Christianity & Health Care Reform
By Morna Murray and Jay Richards
June 28, 2012
In light of today's groundbreaking Supreme Court decision that upheld most of President Obama's healthcare mandate, we're taking a look back at an earlier discussion we held with two of the subject's experts, each with unique perspectives. We hope this stimulates incisive, thoughtful conversation for Christians of all political persuasions.
Is health care for everyone a moral/Christian issue?
Richards: Sure it is. Christians should be concerned about the good of individuals as well as the common good. Good health is something we should want everyone to have. Health care is one of the ways we maintain good health. It is also a scarce good—the demand exceeds the supply. So figuring out how best to arrange things so that people get quality health care is a legitimate moral concern, and a legitimate concern for Christians.
Murray: Yes, I believe health care for everyone is a moral/Christian issue. Speaking from the Catholic perspective, the Church has long advocated for universal health care as a fundamental right that is essential to the dignity of every human being. Catholic social teaching has traditionally emphasized this as well as the preferential option for the poor, meaning a genuine and authentic concern for the physical and spiritual well being of the poor.
Richards: Ms. Murray and I agree that this is a relevant moral issue for Christians, but let’s take just the idea that health care for all is a fundamental right. What does this mean? Each of us has the right not to be deprived by either the state or other people of life, liberty, the pursuit of happiness, lawfully acquired property and the like. By extension, I have the right not to be deprived of care that could extend or improve my life. So do you. But that does not give you or me the right to force someone else to provide me with food, land, a house, or health care—all of which are scarce resources. Nor do I have a right to delegate such coercive power to a governmental authority. If I did, then that would mean I have the right to violate the rights of others, which I don’t.
On the politically conservative side: What would you say to people who say that not supporting health care is not compassionate—not Christian even?
Richards: “Supporting health care” is really vague. No person of good will opposes health care. The real questions are more specific: Who is primarily responsible for the health care of individuals and families? How ought laws and institutions be arranged to make quality health care available to people? How do we encourage innovation in health care? How ought tax and economic policy be arranged to achieve the goal of quality, affordable health care for all who want it?
“Compassion” means to suffer alongside. And we are often called to do just that. But when it comes to public policy, we have to think about effects and consequences—intended and unintended—on people we will never know and can never suffer alongside.
“Compassion” means to suffer alongside. And we are often called to do just that. But when it comes to public policy, we have to think about effects and consequences—intended and unintended—on people we will never know and can never suffer alongside. And that requires careful reasoning and clear thinking so that we do not do more harm than good.
On the politically liberal side: What would you say to Christians who say that things like paying for health care are the role of the church, not the government?
Murray: It is difficult to apply the terms "conservative" and "liberal" to this bill from a factual standpoint. There are "liberal" ideas and "conservative" ideas in it. But I think the partisan labels come from the politicization of the health care reform debate, not the actual facts. So I do not believe this idea that paying for things like health care on the part of the government as opposed to churches paying for them is a "liberal" idea at all.
Republicans and Democrats support Medicare and Medicaid and Social Security. That said, it is appropriate for the government to play a role in providing for the fundamental needs of its citizens in certain situations, and health care is one of them. In fact, providing health care for citizens who cannot afford it is not only the morally right thing to do, it is the economically smart thing to do since numerous studies and economists have proven that emergency room care and other care for non-insured individuals costs the average American about $1,000 in insurance costs per year. Churches play a role in caring for the needy—but they provide charity to the extent that they can and it is a critical role for churches. But the government should be a dispenser of justice and providing health care for all American is the just thing to do.
Richards: I agree with Ms. Murray that these issues aren’t easily reduced to “liberal” and “conservative.” But there are relevant political categories having to do with the legitimacy and competency of governmental authority in various jurisdictions, the wisdom of state control over major segments of the economy, the role of the market in prices and services for goods such as health care, and the like. No rational judgment on these questions is possible without understanding and considering such issues. And based on Ms. Murray’s claim that third-part payment for health care services is somehow the “economically right” thing to do, I assume she agrees with this point. However, we obviously disagree on a many basic economic judgments.
Of course I agree that it is “morally right” to provide things like health care for people who cannot afford it—though I would say that charity requires it. That is not the issue. The issue is whether it is morally right, prudent, and beneficial to force people to pay for the health care of others through their tax money.
Murray: This answer is unrealistic. Poverty in this country is not something that churches and personal charity can address. Not ensuring that all citizens have access to health care is not only morally wrong, it is economically unsustainable. We pay for the fact that health care is not accessible by all, and particularly the poor, by virtue of the fact that these individuals wait longer for care and are often seen in emergency rooms where care is astronomically more expensive and unfortunately, their symptoms have often worsened, making it more expensive to treat.
Poverty in this country is not something that churches and personal charity can address.
Do you think this law does enough to protect the lives of the unborn?
Murray: Absolutely. This is another area where there has been tremendous misinformation and in some cases, deliberate distortion of what is in the bill. This bill provides for the strict segregation of funds that cover abortions from federal funds, as required by the long-standing Hyde amendment. Furthermore, the bill requires insurance companies to have an annual audit of this segregation of funds that is overseen by the state Commissioner of Insurance. The Hyde amendment restrictions remain in place. And these restrictions have been further solidified by the Executive Order issues by the President on March 25. This order not only applies the Hyde amendment to all provisions of the health care reform bill but expressly states its application to funding for Community Health Centers. I would add that the bill goes further than current law by offering positive economic supports to vulnerable pregnant women so that they may choose life for their unborn children and know that they will have the help they need when their child is born.
Richards: The Act is bad on abortion, and does not maintain the status quo on federal funding and abortion represented by the Hyde Amendment. It will increase incentives for abortion by putting additional taxpayer money into the pool of health insurance funds, and will make taxpayers complicit in paying for abortion. These problems are admitted by honest analysts across the political spectrum, though some partisan groups have gone out of their way to confuse Christians about the substance of the final bill (as Archbishop Charles Chaput notes). The Act commits Americans to supporting intrinsic moral evil with their tax money, whether they want to or not. In this way, it crosses the line from merely imprudent and bad policy to fundamentally immoral policy.
Murray: I do not see any facts to back up these claims. Having been a Senate staffer when this bill was first passed, I am extremely knowledgeable about the language. In fact, Catholics in Alliance sent a letter, prior to final passage, to all House members with every provision regarding abortion in the Senate bill spelled out, including page references, so that we could move away from misinformation and look at the question of abortion funding on the basis of the facts alone. The existing restrictions of the Hyde Amendment on federal funding of abortion have been maintained with a strict segregation of federal funds away from funds that can be used to pay for abortion. Moreover, there is an additional requirement that insurance companies have a yearly audit that is to be overseen by the state Insurance Commissioner. This is stricter oversight over federal funding of abortion than we currently have for those states that provide abortion with state dollars through the Medicaid program. Finally, the law provides an extension and expansion of the federal adoption tax credit and provides $250 million to a program geared toward vulnerable pregnant and parenting teens and women.
Richards: We each have a right to our own opinions, but not to our own facts. And on this question, Ms. Murray is misrepresenting the facts. Yes, the Act shares some properties with the Hyde Amendment; but it is demonstrably false for her to suggest that it conforms to Hyde Amendment language.
She should be careful about complaining of “misinformation,” since anyone with Internet access can verify that the final Act fails to conform to the Hyde Amendment restrictions. Everyone from the US Conference of Catholic Bishops to Planned Parenthood admits this point.
Even if there’s a political divide, what are the things (if any) that Christians on both sides can agree on?
Richards: There is of course, no unique “Christian” answer to health care policy. Most of these issues involve applying some general principles and a lot of prudential judgment. Still, I assume that all Christians agree that health care is a good thing, and that we should want as many people to be able to have as much of it as they need. All Christians, I think, would agree that there’s a difference between that goal, and a particular political policy intended to achieve that goal. We should want policies that help give rise to more access to good health care for more people, without violating other important principles and creating worse problems. And if we follow two thousand years of Christian teaching, Christians should agree that any law that creates positive incentives for abortion and forces people to (effectively) fund abortion for others, while pretending to do otherwise, is unjust.
Murray: I hope that all Christians can agree that health care is a fundamental right for all human beings and that we have a special obligation to care for the poor and underprivileged in a way that helps them to access their true God-given potential.
If you would like to see additional portions of the discussion between Jay Richards and Morna Murray, click here. And of course, we would love to hear your thoughts on health care reform from a Christian perspective below.