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Government
He Said, She Said on Health Care
by
D. C. Innes
and
Lisa Sharon Harper
Engaging ideas that you don't agree with is a crucial aspect of intellectual maturity and demonstrates the posture of being provoked and not offended. In
Left, Right & Christ
, Lisa Sharon Harper and D.C. Innes explore how the Christian faith speaks directly to American politics but often leads to different applications. In this chapter excerpt, Ms. Harper (from the Left) and Dr. Innes (from the Right) explore the topic of Health Care in the United States. Please make sure you read both of their excerpts before adding your voice to the conversation.
Health Reform
By Lisa Sharon Harper
Forty-two percent of U.S. adults are underinsured or uninsured, according to a 2008 study conducted by the Commonwealth Fund. The word underinsured describes people whose current high insurance deductible, lifetime caps, or limited coverage would present the individual or family with serious economic hardship in the case of any serious health needs (1). The study found that in 2007 uninsured and underinsured adults were more likely to have low or moderate incomes:
About seven in ten underinsured adults had annual incomes below $40,000 or below 300 percent of poverty— similar to the income distribution of the uninsured. In contrast, nearly two-thirds of those with more adequate insurance had incomes above $40,000. Underinsured adults were more likely than either of the other two groups to have health problems.(2)
In other words, in the U.S., the right to live is earned through economic fortune or white-collar work. Life is not, in practice, an intrinsic right; the right to live is bought—at a high price.
For nearly 100 years, U.S. presidents have tried to move the reality of our health care system into alignment with our nation’s declared values for life, freedom and equal protection under the law. They aspired to transform a system that disproportionately claims the lives of middle and low-income people into one that actively protects the lives of all. Yet, at every turn, they have been met with opposition from an equally strong value-driven American tradition—Laissez-faire conservatism, which helped make the United States a nation of entrepreneurs (3).
[…] In the end, President Barack Obama, House Speaker Nancy Pelosi, and Senate Majority Leader Harry Reid led the executive office and both chambers of congress through a long and windy series of tactical battles throughout 2009-2010. Then, on March 23, 2010 President Obamasigned the Patient Protection and Affordable Care bill into law(4).
The Patient Protection and Affordable Care Act
While The Patient Protection and Affordable Care Act provides neither universal health care nor a public insurance option to rival private insurance markets, it will protect the sanctity of the lives for a record 30 million more Americans. It will add 16 million people to the Medicaid rolls and will subsidize private coverage for low and middle-income people like Nikki White. It will regulate insurance companies more closely, preventing them from denying coverage to Americans with pre-existing conditions and outlawing lifetime caps on coverage. It will cost the federal government $938 billion over the next ten years, according to the non-partisan Congressional Budget Office. But when all is said and done, the law will cut enough costs that it will actually reduce the federal deficit by $138 billion in the same period and by more than $1 trillion over the second decade (5).
[…] Jesus said, “No slave can serve two masters; for a slave will either hate the one and love the other, or be devoted to the one and despise the other. You cannot serve God and wealth.” (Matthew 6:24) No tug of war in American politics illustrates this scripture more than the epic battle for health reform in the United States. America’s deep value for equal protection of the lives of people created in the image of God has been pitted against the deeply-held value of rugged individualism and the entrepreneurial spirit. Both are important. Both make America what it has become. But in a representative democracy our private values affect millions of human lives. So, when push comes to shove, followers of Jesus must open our eyes and see the effects of our ideological loyalties on real people made in Gods’ image.
Jesus reminds us that our creator requires supreme loyalty. If we claim to follow Jesus, then we are to be slaves to the God who “made heaven and earth, the sea, and all that is in them; who keeps faith forever; who executes justice for the oppressed; who gives food to the hungry” (Psalm 146:6-7). If we claim to be followers of Jesus, then we must be slaves to the God who protects and cultivates the lives of people made in his image as he “opens the eyes of the blind” and “lifts up those who are bowed down” (Psalm 146:8)—slaves not only in our individual morality, but also in our vote. Wealth, Jesus warns, will make you hate God. It will demand your supreme loyalty. It will call you to conspire in the crushing of the image of God on earth. It will demand the sacrifice of human lives on its altar. “You cannot serve God and wealth,” Jesus said.
So I ask: As the Health Reform law is enacted over the next decade; as states file lawsuits to overturn the law; as the courts take up the constitutionality of the law, how should Jesus followers respond? There are still approximately 12 million uninsured or underinsured lives that remain unprotected under the current health reform law. We must call for more. We must call for universal care that protects and cultivates the image of God in all of us.
Biblical Government and Compassionate Health Care
D.C. Innes
The Bible is a book for Sunday through Saturday. It addresses all of life because the lordship of Christ reaches to every corner of creation. “Take captive every thought,” wrote the Apostle Paul, “to obey Christ” (2 Cor. 10:5).
The American health care system must be no exception to that principle. What, then, is the biblically Christian position on health care reform? In Left, Right and Christ: Evangelical Faith in Politics, Lisa Sharon Harper and I, from the political left and right respectively, address the question of what God requires of us in our shared political life. We then apply our understandings to the prominent issues of our day, including health care.
Lisa sees biblical support for greater government regulation and systemic transformation, part of what she argues is God’s plan to restore human relations with one another and with creation to the shalom for which we were created (pp.49-50, 79-80, 85-86). For my part, however, this side of the Lord’s return and people being what they are, I see biblical government as far more limited in its function, preserving people in their liberty to serve God in love. In so doing, it protects the various spheres of life—family, church, social, and civic organizations—in which we provide for ourselves and for one another the innumerable goods that constitute a life of human flourishing (pp.58-63; Rom. 13:1-10; I Peter 2:14; I Tim. 2:2).
Does God require a government-run health care system? It’s not likely, given that, biblically speaking, God has not given responsibility for the delivery and financing of medical services to the civil government. Health care is one of the many goods that people provide for themselves and for one another in a properly functioning economy. The government’s role is simply to regulate it to the extent that public safety requires.
What about those who are desperately short in their ability to pay for health services? The reflexive response on the left is to call in the government. The bigger the government involvement the better, it seems. But when public authority intrudes into matters that God calls people to address in the private sphere, the result, as with every violation of the creation order, is a net loss for everyone.
In this case, experience in other countries tells us that a state-run, state-financed health care system quickly and inevitably becomes focused on cost containment at the expense of patient care (1). Because we live in a world of limited resources even for obviously good things, governments that have taken charge of health systems soon come to view the sick (especially the elderly) not as people to be helped, but as costs to be minimized. In the real world of choices and trade-offs, not fantasies, the alternative to price-based rationing is not excellent health care for whoever wants it whenever and wherever. It’s control of your health and life by box-checking, budget conscious bureaucrats calculating your “quality-adjusted life years.” Pretty bleak. Dispersing the power to make health care decisions into the hands of consumers—patients and those closest to them—is on balance the safest, most economical, and most humane alternative.
We can help the poorest among us as individuals, families, religious communities and private charities, and through pro bono work by doctors themselves. Americans are quite generous and have a long history of establishing and funding effective ministries and organizations for addressing neighbor-needs. They feed the hungry, clothe the naked, and bind up wounds through everything from church basements to Mercy Ships. Moreover, the power and provision of private charity would be much greater if it were not constrained by how much government takes in taxes and discouraged by how much government intrudes with entitlements (2).
Based on what we see today, it is safe to say that in a consumer-driven system, hospitals would serve the sick, both rich and poor, with a pricing system similar to what we see in private colleges and universities. In higher education, students from wealthy families pay full fare, while poor kids get a free ride, with donors making up the difference. Can we trust doctors and hospitals not to take a “pay up or die” attitude to the sick? Of course we can. The story of Nikki that Lisa shares in her chapter provides an example:
Thomas W. Green Jr., an internist who coordinated her care, says, ‘The whole hospital got very, very emotionally involved with this girl and this family. She didn't give up. They didn't give up. There were minor, major miracles, major setbacks.’ The hospital kept going even though Ms. White had no insurance. Bristol Regional spent about $900,000 on Ms. White's care. Her tab was one of the nonprofit hospital's largest charity cases that year. In all, it wrote off nearly $19 million in 2006. ‘We spent a lot of money on this girl and nobody complained about it,’ Dr. Green says (3).
Our American and Christian culture of compassion and mutual respect would prevent private health care providers from taking a strictly commercial approach to their profession.
When the Democrats secured the last vote needed to pass the bill they cobbled together, Sen. Chris Dodd proclaimed, "We stand ready to pass a bill into law that finally makes quality health care a right for every American, not a privilege." But when any service becomes a "right" from the government instead of a "good" to be purchased, you can expect its management to be politicized, its consumers to be impoverished, and its development to be stunted.
The American political left, both secular and religious, goes far beyond what I argue God intends government to do, viz., to punish evil and praise what is good (I Peter 2:14). It tries to accomplish with government (preferably the federal government) what is properly a private responsibility. It tries to shrink the sphere of private liberty by expanding the sphere of public action. But God tells us that it is the government’s job to protect that private sphere, not absorb it, so that people can provide for themselves and for one another (I Tim. 2:1-2). As usual, what is best on every level is liberty, personal responsibility, and generous charity, three traditions that are uniquely Christian and historically American.
You can order this book at
Hearts and Minds Books
. Mention Q Ideas when you order and receive 20% off.
If you are interested in receiving the relevant footnotes, please email Caitie
@Qideas.org.
Which of the authors' points do you agree/disagree with? Why?
How do you see your faith informing this policy issue?
Editor's Note: These articles edited excerpts from a chapter in Left, Right & Christ: Evangelical Faith in Politics (Russell Media, 2011). Used by permission from the publisher. This image belongs to Keith Negley and was commissioned by the NYTimes in February 2010.
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