Debate: Is Universal Health Care a Moral Issue?

If you thought the debates over abortion and constitutional interpretation were a hot button within the Christian community, watch out: universal healthcare might be the new fundamentalism.

According to a recent CBS News report, “President Obama this month is turning to the religious community to rally support for the fundamental idea of expanding health care accessibility.” One of the leading voices for the Christian community in this debate is the controversial Jim Wallis, who avers: “Every so often there is an issue that is so clear and compelling, or so alarming and disconcerting, that it really does galvanize the faith community… Inclusive, accessible, affordable health care for all of God’s children is for us a moral issue.”

“The concept of universal, accessible health care resonates deeply with our common values,” said Rabbi David Saperstein, director of the Religious Action Center of Reform Judaism. “We see the people who’ve lost their jobs and health insurance… the people who are left out of what is one of the most remarkable health care systems in the world…We cannot sit idly by while we have a system that just doesn’t work for everyone.”

At face value, I think Christians all agree that we want people to be healthy. We want people to have access to health care. In the Garden of Eden, there was no sickness, nor will there be any in the new heavens and the new earth (Rev. 21:4) – so working for God’s will to be done “on earth as it is in heaven” certainly includes healing, wholeness, and health.

But something troubles me about Wallis’ claim that “inclusive, accessible, affordable health care…  is a moral issue” for Christians. I think it’s the modifiers “inclusive, accessible, and affordable” – which are all deeply malleable words that seem to say more than I’m comfortable saying. If we’re going for “affordable,” why not free? If “inclusive,” should it include abortion or voluntary sterilization or assisted suicide? True to his bombastic persona, I think Wallis has gone beyond the pale here in saying more than he can biblically substantiate.

Do you agree? Or disagree?


Leave a Comment

  1. It is one thing to be a pawn of the political left (which Wallis may be) and another to offer a moderating voice to the passionately “anti-health care” rhetoric coming from some politically conservative Christians. There at least two debates wrapped up in this: what is the problem, what is the solution. I don’t like the expensive and inefficient solutions I’m hearing from the left, but I also find disconcerting the seeming lack of concern for the problem on the part of those who claim the name of Jesus.

  2. Is Universal Health care a moral issue?

    Should our federal gov’t. make 100% sure that all of it’s citizens (even the unwilling) have it?

    Two very, very different questions.

  3. I think it is agreed that everyone wants everyone to have access to health care (that may be a wrong assumption). In the current situation, that isn’t happening. Everyone agrees something has to change So, this plan has been proposed. I don’t think it is a good plan, and the other options being put out by the right (tort reform, cross-state competition) seem like good ideas, but with the current administration those don’t seem to be happening. So, is it better to leave it the way it is and wait even longer for reform to this system that is obviously broken, or to implement a plan that will be really expensive but probably get more people health care? If the church was actually acting like the church (and this is a criticism of my self being included in the church) and helped the sick and suffering, this wouldn’t be a government issue that inevitably leads to a crappy government solution.

  4. i think you make some good points but i think it is an unreasonable stretch to link abortion, etc. because you’re using the word inclusive in a completely different way than wallis is. inclusive for him indicates the scope of the population that should receive basic health care at an affordable cost (i.e. all god’s children as he states), rather than inclusive in the sense the scope of procedures covered (i.e. abortions, etc.).

    these words indeed can be malleable for those who wish to twist the argument as so many politicians are prone to do. it might be helpful if i elucidate the words he is using, because they are indeed pregnant with meaning and actually tell you precisely what wallis intends, if we understand from where he has borrowed them. these words are chosen from the general comment of the United Nations’ International Covenant on Economic, Cultural, and Social Rights, which sought to clarify aspects of the Universal Declaration of Human Rights, issued shortly after world war 2. this is a highly important document in the discussion of human rights.

    Accessibility and inclusiveness are terms used specifically to indicate that access to health care must not be discriminatory based on race or gender. It must also be physically and economically accessible (affordable), as well.

    To ease your worries, this document further uses the term acceptable to describe the right to health care. That is, “all health facilities, goods and services must be respectful of medical ethics and culturally appropriate.”

    For anyone who is interested in understanding health care as it pertains to human rights, whether rooted in protecting the image of god or human dignity, i recommend starting here:

    Because if we dont know what is intended by those proposing an ethical argument for health care, we are resigned to speculation and the formation of arguments around this speculation which doesn’t advance the discussion very far. But it would be a different discussion to access the validity of human rights, which are actually deeply rooted in historical christianity. indeed the concept of human rights was begotten from christianity and gained its present flesh only after WW2. but i suppose this would not be a discussion suitable for a blog and would require lots of reading.

    finally, i would like to also say that we need to be careful not to lump two distinct discussions together. it is one thing to debate the morality of health care policy (i.e. whether or not a right to health/healthcare is valid). it is quite another to argue the scope of what is provided, from basic health care to HIV meds to breast implants to assisted suicide. i think we do a grave injustice to the issue when we lump them together. because my opinion is that christians should solidly affirm with the rest of society that basic health care is a fundamental inalienable right. beyond basic health care, the rest is either up for debate with no clear christian consensus (e.g. the right to a pacemaker) or has a clear consensus against (e.g. abortion).

  5. Not a moral issue. The moral issue is christians and the church expecting the government to fulfill their responsibilities. Matthew 25:31-46

  6. Derrick,

    My contention is that Wallis has “gone beyond what he can biblically substantiate.” I’m not sure that what the UN has any bearing on the conversation because the UN – especially on health care – has a long an liberal history rooted in secularist ideology, not biblical morality.

    “Christians should solidly affirm with the rest of society that basic health care is a fundamental inalienable right”? Can you explain why you believe this is a fundamental, inalienable right? And can you do so without appealing to UN and WHO documents? Because if it’s so fundamental, I shouldn’t have to read the history of ethics in order to intuitively see it.

    I am more inclined to agree with John Mackey: “Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter? …A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That’s because there isn’t any. This “right” has never existed in America.” (from yesterday’s WSJ)

    Food, shelter, and healthcare are privileges we want to extend to everyone we possibly can. They are not rights to be demanded. And there is NO BIBLICAL ETHICAL BASIS for calling them such.

  7. I find the distinction that “Jon” made between “people on the left” and their option for health care reform and “people who claim the name of Jesus” and their option to be artificial.

    Are you saying that there can not be someone on the left that does claim the name of Jesus, or are you saying that only the antithesis of the left is the people who claim the name of Jesus.

    I have an issue with that type of claim and believe that this is the typical response or understanding with most of evangelical Christianity. Which explains resistance to health care reform because it is coming from the political left.

    My issue with the health care reform is that no one is telling us how this will be paid for. There have been some minor details given, but nothing to form an opinion for the reform.

    If roughly 21% of white evangelicals voted for Obama in the election, I don’t see how, in most churches this is an issue as most churches are made up of white evangelicals and would be opposed to the health care reform.

    I for one am glad that these types of conversations are happening because it raises issues with the church and what it can do to help in this situation. If most people are concerned with health care and believe it is too expensive right now, they are obviously looking anywhere for change, even the proposed, foggy health care plan that is on the table. It sure would be a good time for Christians and the church to step in and take part in the discussion instead of just calling this “one step to socialism” and rejecting everything, but provide an alternative.

  8. I can see your point but am wondering if his words have been over analyzed. If we look at his words just as phrase, then I think there is a hint of ambiguity to the true meaning of his declaration. But in context, I think it offers more of an insight as to what he really meant. Under the umbrella of universal health care there is a resounding theme. Health care that is available to all…….inclusive. Health care that doesn’t have an over whelming amount of hoops that one has to jump through……accessible. Health care that would be at little to no cost……affordable. In my opinion, it seems that the idea that he is presenting is that as Christians, the concept of universal health care, as described above, should cause something to resonate in us. Don’t we have a responsibility to help those in need? I think that is the “moral issue” that he is referring to. Granted that there are several different issues that we can impose into the theme of Universal health care, I think that he was being specific.

    In regards to your statement about his use of the word affordable, I can agree. Even in context, one would question why health care should not be free. If it becomes affordable, what happens to those who have no money? Wouldn’t that go against its premise……Universal?

  9. The language of rights and responsibility seems to get confused here. Do Christians have a ‘responsibility to help those in need’? Yes. Does that make health care an ‘inalienable human right?’ I think not.

  10. I think the question of whether health care is a right is foundational to the discussion. Neal Boortz wrote a blurb on his blog recently that helped clarify for me why I don’t think it is a right.


    Look … it’s this simple. In order for you to receive health care someone else has to either expend time or property. To claim a “right” to health care is to claim a “right” to someone else’s time .. that is, a right to a portion of their life: whatever portion of their life it takes for them to either render the health service or produce the medical implement or drug that is being used. Hate to break this to you … but who in the hell do you think you are to claim a portion of someone else’s life as YOURS?

    I think where you come down on the question of whether health care is a right or not will have a lot of bearing on the way you define “inclusive, accessible, affordable.”

  11. Jeff, I was not claiming a mutual exclusivity between “the left” and Christians. Not by any means. I think in this instance Wallis is responding to self-professed Christians who are against increased government involvement in health care. The particular Christians I think he is responding to are conservative types. That’s all I was saying. You are taking what I said in a way different direction than anything I believe, but you would know that if you knew me and you don’t so you don’t.

  12. yes, bob i believe i can show these to be rights without the use of UN documents. i actually only use these to demonstrate where the language is coming from. but i think it is reasonable to say that this would be nearly impossible to do on a blog. and you know as well as i do that i do not have nearly enough time for such.

    i would offer a couple of items though. first, i think its a poor argument to demand that a fundamental right must be “intuitive,” and to further dismiss the central role of historical ethics on the subjects of rights. for example, the how christ atones for our sins is not particularly easy to come to. we are sitting on two thousand years of atonement “theory” from our predecessors. it was not a simple matter for st. anselm 800 years after christ. all that to say, our thinking about atonement relies heavily on a couple of thousand years of christian thought on the subject and without it, it is not self-evident.

    the other point i have assumes that you believe that there is a biblical basis for any rights at all – which at least it seems john mackey does (though i would be interested in how he would respond to the logic that follows). i assume this a priori since i think this is pretty well accepted in western culture – indeed our country is founded on this belief. if you do not we would have to have a new starting point for the discussion, at which point we must seek to examine the biblical basis of any rights.

    i can most succinctly summarize as follows (assuming all people have certain rights):
    (borrowed from henry shue)

    1. everyone has a right to something (fill that in with whatever you like, perhaps life, liberty as our forefathers first stated – security and subsistence as is most concisely summarized)
    2. some other things are necessary for enjoying the first thing as a right, whatever the first thing is
    3. therefore, everyone also has rights to the other things that are necessary for enjoying the first thing as a right

    most evidently of these necessary components would be things like food and water. also – relevant to this discussion is health. these things are necessary because they are required for the enjoyment of other things as rights.

    thats all i can really offer right now, but it might be enjoyable to dialogue further another time. i also have some articles and books that would do the argument far greater justice, if you’re interested.

  13. Derrick,

    Let’s talk more in person. I think your argument has gaping holes in it. Basically I can put whatever I want in the #2 slot, claim that it’s necessary to my ‘basic human rights’ (#1), and then it’s unassailable. This is exactly what is going on right now with the issue of worldwide access to abortion. 1) Everybody has a right to liberty; 2) Necessary to my ‘liberty’ is liberty over my body, which includes abortion; therefore 3) everyone in the world should have a ‘right’ to abortion.

    I’d be interested to know how you argue against these types of arguments in the medical world. I know you do. But they seem to follow directly from the premises you yourself have stated above.

  14. agreed. but i will respond to that point because i think there is a misunderstanding and i think i may be able to clarify it relatively concisely.

    it is commonly understood that rights are prima facie not absolute, which is to say that they can be overriden by more stringent claims. in the case of abortion, the right of the child to life overrides the right of a mother’s liberty. in another example, there is a right to life, but this is overridden in cases of war or self-defense.

    and i think you are treating the argument unjustly by dismissing the import of a word like ‘necessary.’ an abortion would not be accepted as a necessity to liberty (even among liberal philosophers – their argument would take a different form). water, on the other hand, would be universally accepted as a necessity to life. certain things logically follow. therefore, it is inaccurate to say that you can put whatever you want in the #2 slot. i suppose, it would be fair to say that people can put whatever they want in the #2 slot but only things that are truly necessities will actually withstand scrutiny. that is to say that the form of the argument is valid (which has been peer reviewed and affirmed), but one would need to show whether or not the premises are indeed true. in the example you gave the 2nd premise is not true.

    but, yes, the substance of this conversation will be much better with a cup of coffee.

  15. Derrick, if your theory is right, all you’ve succeeded in doing is moving the argument from “Is healthcare a necessary right?” to “Is healthcare necessary for enjoying our necessary rights?” Either way, I think many of Bob’s arguments remain the same. I wish all your real arguments weren’t hidden away in books and articles that are too lengthy and difficult to summarize on this forum.

  16. Derrick, I’m with Paul- link to your articles so that we can understand the issue and how you’ve come to your opinion.

  17. paul,

    you have got it precisely. that is exactly what i am trying to establish. i am trying to establish that there is a right to health and to some degree of health care, so that there is a starting point to discuss what components of health care must be available to all (vaccines, basic preventative medicine, appendectomies (lifesaving), insulin for diabetes, etc.), as necessary for enjoying basic rights. this is precisely the question we must discuss, because i think most people would agree that everyone has a right to some degree of health care (how mortified would people be if a doctor refused a simple lifesaving procedure because it was inconvenient to him?). i am trying to draw out the fact that most people that think they are discussing the same argument are actually discussing entirely different arguments. we must work in the correct sequence, not skipping to the finer points, if there is every going to be even a degree of consensus. i see this same stumbling block in arguments about abortion – there can really be no real progress when one side believes that a 1 week old fetus is already a life (therefore its “termination” is rightfully called murder) and the other side believes a 1 week old fetus is nothing more than an organized group of cells.

    lane and paul – you’re right about the articles. my apologies.

    many of the articles that have been influential for me have come from the journal of medicine and philosophy. i can’t really link to these because they require subscriptions. if you can get access through a library, i would suggest articles by people like norman daniels, thomas pogge, and some stuff by amartya sen and martha nussbaum (who has tried to develop and address deficiencies of john rawls’ “a theory of justice,” then applied it to the philosophy of human rights). if someone is truly interested, i may have some buried in stacks of old articles that i would be willing to dig up.

    books that are good introductions to health as a right:
    -basic rights: subsistence, affluence and U.S. foreign policy by Henry Shue (especially the first chapter)
    -Pathologies of Power: health, human rights and the new war on the poor by paul farmer.

    and if you want to get at the foundations of human rights, i suppose john locke is a start, specifically “the state of nature” within “the second treatise of government” (in which the right to health is mentioned alongside the right to life). i havent read it in a while, though, so i can’t emphatically recommend it. also, thomas aquinas (who i havent read as much of as i should, and not for a very long time).

    but the two books mentioned are probably the most efficient uses of your time if you’re interested.

  18. Derrick, in spite of your reading on the issue, I am still wondering why you would say that health and/or health care is a right. Is it not more accurate to say that health is not a right at all, but rather a privilege afforded to us by affluence and technology? Would you really say that people in Mali are being deprived of their RIGHTS because they don’t have access to the same medical technology we do in the States? Or, would you say that our affluence imposes upon us a RESPONSIBILITY to those who have less? The answer to that question seems to me to be the dividing line between Marxist/socialist ethics and Christian ethics. And that is an important line.

    In all graciousness, I sense an intellectual elitism in your argumentation thus far: “This is a basic human right, trust me, because I read medical journals. I can’t waste time outlining the arguments for all you simpletons out there.” I’m not saying that’s your intent at all… I know it isn’t. But that’s the spirit that I feel in your reasoning so far.

    The Declaration of Independence is powerful precisely because it “holds these truths to be self-evident.” I am simply asking you to argue for the “right” to health care in a way that shows it to be clearly “self-evident” to the general population.

  19. Currently, the children of undocumented persons have access to the finest health care system in the world and my chidren do not. That is my moral issue with our current system. (I have been a legal citizen for 41 years and taxpayer for

  20. bob,

    there are several reasons i cannot fully show in one blog post why people have a self-evident right to health care (minimal health care at the least). first, though we swim in the language of rights i am increasingly convinced that most people don’t have a firm grasp on what is meant by a right (which i will offer as a “rational basis for a justified demand”). The fact is that i think this discussion is amounting to trying do mathematical derivatives without first mastering our sums. This is not a statement of elitism (as it would not take too much study to get the basics down), but an observation that people want to put the cart before the horse. And this is what lane asked for, so i will reiterate that “security and subsistence” by henry shue (within basic rights) is a good place to start.

    the second reason is that a philosophical proof of rights, which are required even for the rights to life and liberty, and especially for the pursuit of happiness, quite simply cannot be contained within a blog post. to expect this is to disregard the intellectual robustness of the topic. i could easily make assertions, and some of these assertions may even convince some people, but this is very different that “arguing for the right to health care in a way that show it to be CLEARLY self-evident to the general population.” and our declaration of independence made an assertion with regards to life, liberty, and the pursuit of happiness but it did not present an argument but stated a position. but this declarative statement harkens to the philosophy of guys like john locke which developed such an idea, but not without having to lay out his argument in the form of a book.

    the final reason is one which i know you understand and hope that you can help to dispel any sense that i “can’t waste my time” because i read journals and other people don’t. this is something we’ve personally talked about – i have limited time (have averaged over 70 hours the last several weeks) and there are other more profitable ways for me to spend the little time i have (scripture, fellowship, laundry, etc.). you should know that its not a matter of “trust me,” as i tried to give what i thought was a reasonable and simple logical proof for it. but its now clear that definitions of responsibility, duty, rights, positive rights, negative rights, etc. need to be further explored. and the simplest way to do that is if i recommend something to read.

    i will try to appease you, however, by briefly addressing your points and then i really must be done.

    1. it is possible to have a right that is an unrealized right. this is with respect to your comment about mali. for example, a person may have a right (endowed by their creator not given by man) to liberty but that right is not realized (this is the term that i believe is used) if he lives in a country that takes political prisoners and he is held as such. the same applies to health.

    2. health is not dependent on affluence and technology (i think the statistic is something like 5 years of the gain in life expectancy is due to medical advances whereas around 30 years of gain in life expectancy is due to preventative measures). health is actually much more heavily reliant on things like sanitation, clean drinking water, clean air within the home (i.e. proper ventilation when oil burning stoves are used), vaccinations, etc. technology does factor into the discussion further on, though. that is, we have the technology to detect certain metabolic diseases when the child is born that if untreated will result either in severe mental retardation or death. we also have the ability to fully prevent any deficit (the prototypical example is a disease called phenylketonuria if anyone is interested). so then the question later on is, do children have a right to be protected? do they have a reasonable claim for intervention if it is within our societies power? our society operates as though a right does exist as we have mandatory screening for this disease and others.

    3. if you hold that a duty is present, then ethicists hold that this is support for rights. for a duty implies rights. that is someone has a justified demand for help in securing what one may not be able to secure for oneself. for example, if a woman is going to die in childbirth, she has a “rational basis for a justified demand,” upon the person who has the corresponding ability to save her life. and there is a nesting of securing rights involved. if a society exists in which mothers cannot preserve their lives in childbirth on their own, then the community ought to responsible, then the state, then the government, then the international community if it is within its ability (which in this case it has the ability to affect reasonable change).

    finally a quote to show that the assertion of the right to health has been in american thought for centuries. this comes from john locke (note that when he speaks of the state of nature this a stepping stone from aquinas’ natural law):

    “The state of nature has a law of nature to govern it, which obliges everyone: and reason, which is that law, teaches all mankind, who will but consult it, that being all equal and independent, no one ought to harm another in his life, HEALTH, liberty, or possessions. For men being all the workmanship of one omnipotent, and infinitely wise Maker.” In this he characterizes it clearly as a negative right and then later as a positive right.

  21. I have lived in 3 countries with universal health care. None of them could compare with the care we get here in the U.S. Those countries’ health care systems are broken down and causing the people to have to pay 50-70% income tax!

    In Norway I went to an orthopedic doctor to get his opinion about a deteriorating foot condition. He took x-rays and had no opinion of what to do. The ONLY thing he said to me was, “Go to the States!” I was stunned.

    Also, in that country, when you go to the hospital, a florist brings you a beautiful flower arrangement. Guess who pays for that! “Your tax dollars at work”.

    Deliver me from such socialism.

  22. Derrick,

    Let’s summarize so far:

    1. I questioned the biblical nature of Wallis’ contention that “inclusive, accessible, affordable health care… is a moral issue.”
    2. You upheld Wallis’ language and made some good points clarifying his intention. But then you closed your first comment by asserting that “Christians should solidly affirm with the rest of society that basic health care is a fundamental inalienable right.”
    3. I asked you to substantiate why Christians should affirm that. (Obviously, as a Christian, I WANT to affirm that, if there is indeed an ethical obligation upon me to do so.)
    4. You responded by saying: assuming that there IS indeed a biblical basis for any rights at all, “everyone also has rights to the other things that are necessary for enjoying [basic human rights].”
    5. I argued that this argument says too much, as evidenced by its use in the abortion debate. As you put it: just because the form of the argument is valid does not make the premises valid. (And, for what it’s worth, I thought we were having a discussion about the PREMISE that health care is a human right, not about the philosophical FORMS of human-rights arguments).
    6. In your response, you once again asserted: “I think most people would agree that everyone has a right to some degree of health care.” Which is the naked assertion I’m trying to get you to substantiate.
    7. I once again asked you to justify the assertion so that we can be clear on whether Christians should affirm that health care is a basic human right.
    8. Your last response has gotten closer to the matter by trying to get at what we mean by the language of ‘rights’ and then applying that to discussions of health.

    I really do appreciate the strong philosophical thought you’re putting into your posts. I hope you know I’m not trying to argue just for the sake of arguing. I really am interested in what our Christian duty is in this debate. If there is a moral ‘right’ to healthcare, that matters. You assert that there is. I’m trying to get you to articulate WHY in a way that the average Christian can grasp. Unfortunately the average Christian is not going to read John Locke and Henry Shue. You seem frustrated that the debate (in public, not necessarily on this blog) keeps focusing on technical policy matters rather than on the substance of rights. I suspect the reason why is because the average American (Christian or not) finds the policy matters a lot more lucid than the murky philosophical waters of perceived ‘rights’.

    If you would like to write a short piece arguing for why Christians should hold basic health care as a basic human right, I would be glad to post it on the blog as a thought-provoker. Maybe that would be a better approach than using a comment thread.

  23. To further clarify: I am saying that to me, the assertion that ‘health care is a human right because it’s basic to other human rights’ is exactly the same as the assertion that ‘abortion is a human right because it’s basic to other human rights.’ I understand the FORM of the argument that’s being made; I question the VALIDITY of the premises.

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