Evangelical Insights on Health Care Reform in America
Evangelicals and Christians should weigh in on the current health care reform debate.
“I suffer no illusions that this will be an easy process. It will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year.”
– President Barack Obama, February 24, 2009
One might agree with our president on at least two points: health care reform is desperately needed, and the struggle to gain consensus on the precise nature and implementation of that reform will be difficult indeed. The New York Times has given a brief overview of the background and development of the national conversation on health care reform that reveals deep and profound differences and disagreements among and between American politicians and citizens, as well as business, insurance, and the health care field itself.
However, Fox News has reported on President Obama’s introduction of the role of religion in the question of health care reform, in which he framed it in terms of moral and spiritual values. Although Fox News focused instead on the in/appropriateness of an ambivalent partnership between government and religion, this move also opens a door to explore a Christian contribution to the conversation on health care reform in America.
Admittedly, health care reform is a controversial topic that has become nationally divisive. The following is not political (and especially not partisan) and does not purport to speak definitively for all Christians or to offer a decisive solution on the complexities of the health care crisis in the U.S. Rather, it would like to lay out a context for the conversation which is considerate of issues that American Evangelical Christians find important for guiding and shaping this critical discussion. Accordingly, it will engage conversation partners from within the Evangelical camp with recognized expertise in relating Evangelical faith and public policy.
Clive Calver and Galen Carey, in their essay on “Caring for the Vulnerable,” remind readers that Christians, themselves undeserving beneficiaries of God’s grace (cf. Ephesians 2:8), have a long and illustrious history of recognizing their responsibility to care lovingly for neighbors, especially the vulnerable, as shows in the Church’s sponsorship of hospitals, orphanages, schools, rescue missions, and so on. Jesus’ well known teaching in the Parable of the Good Samaritan supplies a notable example for followers (Luke 10:30-35).
Although recognizing that in a sense all human beings live with emotional and physical vulnerability, or a state of inadequate protection, of susceptibility to harm, they identify several specific groups which are especially “at risk”. These include the poor, because of economic deprivation, women, suffering from disproportionate powerlessness, children, with undeveloped survival ability and skills, immigrants, enduring separation anxieties and adjustment to unfamiliar and possibly inhospitable environment, refugees, similar to immigrants but facing forceful or even violent displacement and/or persecution, and the sick, which uniquely includes, at least potentially, all people because everyone is likely to face health problems at one time or another, and the topic of interest herein. Calver and Carey also list persons with disabilities, a wide ranger of mental and physical conditions making ordinary, everyday life difficult, the persecuted, or people oppressed because of gender, ethnicity, race, or creed, minorities, those who face numerical disadvantages in society, especially when they may become victims of overt injustice or unfair treatment by those in the majority, the addicted, those with drug, alcohol, pornographic or other debilitating bondages destroying families and individuals, and, finally, prisoners, those convicted of committing crimes, with some innocent, known or not, included, and whose lose of freedom and self-esteem and the need for eventual reintegration into society pose special problems.
Not only Christians in general, but Evangelicals in particular have a history of caring for the vulnerable, including the sick. Groups like the Salvation Army and the YMCA or individuals like William Wilberforce and D. L. Moody quickly come to mind. Furthermore, as Archbishop William Temple rightly noted, care of the vulnerable has by no means been confined to other Christians. Calver and Carey, quoting James 2:15-17, argue that if vulnerability is defined as “without adequate protection from danger and harm,” then “a key element of caring for the vulnerable will be providing access to those structures and resources that will shelter them from current and future harm.” Addressing a wide range of needs and resources may be necessary (cf. Matthew 25:31-46). These involve more than temporary “charity;” they also involve changing unjust structures that contribute to the chains of injustice (Isaiah 58:6). Accordingly this might mean, arguably, that Christians could and should see the current health care debate as an opportunity to discerningly redirect institutions and individuals into more alignment with biblical faith and values.
Significantly, and theologically,
Central to effective caring is the sense of interconnectedness or social solidarity. Human beings are created in the image of the Triune God (Gen. 1:27). The Trinity provides us with the archetypal relationship of interdependence that human beings are intended to image.
In other words, the nature and character of God, and the human relationship to God, determine that human beings are inseparably interconnected with each other. Thus, caring for each other, especially the vulnerable, including the sick, is for Christians an expression of belief in the Triune God. God is a social, compassionate being, and human beings should be socially compassionate. Christians can adopt the biblical concept of shalom, which “captures well God’s vision for humanity, and particular the vulnerable”, as a guiding principle for helping the sick, and for evaluating health care reform. Shalom suggests wellness and wholeness, and includes “physical health and social reconciliation” as well as what Evangelicals mean by “salvation” (cf. Isaiah 53:5; 65:20-23). Again, arguably, Evangelicals across the denominational spectrum, including Pentecostals and Charismatics, could and should see the spiritual and physical health of individuals and of society as appropriate areas of urgent concern.
What is the role of the Church? Our ecclesiology and missiology inform and influence our vision of what the Church may say or do in relations to social issues, including health care but not excluding other concerns (e.g. poverty, security, equality). Offering strong scriptural support (e.g., 2 Corinthians 1:3-7; Proverbs 27:17; Ephesians 4:13-16; Matthew 5:13-16), Evangelical thinkers Calver and Carey agree that the Church’s mission to the vulnerable includes evangelism and discipleship (sharing the message of Jesus’ healing and salvation), comfort (offering care and compassion to victims), community (providing a support network for alienated), forgiveness (ministering God’s restoring grace to the broken), and a prophetic voice (speaking truth to power). Christian families and individuals may also be enlisted through their generosity (sharing time and money), simplicity (living sacrificially for the sake of others), hospitality (welcomingly receiving the hurting), and citizenship (democratically promoting a just society providing opportunity and protection for all) (cf. Deuteronomy 15:7-8, 10-11; Romans 12:13). So far as it involves health care reform, this vision of ecclesial mission and familial and individual ministry seems to suggest active, sensitive, and non-exploitative involvement transcending political and even theological differences to address and embrace the hurting, that is, in this case, the unhealthy.
What about the government? How do Evangelical political philosophy and theology apply? While it is true that a minimalist government promoting good and discouraging evil is valuable for the vulnerable (Romans 13:2-4), it is also the case that the vulnerable need governmental leadership to take an active role in “promoting justice and righteousness, with a special focus on the poor and needy” (Psalms 72:4, 12-14). The broad responsibilities of a government toward its citizens include providing laws that protect, security that ensures personal safety, trade opportunities that enable prosperity, an infrastructure that encourages stability, risk management regarding insurance, health coverage, and emergency relief, a social safety net that provides a line of defense against hunger and homelessness, and education opportunities that empower responsible contribution to and enjoyment of a healthy society. Accordingly, good government does bear some responsibility for the health care system of its citizens.
One should not indulge in naiveté, however. There are some common pitfalls that must be avoided if they are not to eventually undermine effectively caring for the vulnerable, including reforming the health care system of the U.S. Paternalism, or just giving a temporary or permanent handout, may be well intentioned, but it actually harms its intended beneficiaries by robbing them of opportunities for advancement and improvement. Entitlement mentality can develop out of unwise government assistance, displacing initiative. Fraud may even occur among some who disrespect the rules in a mad, wild attempt to “get all they can grab,” so to speak. Futility can overwhelm the most conscientious caregivers when they sense the limitations of any person or program to completely eliminate the evils of poverty and hunger, or to establish world peace, or prevent the terminally ill from dying. Displaced initiative when the vulnerable are encouraged to be helpless and to perennially await rescue not only fails to offer real help but actually offends human dignity.
Is there consensus among Evangelical Christians on health care reform, or even, more generally, on caring for the vulnerable? Calver and Carey suggest a range of actions including “initiatives by the vulnerable themselves, personal sharing of neighbors, collective efforts by churches and associations, and actions by government at local, national, and international levels.” They admit strategic differences occur but suggest consensual agreement on four foundational values is attainable among most Evangelicals: first, the responsibility of Christians to contribute to the care of the vulnerable; second, the dignity of every human being created in the image of God (Genesis 1:27); third, the economic sustainability of solutions is preferable to those requiring continual subsidies from either the public or private sectors; and, fourth, faith-based initiatives, or the appropriateness and effectiveness of qualified faith-based organizations to partner with government in alleviating human suffering. Arguably, these consensus principles might suggest that Evangelical and Pentecostal involvement in the nation’s current debate on health care reform is critical and should be guided by compassionate concern, but also should be cautious about the economical and political pressures exerted by powerful individuals and groups whose interests are quite apart from our own preeminent Christian concerns.
So then, what is a defensible, devout position on health care reform for American Evangelicals? An established social philosopher and activist of evangelical orientation, Archbishop of Canterbury William Temple, once wisely said,
Now it is no part of the duty of a Christian as such to draw plans of a reformed society. But it is part of his [or her] duty to know and proclaim Christian principles, to denounce as evil what contravenes them, and to insist that these evils should be remedied. Further, it is his [or her] duty to judge how far particular evils are symptoms of a disease deeper than themselves, and if that seems to be so to ask how far the whole existing order is contrary to the Natural Order.
Temple added that Christians “must maintain their independence [of public policies and political parties] so that they may judge whatever exists or whatever is proposed with so much as their faith has won for them of the Mind of Christ.” Arguably, our Evangelical Christian values should serve to critique our nation’s public policies without becoming condemnatory through rampant political or sectarian infighting.
More specifically, the National Association of Evangelicals recently produced a balanced but provocative press release including a plea regarding civility in the current health care debate. Therein Evangelicals recognize the legitimate need for health care reform, the complexity and challenge of effecting reform, and the necessity of patient civility in the process. NAE also reaffirms commitment to sanctity of life, reminding that abortion is not health care and warning against government sponsored euthanasia (though affirming a sacred place for individual “end of life” planning).
Finally, the NAE calls on the President and Congress
to make health care accessible to all; to promote judicial and tort law reform that will bring into balance legitimate claims and fair compensation; and to enlist the counsel and help of governmental institutions, social agencies, insurance companies, and churches to establish health care provisions that will maximize the creativity of the private sector while minimizing government control.
The NAE statement avoids the extremes and excesses of “far right” and “far left” politics, which tend to promote ideological agendas at the expense of all else. However, it advocates challenging changes to the status quo that can be beneficial to many American people—including Evangelical Christians, of course.
Derived from the preceding, a few careful (very general) suggestions for American Evangelicals regarding health care reform may be in order. First, we should fight for reform for the sake of fellow human beings. Our present system is obviously imperfect. That equals unacceptable human suffering. Regardless of our personal state of health or adequacy of health care coverage, we should think first of those who are sick without sufficient resources. Here, let us love our neighbor as ourselves, and do unto others as we would have them do unto us. Second we should evaluate reform by the standards of our Evangelical faith. Sin is an institutional and individual reality in this world only overcome by God’s grace in Christ through the power of the Holy Spirit, and even at that we deal with the presence and influence of sin until the Parousia of Christ and the ensuing eschaton. We should apply strict standards of righteousness and justice to the health care reform process. This application necessitates careful checks and balances that guard against abuse on all sides. Therefore, we should energetically endeavor to avoid any monopoly of power and all concentration of resources.
Third, we should defend democracy in devotion to the spiritual and moral case for and cause of freedom. Freedom is a Christian value, and democracy promotes freedom, so we should defend democracy, not blindly or rabidly but nonetheless ardently, and in appreciation for its liberating potential for human beings. Accordingly, wherever so-called health care reform limits or restricts human liberty, not in the responsible form of mutual discipline but in violation of human choice and self-determination, we should strive against it with might and main. Fourth, we should finance reform in a responsible rather than reckless manner. Christianity teaches financial honesty and integrity. Accordingly, how Americans will pay for health care reform is a legitimate concern.
Ducking it amounts to duplicity at best and dishonesty at worst. Obdurate sentimentality that obscures the financial responsibility we owe ourselves and our descendants will not affect real reform; it will only be a procrastination of the reform cause and, ultimately, a prolongation of human suffering. Fifth, we should view the preservation of our Christian witness as the chief value to present and protect throughout the entire process. More critical than anything else is for a watching world to see a faith in Christ that makes a crucially positive difference in all the affairs of life, even—or perhaps, especially—when there is more debate and division than agreement and harmony.
In conclusion, perhaps American Evangelicals ought not to uncritically support the Obama administration’s present health care reform proposal “as is” because of severe failings in several of these areas. Commendably, it does appear to express a primary concern for alleviating the suffering of fellow human beings. Regrettably, it does not appear to take into adequate account humanity’s sinful tendencies toward abuse of power, or to provide for ample freedom of choice by many of the people who will likely be most directly affected by its eventual implementation. It does appear to have the unfortunate ability to begin a circle of socialist ripples in the pond of our treasured national democratic heritage. Again, it does not present a feasible financial plan for initiating and sustaining the health care program advocates that is fair to vast numbers of the nation’s citizens or their descendants. However, possibly American Evangelicals can use the Obama administration’s present health care reform proposal as a foundation for furthering the conversation in a progressive journey toward more responsible reform. The best thing about President Obama’s proposal may just be that it has finally brought an urgent need for national health care reform front and center into the American consciousness. Now discussion and development around such central Evangelical insights as herein expressed could potentially open up new possibilities in the area of health care for all of the American people. And the physical and spiritual health and life of Americans are certainly issues about which Evangelicals should be thinking and speaking—and on which we should be acting as well.
(Article by Tony Richie. Footnotes available by e-mailing brothrtony@aol.com)
