicide is a violation of the Sixth Commandment, how can we morally justify withholding medical treatment from someone who is critically ill? The only remaining question, then, is how do we pay for the treatment provided?