Associated Baptist Press - Opinion: The moral imperative of health-care reform

Opinion: The moral imperative of health-care reform

By David Gushee

Monday, August 24, 2009

(ABP) -- The national debate raging over health-care reform has become a maelstrom of competing claims and counterclaims. It has been deeply infected by political demagoguery and hysteria.

The tenor of the debate raises the legitimate question as to whether our nation still has the capacity to tackle an enormously complex policy challenge such as this one. Each day we spend millions of dollars to defeat external threats -- but if we cannot address our own domestic problems any more effectively than this, then it will not be al Qaeda that undoes us.

The primary Christian interest in health-care reform is the moral imperative to extend adequate health care to all of our nation’s people. Why is health-care access a moral imperative? Choose your Scripture text or your moral theory, but they all point in the same direction:

Those of us who enjoy access to health care could try a Golden Rule test, and ask whether we are doing unto others as we would have them do unto us if we do not fight for health care for those who do not have it. Is this how we would like our children to be treated when they are sick?

We could work from Jesus’ teaching of “love your neighbor as yourself” and ask whether we can simultaneously love a neighbor and not care if they die from a treatable disease because they cannot pay for care.

We could work from a theology of human rights that includes bodily rights, which includes a right to health care -- at least in societies such as our own that have the capacity to deliver health care.

We could speak of basic principles of distributive justice in regard to the goods needed for a decent life in a community, and note the obvious fact that the unjust maldistribution of health care in this country is a huge national scandal and an affront to the God of justice.

We could focus on Scripture’s concern for the poor and the demand that they be provided for, and then link poverty and lack of adequate health care -- for these are linked every day, in deadly ways, here.

The national debate over health-care reform has lost, or never developed, a truly moral focus. It has not been treated as the great moral crusade that it is. To find a way to extend quality health care to 50 million Americans who do not currently have it would be an extraordinary moral victory for this country. But except around the fearful edges of the debate -- “pulling the plug on grandma,” “death panels,” abortion -- the moral case has been muted, shouted down, abandoned or never made.

A word must be said about these most extreme fears. In my view they reflect some combination of honest grassroots-level misunderstandings of complex policy issues -- misunderstandings that are often fed by purposeful misrepresentations by activists seeking to derail health-care reform or to deal Barack Obama a setback. Such misunderstandings have been enabled to some extent by a lack of message clarity on the part of those advocating various pieces of reform legislation.

No American Congress will pass health-care legislation with Nazi-type euthanasia panels. No one will start surreptitiously pulling the plug on grandma. And if some contingent tries to slip in expansion of taxpayer funding for abortion into the final bill, it will lose my support and that of many others.

It must be observed, however, that for a certain contingent of American Christians, issues only become “moral issues” at the edges of life -- at the beginning and the end. Providing health care for 50 million people is not itself viewed as a moral imperative; the issue only becomes morally significant if it might, somehow, just maybe, lead to more abortion or to euthanasia. Is it not possible for Christians to care both about people getting health care when they need it, and about abortion and euthanasia? Once again we see how important it is that Christians develop a holistic, comprehensive sanctity-of-life ethic concerned about human well-being from womb to tomb -- and everywhere in between.

I have argued that extension of health-care access is a great moral imperative. I have also argued that it must not, cannot, and -- as far as I can see -- is not being purchased at the price of succumbing to euthanasia or taxpayer-funded abortion. It also seems clear to me that gaining this expanded access to health care at a reasonable price to the taxpayer, business and the federal budget is a highly important prudential goal.

Which kinds of reform strategies will be the most effective at extending coverage to the most people at the least additional cost are questions best left to those who have the expertise to make informed judgments on such matters. But that we need something like the health-care legislation now struggling through Congress seems to me very clear on Christian grounds.

-30-

David Gushee is distinguished university professor of Christian ethics at Mercer University.

EDITORIAL DISCLAIMER: As part of our mission to provide credible and compelling information about matters of faith, Associated Baptist Press actively seeks a diversity of viewpoints in its columns, commentaries and other opinion-based content. Opinions expressed in these articles are not intended to represent ABP editorial policy and do not necessarily reflect the views of ABP’s staff, board of directors or supporters.

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Amen!
written by AJC, August 24, 2009

Thank you for a well researched and much needed article. Can we represent Christ when we're yelling at Senators and spreading unfounded rumors? No, but we can represent Christ by caring for people from "womb to tomb--and everywhere in between". My husband has worked as a chaplain and has said that it is a big need to have doctors provide advice on end of life decisions, but so often they are not paid for this and are so afraid of being sued that the task falls to the chaplains who have no medical knowledge. Somehow this has turned into a rumor that the family will have no say in the decision and it will all be left up to a "death panel". I, too, will NOT support this bill should it destroy small businesses and fund abortion, but I don't see that happening.

...
written by wilx1, August 25, 2009

Health care is a right only when it does not infringe upon my rights by forcing me to pay for it. That is the beauty of our Constitution. "Love my neighbor as myself." I do. I am responsible and hard working and pay for everything I have and I love my neighbor enough to expect him/her to display the same type of work ethic. As a young and very poor Seminary student with a wife and two children I had health insurance for my whole family. We did not have cable, we drove old cars, and we did not eat out, but we had health insurance. These are the choices that most of the uninsured do not want to make (poll's reveal that over half of the uninsured simply don't want to pay for it and are between 18-35).
As Christians we must be careful that we do not deify the poor and make of the poor a new form of idolatry whereby we are somehow justified before God because we "care" for the poor. We must also demand of the "poor" that they take some responsibility for their condition and take to heart the biblical command, "whatever your hands find to do, do it with all your might (Ecc. 9:10)."

The high cost of health care can be directly attributed to government intervention (taxation, regulation, etc.)and now we want the government to fix it?

Doublespeak?
written by tenor1, August 25, 2009

RE: "But that we need something like the health-care legislation now struggling through Congress seems to me very clear on Christian grounds."
How is it that the good doctor would apply the Christian standard to the deliberations and decisions of the U. S. Congress when overt participation and display of anything close to the Judeo-Christian example on government property causes acute apoplexy within the ranks of the ACLU and I suggest the good doctor himself?

Why is it that fully half of those "50 million uninsured" (it keeps growing) who can afford health insurance but choose to be self-insured, pay-as-you-go, are lumped into the group who the Obamites would have you believe are denied health care? NO ONE BUT NO ONE is denied necessary medical treatment in this country, at least until the government gets control of it. The Great One himself stated that better (spelled c h e a p e r) decisions might be made to "take a pain pill rather than have that joint replacement." END OF QUOTE.
True reform, but considered untouchable by the trial lawyers in Congress, would be to address tort reform, grant insurance portability across state lines which the Congress has expressly forbidden, and then get the heck out of the way of the private sector health care industry to be competitive, lower costs, and serve all Americans.

Access to medical care is a moral issue
written by Common Loon, August 25, 2009

wilx1,

I refuse to believe that 45 million uninsured people could all simply "choose" to buy health care if they would just cancel their cable subscriptions.

Your re-interpretation of the Golden Rule seems to be, "expect from others what you would expect from yourself." I'm self-sufficient; therefore you should be as well.

Sadly, this shifts the focus from an others-centered kindness and inclusion to a self-centered stinginess and isolation where the primary objective is to "do it on your own since I did it on my own."

This approach might be distinctly American, but it's not very biblical.

Gushee misses the point.
written by Ken, August 25, 2009

The question is not whether Christians have a moral obligation to help the poor. That obligation is indisputable from Scripture. The question is, is a government-run health care system the best way to do it? Our government has a long history of doing everything in the most-expensive and least-efficient way. How do we know they'll be any different with health care? In this case, the cure could end up worse than the disease.

Second, Gushee's argument that "No American Congress will pass health-care legislation with Nazi-type euthanasia panels" is both simplistic and naive. Fifty years ago, people didn't think our government would ever legalize abortion or same-sex marriage. They have done the former, and many are trying to do the latter.

Third, this health care plan before Congress will indeed allow for the government to provide abortions at taxpayer expense. It contains no prohibitions against such a practice, and attempts to add such prohibitions to the bill have been voted down. I fail to see what is so "moral" about that.

Finally, I have long since cease to be impressed by the "compassion" of liberals who push for government spending programs. Anyone can be generous when they're spending someone else's money.

Self Sufficiency is the Goal
written by wilx1, August 25, 2009

Common Loon,

The goal of helping the poor, according to Scripture, is so that they will become self-sufficient and contribute to society. If the government takes control of health care, which is the self-professed long-term goal of the President, then how are they/we becoming self-sufficient?
Helping someone become self-sufficient is the loving, compassionate thing to do. Simply placing them in a government program for life is akin to slavery and robs the rest of us from the fruits of our labor. Many of the uninsured are uninsured because they choose to spend their money elsewhere. For those who are truly "poor" there already exists government options.

...
written by Common Loon, August 25, 2009

For those Christians who disagree with Dr. Gushee, do you have any other counter-proposals besides telling the millions of uninsured families and children (who are also your fellow Americans by the way) to simply pull themselves up by the bootstraps of rugged individualism?

Rather than scapegoating the poor for their struggles, the God of Scripture reveals Himself clearly as one who defends the weak and lifts up those who are most vulnerable, including children and the sick.

As it stands right now, over 9 million children in this country do not have health insurance, which I believe is a serious moral issue that grieves the Father's heart. If your child is sick and needs immediate medical care, the fact that you're unemployed or have a pre-existing condition should not be a barrier to getting help.

...
written by tj282828, August 25, 2009

"No American Congress will pass health-care legislation with Nazi-type euthanasia panels. No one will start surreptitiously pulling the plug on grandma."

Right. . . and moral America could never kill babies with abortion or support suicide either. Oh wait, we already do that! Oregon has assisted suicide! Grandma beware!!! Moral America is a thing of the past.

Gushee at his best
written by Dr. J, August 25, 2009

The moral imperative to care for one's neighbor is nonnegotiable. It is a Christian imperative. It is not a government, taxpayer imperative. If you see a person who needs healthcare, you meet the need. Don't ask taxpayers to fulfill your christian duty.
Another moral imperative is not to steal. How is it any less immoral to take money (steal/tax) and redistribute to others? Or to take taxpayers' freedoms from them to provide a national solution? Or, how moral is it is add an addition $1 trillion of debt to our children and grandchildren's legacy? As usual, Gushee is way out there on the left.

Common Loon
written by Ken, August 26, 2009

"Rather than scapegoating the poor for their struggles, the God of Scripture reveals Himself clearly as one who defends the weak and lifts up those who are most vulnerable, including children and the sick."

No disrespect intended, but God does indeed blame the poor when their poverty is a result of their own laziness and irresponsibility. Read what Proverbs says about "sluggards." The apostle Paul specifically said that the church is under no obligation to help people who refuse to work. Read 2 Thessalonians.

Of course, I know not all poor people have brought poverty on themselves. Still, I fail to see how a government-run healthcare system is going to solve their problem. I also fail to see what is compassionate about spending someone else's money.

...
written by jsisgett, August 26, 2009

For those who believe the government "can't" do health care, have you heard of Medicare? It is government run insurance that has only about a 4% overhead. Very rare is the senior who doesn't want, like, or use it. Another government run program, the VA, consistently outperforms the private sector in terms of both effectiveness and satisfaction. Granted, you will find individuals who are unhappy with both the programs cited or who have not received the quality of care they should have, but those are the exception. Until you have had to fight with a private, profit-motivated insurance company, you don't know what frustration and dissatisfaction are about.

One area Gushee barely touched on is that health care should be seen as part of the national commons, the same as police and fire protection, the military, and education. We all have a stake in seeing that these areas perform well and are properly funded so that economic or social location does not prevent anyone from receiving these benefits. Basic fairness dictates that one's relative wealth or skin color should not disqualify a person from access to these social goods. The same is true of health care. If I lose my job and health insurance tomorrow then get a cancer diagnosis next week, I should not face a death sentence because of those circumstances.

response to jsisgett
written by Dr. J, August 26, 2009

So, because you lost your job and were not responsible enough to save for an emergency, I must pay for you. That does not sound like 'basic fairness'.

An Open Letter
written by Joe LaGuardia, August 26, 2009

Dr. Gushee,

Thank you for a wonderful contribution to the health care reform conversation. I always look forward to reading your thoughts on such pressing issues (got nervous when I didn't see any article by mid-August), and can see that the wait was well worth it.

My father is a small-business owner (has been since he was 21) and is struggling to save for retirement (he lost a small nest egg due to Enron's collapse), but pays a little over $12,000 a year for health insurance (for him and my mother).

If my father passes away, my mother will not be able to afford healthcare whatsoever; nor is she of eligible age for medicare.

When we talk of healthcare reform, my father expresses that he does not want free health insurance--that would undermine his sense of dignity, his love for country, and his work ethic. But Dad cannot afford to retire because of healthcare. He will probably have to work until he dies.

Luckily, and much to my father's relief, the President's plan does NOT call for a "free" health plan like that of Britain or Canada. On the contrary, Obama's plan for reform will simply bring competition to the market by providing a public option that contains a larger pool of consumers to drive down costs. A simple, no-brainer plan.

This is similar to what my wife--a public school teacher--gets through the state. Her monthly premium is a little over $300.00 for the FOUR of us because there is a larger pool of healthcare consumers, which in turn drives down costs. We have plenty of power to decide who cares for us (the State has never intervened in our healthcare decisions), and our health care is both timely and of high quality.

I hope that reform passes so that my father can have a similar plan, maintain his sense of dignity and work ethic, and at least cut his healthcare costs by a fraction (even 20% will help). This is his hope as well. Not to mention that my mother's future, if my father were to pass away, depends on it.

Did I mention that Dad does not smoke, have any pre-existing conditions, and is healthy as an ox? But he still has to pay those exorbitant, out-of-control prices. It makes no sense.

I would hate for the government to intervene on this issue. We should, after all, help thy neighbor, right? Unfortunately, until my church and my parent's church provide healthcare to their parishioners, I guess that government will have to do. Kind of like those safety regulations that the government had to impose on car companies in the 1970s--you know, the care companies that claimed that shoulder belts and airbags did not make people any more safe than lapbelts? Churches weren't too vocal on that one either. I think it was Ralph Nader, not a pastor, who led the way for automobile safety. But I digress.

Like automobile safety standards--which the government had to impose--Healthcare reform is something that only a government such as ours can pull off. It is both a moral necessity and a just cause.

Blessings,

Joe

jsisgett
written by Ken, August 27, 2009

Yes, I've heard of Medicare. It regularly struggles to stay solvent. With the aging Baby Boomer population, it's only going to get worse. The cost of Medicare is about four times what was originally projected.

As for the VA, all you have to do is go into a VA hospital and you'll see what the government does with health care.

You say only a few people are frustrated with Medicare or the VA. I beg to differ. I've been a pastor for more than ten years, and I've talked to very few seniors and veterans who weren't frustrated with the slow service and the red tape. That's just a sample of what will happen if the government gets its hands on the rest of our healthcare system.

Joe
written by Ken, August 27, 2009

"Obama's plan for reform will simply bring competition to the market by providing a public option that contains a larger pool of consumers to drive down costs."

Maybe you and I can debate this issue. I only ask for two ground rules: 1) I get to make all the rules, and 2) I can change the rules anytime I want and for any reason. Now be honest: would you agree to debate me under those conditions? Of course you wouldn't. That would be completely unfair to you, and would put you in a no-win situation.

That's exactly what private insurers will be up against if they have to compete with the government. The government will make the rules, and the government will be able to change them anytime they want. How can private insurers be expected to compete under such conditions?

...
written by ABP Reader, August 27, 2009

I appreciate the opinion piece. The majority of conversations in my ecclesial context end up affirming health care reform, but that's just my context. I won't presume to know what all Americans or Christians believe, and I'm certainly incredulous about the news outlets and talk shows revealing the pulse of America/Christians. As someone with a job and decent health insurance, I hope something is done soon.

Joe
written by jsisgett, August 27, 2009

Right now, private insurers make the rules. Their first rule is "20% off the top for profit." I've negotiated with these turkeys and know this to be true.

Joe
written by jsisgett, August 27, 2009

Oops. That last comment was for Ken. Sorry, Joe.

So it's the government's job?
written by Doug, August 27, 2009

Prof. Gushee, I absolutely do not see how you make the leap from a moral imperative on Christians (which itself can be debated, contrary to the open-and-shut case you present it as) to the conclusion that such a Scriptural mandate on Christians (if one grants that is true) justifies the creation of an obscenely inefficient and utterly compassionless federal program to fulfill that imperative. Do you believe that Christians have an obligation to provide healthcare to the poor? Then work in your local church, and your denomination, if part of one, to effect that outcome in the name of Christ! You cannot defend from the Word of God the notion that we, through our government, should provide womb-to-tomb care to all people. How would Christ be glorified through the confiscation of wealth by God-hating, agnostic government workers to pay for medical care for everyone? It would be only politicians (primarily of one party) seeking to glorify themselves and their party - and the memory of Ted Kennedy, as is the newest angle - by playing Robin Hood with taxes and health care.

...
written by billmyatt, August 28, 2009

thanks for a great opinion piece, dr. gushee. i agree with the underlying concern about the way this issue speaks to the questionable integrity of our country's internal fabric. you said:

"If we cannot address our own domestic problems any more effectively than this, then it will not be al Qaeda that undoes us."

immanuel kant (not likely a popular thinker to many of the commenters) said this:

"A propensity seems to have been implanted (perhaps designedly) in the human race causing every single state to strive if possible to subjugate every other state and to erect a universal monarchy, but, when it has reached a certain size, to break up, of its own accord into smaller states. In like manner every single church cherishes the proud pretension of becoming a church universal; yet as soon as it has extended itself and commenced to rule, a principle of dissolution and schism into different sects at once shows itself."

in other words, there is an analogous similarity between the social groups of churches and states; the tendencies of the one act as indicators toward the tendencies of the other. kant's point is that once a particular group--whether political or ecclesial--loses its ability to dialogue openly and peacefully about important, and sometimes fundamental, issues, then it will lose its ability to remain intact. once it "commences to rule" by discouraging dialogue or by an inability to have peaceful dialogue, the result is dissolution.

even though our country was built on this kantian ideal of unity-through-dialogue, the united states have had some difficulty maintaining unity historically. significant bloodshed is a periodic occurrence. and the intensity of the present debate--especially when it is riddled with such asinine, anecdotal arguments all around--makes me nervous about the future.

taking kant's cue to compare church and nation--if the state of baptists in america is any precursor to the future of our nation, we're in big trouble.

response to Doug
written by Dr. J, September 03, 2009

Right on Doug! In the good ol' days, Christians did not depend on government. Instead, when Christians saw needs, they met the needs as best they could out of love of others and God. Now, we have people like Gushee trying to impose our Christian responsibilities on the government. It is a ridiculous leap. Also, it is very selfish. He advocates the US government spend $1 trillion it does not have on the current generation without regard for the mountain of debt future generations must pay. This is very selfish and very irresponsible.

jsisgett
written by Ken, September 04, 2009

So you think things will get better if we turn it all over to the government?

it is not our place to judge
written by kmt, September 04, 2009

Dr. J. writes, "So, because you lost your job and were not responsible enough to save for an emergency, I must pay for you. That does not sound like 'basic fairness'."

Basic fairness is that health care is a right not a privilege. It is not our place to judge individuals. That is for God alone and when we presume to judge whether someone "deserves" something as basic as health care, we are making ourselves into God, becoming prideful, and blinding ourselves to his mercy and love.

Jesus did not say, "If someone asks for your shirt, give it to him if you decide he deserves it." He said, give him your coat as well.

This health care debate is about a simple issue. We have millions of uninsured, millions of underinsured, and a health insurance system that is not about health but about profits. We are being asked for our shirts. Will we give our coats as well? In fact, are we willing to empty the closet so that our brothers and sisters can live in dignity? The Christian response has no room for a "me first" response.

I am a Canadian citizen now living in the United States. The fear I see about a publicly run system boggles my mind. I think this country undoes itself with all this fear and anxiety. You are your own worst enemies in so many ways. I came down here for family reasons. But I look at what I got through a publicly run health insurance program and what I get with what many consider an "excellent" private plan, and I'd trade for the public any time. No copays. No deductibles. My premium was $300 a year. I paid higher taxes, but when you add what I pay in taxes here plus health insurance, plus everything my private health insurance won't cover, my costs were considerably less in Canda. And, I was never denied treatment, nor was my health care provider ever denied payment for a procedure by an insurance company. And there was the security of knowing that no one died in my country for lack of health care.

I used to work as a hospital chaplain in a Canadian hospital and never was the primary fear of my patients how they would pay for their care, or if they'd be able to avoid bankruptcy. My father has had multiple surgeries and never paid a dime out of pocket.

Don't let the fear of what you have not experienced keep you from taking the leap.

Be a real non-socialist
written by Arce, September 04, 2009

I encourage all who fret about "socialist" health care to eschew their use of:
Tax supported roads (Oh, that is all of them!)
Tax supported sidewalks (Oh, that is most of them!)
Tax supported fire and police services (Oh, that is almost all of them!)
Tax supported prosecution of criminals and the incarceration system.
Tax supported parks.
Tax supported libraries.
Tax supported schools.
Tax supported regulation of foods and other products for safety and health.
Tax supported regulation of financial institutions so they don't steal your money.
Tax supported protection of property rights (deed filings, etc.)
Tax supported monetary system.

Live without benefit of the tax supported functions in our society and see how difficult life can be. Be a true non-socialist and go live as a hermit in a cave with your own weapons to protect yourself. But don't go there by road.

roads are not socialist
written by Xenophon, September 05, 2009

The reason that roads, parks, criminal justice system, the monetary system, etc. are not socialist is that these governmental actions are not extensive and intrusive enough to alter what individuals choose for themselves or in conjunction with others who consent to the interaction. In fact, these governmental actions facilitate and protect people as they are left free to pursue their own ends.

The statist left, which includes Social Democrats, welfare statists, socialists, and Marxist-Leninists, argue for using the power of the state to achieve what they see as social justice by systematically interfering in the private spheres of individuals and voluntary relationships individuals agree to. Leftists of any variety see the pattern that results from spontaneous and free interactions as undesirable from a macro point of view as liberty tends to upset any pre-established social or economic pattern including equality of result. Equality of result as opposed to equality under the law is what unites the left and that is what is in play in the dispute over increased governmental involvement in health care. The main objection those us on the right have to socialized medicine, broadly conceived, is the intrusive, disruptive role played by the state in the affairs of individuals and private institutions.

"morality" versus reality
written by Xenophon, September 05, 2009

I am troubled by the claim made by Dr. Gushee that morality demands that we institute some form of the Obama health care package. Dr. Gushee relies on a number of ethical theories including the Golden Rule in making this pronouncement. I shall consider the ethical theories he cites in this regard below, but I am troubled by his appeal to ethics in seeming complete disregard for practical reality.

First, let us reflect on some crucial facts. According to a study at the Hoover Institute led by Milton Friedman, as government involvement in health care has increased over the past century, input in terms of dollars has increased dramatically in the U.S. and in Europe while output progressively slowed. What we see here is a general tendency that is frequently duplicated in other bureaucracies. This observation was first made by English physician Max Gammon who noticed the "black hole" effect in his study of the nationalized British Health Care system, which he termed "the theory of bureaucratic displacement."

Another problem with extensive involvement by government in health care is the continuation of third party payers that removes incentives for consumers of health care to shop around for the best prices in conjunction with the best product for the price. As health care in the U.S. and Europe has increasingly been paid for by government and private insurance with no incentive for individuals to monitor cost, we have seen costs rise exponentially. With third party payers, there is no discipline imposed on providers of health care to efficiently hold down costs. When government imposes price controls, it can only do so in the most ham-handed way so that the quality of care is diminished. This problem gives rise to the horrors of non-price rationing, which can and does endanger people's lives.

These concerns are borne out in the overall quality of health care in the U.S. versus single-payer systems or systems such as Germany with heavy governmental controls. Once a person is ill, the patient is much more likely to recover in the American system. A study published in *Lancet Oncology* (2007) found in an international comparison that Americans are much more likely to survive cancer probably in large part due to more extensive use of diagnostic testing freely taken advantage of in the U.S. but cut back in Europe due to cost considerations. Other procedures available to Americans that increase their quality of life are not available in Europe.

So, returning to the Golden Rule, why would I wish the statist egalitarian system on anyone but my worst enemy? If people cannot afford health care or insurance, then we can subsidize heath care for the poor either through government health care vouchers or by private charity. There is no reason to impose such an inefficient and potentially dangerous system on us all in order to help a few who would be as endangered as anyone else. While people have a right to purchase health care, it is inconsistent with the right to private property to suggest that people have a right (a moral and legal warrant to use violence) to health care in the sense of forcing people to pay for another's medical services. We do not frame such arguments to provide the poor with food (have you heard of people claiming a "right to food"?), so why do we make such unique claims for health care? I would suggest that we feel the need for some extreme action in health care because of Gammon's Law being at work in the medical field as government has increased its influence there. As we have continually increased the role of government in health care, we have created more of a problem for us all in receiving affordable medical services.

Finally, we must not simply issue pronouncements about what is "moral" without considering practical realities. We live in a fallen world and some accommodation must be made to human fallenness (people respond to financial incentives more consistently than they do to pleas for compassion) and ignorance (a big part of the strength of markets is facilitating the discover of relevant knowledge in how to best produce and deliver products and services to those in need). I would suggest reading the Bible as much for practical wisdom as we do moral imperatives. We can reach a more effective balance in these matters by considering the flexibility and the shrewdness that we find in Solomon's writings as well as reading and acting on what Jesus actually said.

The moral imperative of opposing government health care.
written by Peter Van Wieren, September 07, 2009

Dr. Gushee,

I expect that there are few, if any, Christians who would disagree that seeking to provide health care to all who are in need of it is a noble goal that should be pursued. In pursuit of that goal, however, Christians have all too often failed to give consideration of whether the various particular means of achieving it are or are not consistent with God's Law.

The words "society" and "government" have frequently been employed interchangeably in this debate as if they are one in the same concept. They are not. The difference is relevant in the fact that, without exception, every government decree is implemented by the use of force, or by the threat of the use of force. On the other hand, society is composed of voluntary associations, and voluntary exchanges of goods and services (e.g. health care). These take place on a basis of mutual agreement and to the mutual benefit of the individuals involved.

A key question that Christians must not neglect is the question of whether or not the use of force is a just means of carrying out the task of providing for the poor. Jesus sent out his disciples to teach men to obey all that He commanded. To my knowledge, however, He did not authorize his disciples to use force to compel men to obey all of His commands. Providing for the poor by means of the use of force is not justice, it is rather a violation of justice.

First, it is evident that the economic goods and services that exist and are available for consumption were created by the means of the labor of particular individuals. By the law of nature, that which is brought into existence by the effort of an individual is the property of that same individual. The property that belongs to a man is that which he has created by his labor, or that which he acquired through voluntarily exchange with another, or that which he was given by another. These are entirely righteous means of acquiring wealth and property. The scriptures affirm the concept of individual ownership of property, and that deprivation of an individual’s property rights is a violation of the Law (e.g. "Thou shalt not steal", and the laws pertaining to restitution).

Second, regarding men who utilize the above means for acquiring wealth, some will find more or less success in their efforts. God recognized that differences in wealth would exist. He spoke words especially relevant to those who have less: "You shall not covet your neighbor's house. You shall not covet your neighbor's wife, or his manservant or maidservant, his ox or donkey, or anything that belongs to your neighbor". When one individual takes the property of another it is an instance of theft, and this is a violation of God's law. God did not grant the poor an exemption from this law that would permit them to steal from the rich in order to remedy their inequality. In the same manner, it is true that if person A is poor, and person B is rich, that third person C would also violates God's law if he takes from B in order to give it to A.

Proceeding a step further, when such actions are undertaken by groups of people, this remains a violation of God's Law. (e.g. group C, in an organized effort, takes from group B to give to group A). What is a violation of God's Law in an individual instance cannot become justified when that same action is multiplied many times over - even if these groups succeed in implementing their action through government decree. For what individuals might carry out external to the government is, in its effects, no different than what can be carried out within government.

A government health care program is necessarily based on the expropriation of wealth from some to give it to others. Therefore, a government health care program is inconsistent with God's law and it is morally imperative that Christians oppose, rather than support, this means.

It may, however, be objected that the government is authorized by God to involuntarily take property from citizens (Romans 13:1-7/1 Peter 2:13-14), hence the government is exempted from the possibility of violating the law "You shall not steal".

(continued)

...
written by Peter Van Wieren, September 07, 2009

No one is free to arbitrarily define the limits of government power; rather, men ought to discern the limits of government power according to the extent of authorization God has granted. These verses inform us that, indeed, Caesar is authorized to tax, however, it also specifies that the purpose for taxation is the administration of civil justice. The administration of civil justice is a valid function of government, and taxation for that purpose is not theft. These verses show that it is our duty to support those functions of government that are legitimate from the point of view of God's law. These verses do not authorize Caesar to tax for any and every purpose. If indeed there are limits to Caesar's authority, then these scriptures carry with them both means and purpose. The means is taxation. The purpose is the administration of justice: law enforcement, courts, etc,. Do you agree that Caesar has not been authorized by God to levy tax for any and every purpose under the sun? (e.g. to advance religion, evil, or lawlessness)? The question at hand therefore becomes: Is the provision of health care a valid civil object for government?

It is one thing to suggest that God permits the state to take money by force to fund valid civil objects. It is quite another to say that God requires us to submit our body to the state for its maintenance and care, which is none other than slavery--the power of the state to impair the dominion authority of a man which he received directly from his Maker without passing through the hands of Caesar. The care of one's body is a duty owed to God, not to the state. If the state assumes jurisdiction over payment of health care, it inexorably follows that the state also assumes a jurisdiction over that care, either to compel a man to receive this or that medicine or prohibit him likewise; then a man is no longer free to direct the oversight of his own health as his reason dictates.

On some occasion Jesus was questioned by the Pharisees about taxation and He gave an answer which was neither hyperbolic or rhetorical. It is written: "...Whose is this image and superscription? They say unto him, Caesar's. Then saith he unto them, Render therefore unto Caesar the things which are Caesar's; and unto God the things that are God's." Jesus recognized that Caesars jurisdiction is limited to those things that are Caesar's.

A man's body does not bear Caesar's image, but rather it has been made in the image of God. For Caesar has not made men; rather God has made men. But if Caesar has the lawful jurisdiction to say to a man, "You may or may not receive this or that treatment" or "You must enter into a contract for health insurance as a predicate to your continued existence" then the state has imposed its own will for our existence well beyond that of God who made us without the need for this contractual pre-condition. Hence, for Caesar to assert jurisdiction over the health of a man's body for the purpose of "improving" it is a double evil--First it is an usurpation of a mans duty to self-govern. Second, it is an usurpation of Gods authority because the state places its image upon men, and rejects God's work. The administration of a man's health is not a civil object. That purpose lies at the very heart of individual self-government, and, as such, is governed solely by a man's reason and conviction.

Further, it should not be overlooked that according to Romans 13 Caesar's authority in the administration of justice is given to punish those guilty of "wrongdoing". Namely, Caesar's jurisdiction covers human actions, not the state of a human being (e.g. the state of being sick, or the state of not having health insurance, or the state of not having the correct health insurance coverage). If the civil government assumes jurisdiction over a man's health, then it does so by employing the means associated with that jurisdiction--force, coercion, and violence. These means are affected by the sword, which in today's parlance is the gun, the taser, and the jail house. These means destroy a man's authority to govern himself, make him a slave to his state master, and infringe upon the exercise of a man's reason and conviction. This is contrary to God's charge.

(continued)

...
written by Peter Van Wieren, September 07, 2009

You have argued in your recent article that it is a legitimate function of government and morally imperative to force money and labor from men for the purpose of compassion and carrying out the commands Jesus has given to us. If, perhaps, the aforementioned arguments are unconvincing to you (or any other reader of this letter), then I would like to ask if you would or would not consistently apply this principle into other areas? And more importantly why? For example, whereas churches are quite often lacking in funds and people are not faithful in supporting churches as they should, would you support the idea of a government imposed church tax like the nations of Europe (perhaps it could be 10% to be consistent with the idea of a tithe)? Likewise, would you support the idea of a government tax to support full time missionaries who work oversees, or domestically? Would you support of government tax to pay not for the health care of those in the US, but those in third world countries?

Or, as I have mentioned, is it lawful for Caesar to tax for any purpose, for good or ill? If not, please draw the line differently based on biblical proof.

Regarding the arguments stated in the article:

The arguments of the "Golden Rule test", "love your neighbor as yourself" test, and "Scriptures concern for the poor" test fail to establish support for a government program because of failure to include consideration of all parties involved. What is not seen is the forcible taking of property from those who pay the cost of the services. When one lacks the means to provide the medical services needed, is then robbery of one who can provide it justified? Certainly not. In speaking on this topic, Mr. Steve Gregg has well said:

"I believe [a man] honors God more by committing his case into the hands of the Almighty than he would by breaking the laws of the Almighty in order to prolong a life. The life he is seeking to prolong must eventually come to an end at some time in the will of God. Perhaps this is the time and the manner in which God chooses to bring it about.

"This suggestion may sound impractically idealistic, but I believe that the martyrs, and Jesus Himself, acted upon the same principle--to wit, that it is better to die for one's determination to obey God, than to prolong earthly life by denying Him and violating His commands. "For whoever desires to save his life will lose it, but whoever loses his life for My sake will find it" (Matt.16:25). Many of us can see that this principle holds true in the extreme cases, like those of Christ and Christian martyrs, but have difficulty applying the same (universal) truth to mundane, daily affairs."

The argument of "bodily rights" is invalid due to making the unwarranted extrapolation that a persons unalienable right to make decisions pertaining to his health without interference of the State, extends to compelling others to provide the means for attaining needed or desired services (see above).

(continued)

...
written by Peter Van Wieren, September 07, 2009

The argument of "distributive justice" is also invalid for at least two reasons. First, the criteria of "a decent life" is an entirely subjective and changing standard, especially when the whole of world history is considered. The idea of "a decent life" compared to one's temporal neighbors exclusively, cannot be said to establish the idea of a minimum absolute standard to which men have an alleged "right", but rather it is an appeal to envy of one's neighbor. Second, the argument neglects that economic resources are brought into existence and owned by their creators - who are individuals, not the community. It is the owner of property who has the right to dispose of it as he wishes. Health care resources are not communally owned, and hence it is not the right of the government to take and redistribute these resources (see above).

The concerns regarding "death panels" should not be dismissed as "misunderstandings of complex policy issues". It is obvious that no politician at the outset promotes a health care plan that includes "death panels". However, in the implementation, such will be the inevitable outcome of socialization of health care due to economic law. The resources of this world are scarce and limited; this is why they are economic goods that have monetary value (a price). Any government promise that limitations on the use of resources will not be needed is Utopian and cannot be fulfilled. For the role that prices serve in matching consumer demand with producers willingness to supply will be removed by socialization. The end result of the introduction of lower prices (or zero prices) can only be that demand for services will increase, and the extent of supply will decrease. When the lack of resources becomes apparent, it is inevitable that rationing will occur and a decision making process will be required to determine whom and when individuals can receive care.

The concerns regarding "abortion coverage" are also valid. Government programs virtually always expand in scope, and health care will be no exception. Medicaid already funds abortions.

Instead of promoting a government program to provide health care, Christians should, rather, advocate just means of achieving it. Personal benevolence or benevolence via the church are valid means. Additionally Christians should support the removal of government licensing, restrictions and regulations of all sorts which make health care less accessible by increasing its costs. Christians should oppose the governmental takeover of health care, for it is a violation of God's law "You shall not steal", and it is an instance of unlawful expansion of the jurisdiction of the civil government.

Peter Van Wieren

Opposing hypothetical boogie men.
written by Arce, September 09, 2009

I am tired of Christians creating extrapolations from anything that is even close to being contemplated in the proposed legislation into horror stories in order to stimulate opposition. That is LYING!!!!! And it is not a Christian thing to do.

Obama has not proposed a government take-over of health care. 30 years ago, health care was 8 percent of the GDP, today it is 16 percent, and the amount spent on it is doubling every decade or so. We must make some kind of reform to reduce this cost spiral. The money is being made by insurance companies, who fund procedures rather than health. What is on the table is that reform is necessary or the cost of medical care will ruin this country and render us a non-functional third world economy. Medical costs have bankrupted our auto industry, as an example. Reform is a necessity. What is needed is a civil discussion of WHAT reform is best for the country, not fear mongering. Adopting the model of the Cleveland Clinic and the several other integrated health management systems would reduce costs by 20% and improve the quality of care.

The instant response of most medical insurers when you are diagnosed with a significantly expensive to treat disease like some cancers is to fine-tooth comb your medical history and application and turn some irrelevant line from that paperwork into an excuse to deny coverage. That frequently means a denial of treatment, or at least a significant delay, and death frequently results. I see this as an attorney and have no ability to help people get through the maze because of the way the policies and laws are written -- they protect the insurers more than the insured.

Acne
written by Arce, September 09, 2009

An interesting example is that almost no one lists acne as a medical condition that they had as a young person. And acne not on your application can result in denial of coverage for certain cancers! Is that justice?

Rights
written by andy2012, September 14, 2009

so, i'm reading above and someone says that healthcare is a right until it infringes on their rights by making them pay for it. Is this writer aware that taxes already pay for Medicaid for the poorest citizens -- thus, ensuring a right to healthcare for the poorest citizens even though they can't pay? What about Medicare, for those Americans over 65 -- regardless of income or past contribution, Americans over 65 are eligible for Medicare coverage.

And what of public schools? Not all citizens send their children to public schools. Some don't even have children. But we all pay taxes to educate all children -- would this writer abolish medicare, medicaid, and public schools? Are this writer's rights being infringed by the public good that comes from his/her taxes? Should their be no taxes, so s/he can keep all the money he earns from his honest labor? And will the writer claim no public benefits to which he may be entitled?

A little logical consistency would be nice...

...
written by robber, September 21, 2009

Arce's comment: "Tax supported regulation of financial institutions so they don't steal your money."

If that's not the most ironic statement I've ever read in these threads, it's got to be the funniest.

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