Thursday, October 15, 2009

SoJo on Health Care Reform (Pt. I)

Sojourners magazine editor Jim Wallis lays out his case for health care reform. I agree with Wallis that there are moral reasons to support reform, but I think there are several shortcomings in the argument he presents. This is part I of a two part consideration of Wallis' case. Part II will follow tomorrow.

Mr. Wallis writes:

I believe there are some fundamental moral and biblical principles on which to evaluate any final legislative agreement, principles on which many people of faith -- even politically diverse people -- might agree. After the heat of the summer's confrontations over health care, it's time for a cooler fall debate. It's time for a re-set of the health-care debate, and a return to some basic principles could help.

Five Principles of Faith for Health-Care Reform

1. Health, not sickness, is the will of God. We can see this from the story in Genesis of the garden, where sickness was never found, and from the vision in Revelation of a city in which death will be no more. When we are instruments of bringing about that good health, we are doing the work of God. The gospel stories of Jesus healing people, of restoring them to physical wholeness and full participation in their community, always signaled God's presence.

All this may be true about God's will, but it's not an argument for government subsidized health care. It's an argument for healthy living, wise personal choices, and, in emergency cases, for neighborly assistance. Churches, especially, should, and do, devote a large measure of their resources to helping those in the community who are in need. By laying this responsibility on community organizations there can be an expectation that the recipients of our benevolence will be supervised, that the church can require of them that they submit to being instructed as to how to function in healthier, more productive ways, and that they're not depersonalized by simply being reduced to a number in a giant government bureaucracy. In the long run this would be a far better solution for many poor individuals than just signing up to have the government throw money at their medical bills.

2. United we stand, divided we fall. The division between those who can afford adequate coverage and those who cannot is a threat to our unity, to the health of our neighbors, and to our nation. 46 million people in our country are uninsured, and millions more who are insured still can't keep up with their bills. Our moral and religious standards say no one should be left out of a system simply because of not being able to afford good health. The common good requires a system that is accessible to all who need it.

This is a little bit misleading. As many observers have pointed out, the 46 million figure includes millions who can afford insurance but choose not to buy it, millions of children who qualify for programs like SCHIP but whose parents have not signed them up, and millions of illegal immigrants who have no claim on the public purse. The number of actual indigent citizens who cannot, through no fault of their own, get insurance is more on the order of a fourth of the figure Wallis cites.

When Wallis writes that our moral and religious standards demand that no one should be left out of a system because of not being able to afford good health he's being somewhat disingenuous. Our values call upon us to help people in need, to be sure, but no one disputes that. What is in dispute is whether we as individuals should have the right to determine who among the needful gets our help. To insist that we have a moral obligation to help people is an oversimplification.

After all, we are no more obligated to pay for our neighbor's medical care than to pay for his auto repairs and insurance or his rent or home mortgage. We are under no moral obligation to forfeit what we have worked hard to earn for our families in order to subsidize someone else's consistently poor choices about diet, smoking, drug use, etc. We may well decide that we want to help such persons in our community, but that should be our choice, based upon our assessment of his need and his responsibility for the circumstances in which he finds himself. For the government to take money from us to give to people who, for all we know, refuse to help themselves is itself immoral.

More on the Sojourners argument tomorrow.

RLC