[Editor's note: This series of articles was adapted from an event entitled "Reforming the Healthcare System: How a Biblical Worldview Bears on the Current National Debate." It was hosted by the richmond center for christian study and featured lectures by Dr. Terrill Wade, a retired family physician, homeschooler and educator.]
The first article on this topic (in a three-article series) declared that the Bible definitely has answers to the healthcare crisis in America. The answers aren't simple, nor will they make everyone happy, but they're certainly clear. A robust biblical worldview bears on every part of life and culture. So, naturally, I believe the Bible is where we must begin if we are to adequately address any problem—including problems of this magnitude.
So far we have seen that the Bible speaks to our individual duty to love and help the needy, as well as calling health providers and businesses to examine their financial and ethical responses to the problem.
But most of us really struggle to care well, even for those immediately around us. Most businesses do not embrace voluntary restriction of profit. And discriminatory practices continue. Meanwhile increasing numbers of people are unable to keep up with rising healthcare costs, while at the same time more people are needing care, making access to healthcare even more difficult.
So we are left with the question "Does God mean us to leave the situation as it is while we continue trying to make small dents in the situation, or is there a biblical basis for the federal, state or local government to take a role in healthcare reform?"
This is the area of most profound disagreement between Christians.
Why is there such disagreement?
There are numerous reasons. In the eyes of one group of Christians, a federal government role in healthcare reform means it is moving into areas from which it was specifically excluded by the Constitution. Since many Christians are firmly convinced of the reliable wisdom of the founding fathers in desiring to keep federal government small in order to allow individuals to follow God in their own way, this step is considered disastrous. They also do not see healthcare as being a biblically assigned function of the government, and point to the fact that government involvement often ends up stamping out the Christian message of hope for the needy it serves. This is not compatible with the mercy ministries of the New Testament.
Some Christians want to keep the federal government out of healthcare on pragmatic grounds. Big government involvement always ends up costing society far more than estimated, thereby reducing the money individuals retain to contribute locally to more efficient charities. At the same time, because of the nationwide stretch and huge numbers involved, red tape increases while response times are slowed and solutions become one-size-fits-all. The system of free money handouts often utilized by the federal government has the effect of encouraging the dependency of the recipients and diminishing the responsibility and self-worth that God has associated with working.
On the other hand, some Christians, totally fed up with the decreasing ability of individuals and group charity efforts to keep up with increasing healthcare needs, and frustrated by the ongoing lack of voluntary change in society, perceive the Federal government as being the only entity big enough to move us, in spite of ourselves, to do the right thing. They are deeply concerned that all of those who need healthcare receive it, in line with Scriptural teachings about providing mercy and justice for the needy.
In light our disagreements, I think we should consider two things before examining the role of government any further.
In the first place, I would caution us to be careful not to elevate any of man's wisdom to a position over God's—whether it belongs to the man-made document of the Constitution, or man's view of the appropriate way to dispense mercy and justice. It is a constant challenge to discern what parts of our worldview are actually rooted in God's Word, and what parts we have imbibed from our upbringing or teaching.
Secondly we should realize that there is no sphere of our lives which is free from government. [Government is defined here as either "restraint, control" or "a position of authority."]
Government is present from the level of governing of one's own heart, to the governing of our families, to government within the church body and local civic organizations, up through county, state and federal government levels.
In our fallen state, we must have government of some sort in all of our communal activities or we fall into chaos. So government is necessary in society and, done well, it is one of God's common grace gifts.
The current healthcare reform debate in the U.S., however, is specifically concerned with our federal government, an elected secular body of a few citizens who have been given "by the people" the authority to make laws and to ensure their establishment, which will be for the good—the general welfare—of the citizens of our nation.
We are concerned with what can be drawn from Scripture to answer this question "Has the federal government been given a legitimate interest in ensuring that all citizens have reasonable access to health care?"
It is worth noting that a negative answer to these questions would not alter the fact that the federal government already insures [is the Single Payor for] more than 50% of United States citizens—Veterans, as well as those on Medicare, Medicaid, and SCHIP to name the largest groups. The U.S. federal government is already deeply entrenched in healthcare.
Turning to the Bible now, we see several types of societies represented in the Old and New Testaments, illustrating different governing situations.
All of them are under God's sovereign rule, but the Garden of Eden, the nation of Israel (except during the Babylonian exile), and much of the book of Revelation represent theocracies—societies in which God rules directly because He is present. His laws are to be obeyed and there is no room for idolatry and sin, on pain of death.
We are not in such a theocracy, but because God gives us such a clear picture of Israel and shows us His requirements for, and the commendations and condemnations of His appointed authorities, we can really see the role of godly rulers in relation to the needy.
Here are some examples:
- Judges were held accountable for adjudicating fairly - no injustice, partiality or bribery (2 Chronicles 2:7)
- Lawmakers were warned about making laws that deprived the poor, oppressed, fatherless, or widows of their rights and justice (Isaiah 10:1)
- Kings were directed to promote justice, and adjudicate the poor fairly, in order to keep the country and the throne stable (Proverbs 29:4)
- King Josiah was praised "He defended the cause of the poor and needy, and so all went well. Is that not what it means to know me? declares the Lord." (Jeremiah 22:16)
It seems that God called on kings, lawmakers and judges in Israel to ensure that the poor across the nation received justice and care, rather than leaving that care solely as a function of the individual Israelites. This probably implied making sure that appropriate laws were carried out.
We can draw much insight into leadership roles from the monarchy of Israel, though we do need to remember that kingship in Israel was a type [a forward look] of the Christ, the eternal ruler who was to rule over all things. Much of what the kings of Israel were called to do represents what Christ will in fact fulfill when His kingdom is finally and fully established.
However, Psalm 82 is a psalm which some commentators feel may well be addressed to all kings and authorities outside, as well as inside Israel. It portrays a scene in which God is calling kings and men in authority to account;
"Defend the cause of the weak and fatherless.
Maintain the rights of the poor and oppressed.
Rescue the weak and needy…"
This psalm directly places responsibility for the well-being of the needy onto the leaders.
The other type of society in Scripture is represented by the time of the individuals called by God prior to the establishment of Israel, the community of Israelites in exile, and the early Church. It is also the kind of society present in the United States today. In these societies God deals individually with His people, within the context of the larger secular society. In the parts of Scripture that deal with these societies, God elaborates only in a couple of places on the role of secular government.
In Jeremiah 29:7 the prophet tells those going into exile to "seek the peace and prosperity of the city to which I have carried you into exile. Pray to the Lord for it, because if it prospers, you too will prosper."
This would seem to validate our working for the good of the larger secular community, rather than just for the good of fellow believers, and could well involve working through authority structures. There is also no doubt that peace and prosperity in a community depend on citizens having their most important needs met.
Romans 13:1 is the most lengthy discussion of actual secular government on the level of the federal government, and Paul was talking about a government that was a lot more hostile to Christian beliefs and values than ours. After establishing that all authorities are established by God, and specifically mentioning the role of the authority as God's servant to bring punishment on wrong doers, Paul goes on talk about the authorities being God's servant to do us good, and to commend those who do right. Exactly what it means to ‘do us good' and ‘commend those who do right' is not exactly clear, but it could fit with the call in Psalms 82:1to authorities to protect the needy.
As a result, I do see some basis for government in a society like ours to take a role in ensuring that the healthcare needs of its citizens are met if they are not being adequately covered by private means.
This might involve legislation to remove discriminatory fee structuring, restraint of excessive profit making in the healthcare field, setting up incentives for preventive health practice, and removal of the tax free status of some health insurance. I do not see a role for a public option, however.
Personally, I could also agree to mandatory health insurance, based on an income sliding scale, that would allow coverage of doctor visits, hospital treatments, place a reasonable cap on yearly medical payments, and cover pre-existing conditions. I see this as an application of the principle of bearing one another's burdens and placing others needs before my own.
I do want to add several limitations immediately.
Such government involvement must be consistent with the protection of life at all stages, and the protection of the conscience-rights of healthcare providers. I believe that to be essential in order to remain consistent to God's placement of intrinsic value on each human being.
Such help is most effective and ministry to the whole person is most possible when help is given at the closest level to those needing it. So, it would seem to make the most sense to push for reform at the county and state levels, rather than at the federal level.
I do not support the health reform package currently being rushed through Congress and the Senate, but I believe that Scripture does contain the basis for some form of involvement by our government authorities in the care of the needy in this country, at this time.
We have now looked at how Scripture calls individuals, businesses and government to carefully examine their role in healthcare, and we need to pray that God will give us the courage to make needed changes.
This series of articles was adapted from an event entitled "Reforming the Healthcare System: How a Biblical Worldview Bears on the Current National Debate." It was hosted by the richmond center for christian study and featured lectures by Dr. Terrill Wade, a retired family physician, homeschooler and educator.
To interact with Dr. Wade and others at The Richmond Center for Christian Study, visit their blog here.
Here is a short video clip of the healthcare reform event from which this article was adapted:
The Richmond Center for Christian Study seeks to demonstrate the reliability of a biblical worldview and show how that worldview bears on every part of life and culture. Understanding that the cross of Jesus Christ radiates profound effects throughout all of reality, it is the desire of The Richmond Center for Christian Study to grow Christ's kingdom by winsomely helping people see these effects and joyfully embrace Christ as Lord.
Chris Daniel, Executive Director of the Richmond Center for Christian Study
Dr. Terrill Wade, board member of the Richmond Center for Christian Study and retired family physician
Dr. Donald R. Stern, Richmond Area Health Director
Dr. Michael Murchie, Assistant Medical Director of CrossOver Clinic in Richmond, VA
For more information about The Richmond Center for Christian Study, visit their website at richmondstudycenter.org