By David Gushee
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.