The Moral Vacuum of the Health Care Debates

On Thursday, the United States Supreme Court upheld the constitutionality of the Affordable Health Care Act.  After months of raucous rhetoric (it’s difficult to use the words “debate” or “conversation”), we will now have accessible health care  for millions of our co-citizens, and guarantees for those of us currently with health care, that we will not be without coverage upon a job loss, catastrophic or chronic illness, or  unexpected disabilities in our families.  For the sake of fair disclosure, if you haven’t already figured it out,  I support this important move and believe access to health care is a fundamental human right, given so many other aspects of our lives are contingent  on the ability to seek preventive health care, have routine screenings, and receive quality  medical care.

What has disturbed me most over the months has been the lack of theological and moral arguments for access to health  care.  I am not naive about economic realities (even though I am not an economist) nor about the complexities of implementing imperfect  policies (I am not a social policy expert).  I am just a Christian social ethicist who thinks Christians can add something helpful to this conversation in light of the long historical commitment which the  Church has had in providing health care, particularly to underserved and vulnerable groups of people. 

What is needed to civilize and make our  current “conversations” more adult?  Can Christians add anything helpful to the “debates?” Just a few suggestions here from this particular Christian social ethicist:

1.  We need to recover  an understanding the common good.  We have some commitments that access to such things as a quality education, safe roads, and a clean environment are good for all of us.  Can the same argument be made for access to health care as a common good, which serves all of us?  With God as the Creator we have in common, and as persons who share common spaces, can we not see that the health and well-being of others impacts the health and well-being of all of us?

2.  Persons on both sides of the “debate” recognize that our current health care delivery system is flawed.  Health care costs continue to rise. While it is purported that we have the best health care of any industrialized nation, we also have the most expensive, with the largest numbers of citizens uninsured. Health care is already rationed based on who can pay, or who has insurance, and our choices are already limited.  While I am grateful for employment and the health care coverage that comes with it, we are offered one plan with a designated network of doctors and medical providers from which to choose (all this is to say that the sound bytes of our choices being taken away doesn’t make sense given our choices always have degrees of limitations placed on them).

3.  How about a little empathy? I find it incredibly disingenuous, if not downright immoral, that those with  health care insurance provided for them are often the shrillest in their objections to opening up access to others.  Can we imagine, just for a moment, what it would be like to be unemployed and without coverage?  To fall suddenly ill with very few resources and options available for medical attention?  So, I make the basest of appeals to our  common humanity:  can those of us with adequate coverage provided for us with our shared financial participation at least imagine what it would be like if this wasn’t the  case?

In his book, A Theory of Justice, John Rawls outlines what is necessary for a fair and equitable social and political culture.  He suggests our common decisions ought to be made behind a “veil of ignorance” to remove any biases and prejudice in our common decisions.  Rawls’ “veil of ignorance” means that I don’t know who I am on the other side of the veil.  I may be the one who is ill, vulnerable, and without access to health care.   Decisions are then made on possible contingencies that come with the human experience so that social goods are distributed equitably.

While it is difficult to move straight from Scripture to our health care debates (nothing in our concordances here), perhaps the “original position” narrated in Genesis 1 and 2 is helpful for piquing our theological and moral imaginations when it comes to health  care access.  What was God’s creative vision for human communities?  Why a good earth? Why adequate food?  Why a beautiful and clean Eden? Why healthy relationships?  Why interdependence? Why meaningful work?  Why shared responsibility with God in managing and stewarding God’s good creation?  God’s goods at the onset of creation were meant to be shared.  God shared them with us, with the expectation that we share with others.