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Developing a Biblical Basis for Health Care PDF Print E-mail
Written by Calvin Fox   
Tuesday, 06 October 2009 09:14

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It is overwhelming!  There are more than a 1000 pages in the Governments proposed Health Care Plan and details are being changed in Committee daily.  Much od the content is very complicated and technical and we must end up trusting "the experts" to work it all out (never a comforting idea).  There are some basic issues and concerns that are being debated and about which equally sincere and knowledgeable people, often using the same statistics, strongly disagree.  These issues are argued on the basis of conflicting ideologies or philosophies about Government, from very Conservative to very Liberal. 

As a Christian, I am concerned with what God says about all of this. Specifically, what principles are taught in the Bible that should govern our Country's Health Care Policy? If Christ and His Word are sovereign over all, He must have a word for us on all of this.  What is it?


Fundamental Biblical Principles to guide Health Care Policy

A core commitment is respect and care for persons, all persons.  Thankfully, this is a Biblical basic that is shared by most Americans as part of our common cultural values.  Regretfully, most Americans do not share the reason why all humans have infinite value They will simply say, "Because they are human, that is why! (i.e.- They have value because they have value.  This is circular reasoning and under pressure it does not sustain the commitment to respect all persons.)  Christians believe each and every human being, from conception, is made in the Image of God and as such has infinite value to Him and therefore to us.  This specific belief is absolutely fundamental in the matter of health care and guides us through all the specific issues.  This is the main reason to provide the best health care possible for all.  This is why we will advocate for access to health care for all people of all ages regardless of who they are.

The second Bible Basic governing health care is that persons are a combination (a unity) of soul and body and their Health (and health care) must include both, not one or the other.  Health and Health care must be holistic.  We will not be treated as an organ or as a disease or as a statistic or as a commodity.  We are human beings.  When we respect persons we respect all that they are, body and soul together. 

A third Bible Basic is that human life is a gift from God, including when it is given and when it is taken.  Ultimately the issues of life and death are in His hands and we must not usurp His place.  This means we must respect how God designed life to begin and end.  It we will also make appropriate, fair and legal preparations for dying.

We believe that when death happens, we pass on into Glory with God and a fuller life than we have here. Many of us act as though we do not believe this.  We must not work against the Lord's call to join Him in Heaven or act as though it were not true.  As in all things, we must be wise stewards of our resources and the gift of life that He gave us. Christians must come to grips with this issue and make faith-full decisions for the end of life on earth. 

Fifth, Christians must clarify what the Bible teaches about the responsibilites of Family and Civil Government.  The first and foremost health care provider must be the family.  The issues of life and death must be decided by individuals within the context of their families and their Faith (of course such decisions must be legal and wise)  Civil Government has no business making such decisions for them. 

Health insurance policies, the costs and payments and approval of treatment plans should not be in the hands of government Committees or Bureaucrats.  We do not trust a federally controlled system to be fair, well-managed and cost effective.  We do not want a single-payer, "public option" to replace private insurance.  Reforms should encourage individual ownership of private health insurance and both coverage and treatment decisions must be made made between patient and private physician. 

Other Guiding Biblical Principles

Health care in Israel was simple.  It was primarily the responsibility of the individual and was  provided within the family at home.  The village or community helped the family as needed.  There was no such thing as the Welfare State in ancient Israel.

Some Christians use Ezekiel 34 and similar texts to support their claim that the US Government is responsibility to provide medical insurance for the health care of all citizens. I am not persuaded.  There were 4 essentials to health care in Israel: Diet, Rest, Quarantine and Safety.  Israelites ate healthy and strictly avoided foods that might cause disease (such as uncooked pork or fatty foods, eg- Dan 1:4-16) Their regular diet included vegetables, grains and fruits as well as some dairy products and oil.  Of course, they walked and did physical work (no cars).   They observed the Sabbath which meant they stopped working, slowed down and took time for worship, family and rest at least one full 24 hour day every week.  They practiced quarantine.  They recognized the dangers of skin disease and bodily discharges and set those who showed signs of these apart from everyone else.  They fought disease by prevention.  This was also evident in their laws about public safety in buildings, roadways and workplaces, including the farm.  The Kings (the Government) that Ezekiel was criticizing failed to enforce health and safety laws.  That does not lead to a mandate for the US Government to provide Health Insurance for all.  It is a mandate for Prevention by everyone. American's heath care is primarily in the hands of Americans who care for their health!

The practice of preventative policies, such as are taught by the Bible. have always helped to ensure public health and reduce health costs in any society that practices them.  It would greatly improve health care in America if everyone living here were to eat a healthy diet, observe a Sabbath for worship and rest, take precautions to avoid germs (wash hands, drink clean water, cover the garbage cans, get rid of mosquitoes, etc) and follow safety rules at home, on the road, at work and play.  This is not just Biblical, it is common sense!  The greatest improvement of Health Care in America begins with Prevention.  Most of the diseases that cost the most and finally kill us are caused by our voluntary behavior and therefore are preventable or their impact greatly reduced if we change the way we live.  That most Americans are not doing this is a scandal.  Realizing this factor has been one of the major findings of my study. 

"Many leading health conditions — such as heart disease; stroke; lung disease and many cancers; obesity; AIDS; suicide; teen pregnancy; drug abuse and addiction; depression and other mental illnesses; neurological disorders; alcoholism; violence; injuries and accidents — originate in behavior and can be prevented or controlled through behavior."

"The Centers for Disease Control and Prevention has concluded that “the United States cannot effectively address escalating health care costs without addressing the problem of chronic diseases.” The Milken Institute estimates the annual economic impact of preventable chronic diseases on the U.S. economy to be more than $1 trillion. Fully 75% of our current healthcare spending goes toward chronic conditions, the vast majority of which could be better prevented or managed."

Source:  http://www.psychologicalscience.org/observer/getArticle.cfm?id=2465

"Chronic diseases such as heart disease, cancer, and diabetes are leading causes of disability and death in the United States.   More than 1.7 million Americans die of chronic diseases each year, accounting for 70 percent of all deaths in the United States.  70 percent of the nation's total medical care costs go to treating those with these conditions."  And they are preventable if Americans changed their personal behavior."  (It is ironic and hypocritical that Evangelicals tend to blame victims of AIDS for their disease and are not sympathetic to them, because we think they brought it on themselves for their alledged behavior,  while we die mostly from diseases caused by our own behavior but do not blame ourselves for that and want sympathy and insurance coverage)

Source: http://www.ymca.net/activateamerica/activate_america_background.html

In contrast," worldwide most deaths from disease are caused by problems with the water.  "According to the World Bank, 88 percent of all diseases are caused by unsafe drinking water, inadequate sanitation and poor hygiene.  At any one point in time, 50 percent of all people in the developing world will be in hospital suffering from one or more water-related diseases. Most will be children, water-related diseases being the second biggest killer of children worldwide (after acute respiratory diseases like Tuberculosis), according to Water Aid. (Diarrhea alone has killed more children in 10 years than all the people killed in wartime since World War 2, according to UNICEF).  Humans have become walking, talking carriers of diseases, thanks to poor sanitation and undrinkable water".

Source: http://www.independent-bangladesh.com/2007121869/health/nearly-90-of-all-diseases-caused-by-unsanitary-water-conditions.html

The Constitution and Government Health Insurance

Until the late 19th century, health care (and the care of the Poor) in America was primarily the responsibility of the family, then the church and next the local community.  This is not only a rural and small town model, it is also part of the Biblical Model for Health care.  Only as a last resort, as medical care costs increased, was the State and Federal Government involved in health care.  

Pay-ahead Insurance for health care from any source was virtually unknown in the US before 1920.  Most sick people were cared for privately at home and by the family.  As the costs for medical care increased, hospitals began to offer insurance coverage and then doctors did the same.  That was the beginning of Blue Cross and Blue Shield private medical coverage in the 1930's. Commercial insurance companies began offering medical coverage in the 1940s.  After WWII, businesses began offering insurance plans to their employees as part of their wages and benefits.  This was done with the encouragement and regulation of the Federal Government.  By the 1960's most Americans had private third party health insurance.  There was a history of opposition to proposed Federal Health Insurance until the Presidency of John Kennedy when it found support in Congress.

In 1965 Medicare began as Federal single payer health insurance for the elderly.  It was followed by Medicaid which is a welfare program (an entitlement, not insurance) that provided medical coverage for the poor.  By 2001, Medicare and Medicaid provided 32 % of all health care costs in the US.  The percentage has increased every year.  In 2008, Medicare accounted for 13% (386 billion) of the federal budget. In 2010 it is projected to account for 12.5% (452 billion) of the total expenditures. For the decade 2010-2019 Medicare is projected to cost 6.4 trillion dollars or 14.8% of the federal budget for the period. 

This week as I write this paper, Congressional Leaders are debating the vast expansion of Medicaid, changing it into a Medicare type program for the Poor.  Governors are resisting the move.  It could well bankrupt some States as the number of indigent, uninsured people applying for the aid is rapily increasing.  It will lead to drastic cuts in other health, education and welfare services as money is diverted from them to  paying for increased Medicaid.  (The National health Care Crisis goes hand in glove with the problem of Poverty in America.  We will need to reduce the latter if we are to really control the former.)   

Many believe that Government Health Insurance is mandated by the Constitution- that it is a "constitutional right" for all citizens.  I do not agree.  The Congress did not agree either until 1965.   Nothing is said in the Bill of Rights or the Constitution that warrants a claim to such a "right".  We are told in the Preamble that we have an inalienable "Right to Life". In practice, one's life can be forfeited or taken away by the Government as punishment for a crime or treason   (Amendment V).  The "Right to Life" is simply the right to self-preservation.

While health care is essential to living, insurance by the Government for the costs of that care is not required by the Constitution.  Likewise, water, food and shelter are essential to life.  No one argues that the Government is responsible to provide insurance to cover the costs of these things to all (or to any, for that matter)  We are personally responsible and free to acquire them as needed.  Health Insurance is in the same category as life and automobile insurance.

Insurance providers should compete and customers are responsible to find the exact coverage they want with the best value.  Options that seem reasonable to me for Health Insurance for employees include Health Savings Accounts and Personal Wellness Accounts. These are ways to give employees money to be used by then to purchase insurance of their own choice or to save for medical expenses.  This would also make the Insurance portable.

People need to know what the costs and payments for various treatments actually are and this will give them incentives to save, as well as knowledge necessary to make wise choices when buying care.    Policies could have a high deductible, with most care being paid out of pocket from those Health Savings Accounts and Personal Wellness Accounts and Insurance itself covering only acute or catastrophic care.  For responsible people who live healthy, this makes coverage affordable.  In addition, Insurance should cover only what the customer wants. No one should be required to buy coverage not wanted nor be penalized for coverage of pre-existent conditions.   Private Insurance should also be tax deductible for those who chose it, just as employee insurance is now tax deductible.

The major concerns most evangelicals have about proposed Health Insurance reforms being proposed by Congress seem to cluster around either abortion or euthanasia.  Any Government Plan adopted must respect freedom of religious and moral conscience and not require tax-payer funded abortion or embryonic stem cell research and it must must not coerce or limit end of life decisions.

For those unable to afford minimal insurance coverage from any Provider, the State or Federal Government (taxpayers) could offer subsidies to them on a sliding scale.  Unfortunately, this seems like it will continue to be a mounting problem and thus the increase in Medicaid.  Again, it is related to the issue of Poverty.

"Liberty" is also said to be an inalienable right, but in practice, Liberty  must be limited for the common good and by social contract.  Likewise, any right to Life (or health care) must also be subject to the common good and be subject to social contract.  Health care can not be unlimited and universal when there are limited resources that must be shared with all citizens who now number more than 307 million. Sharing for the common good is a Biblical principle.  It must be fair and equitable. 

This means that citizens (and corporations) must voluntarily contribute to the care of the Poor or those who can not pay for care. This is very Biblical.  Making provision for tax free donations on personal and corporate income tax forms might go a long way to facilitate voluntary charitable donations for the common good.

The Preamble of the Constitution says that it was adopted to "establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity".  Promotion of the "general welfare" meant  promotion of the overall prosperity and well-being of the entire Nation.  To the Founders, it did not specifically mean efforts to care for the sick and needy within the Nation.  They did not believe the Federal Government has responsibility to guarantee all access to health insurance.

Certainly the Founders did not envision Federal Health Insurance when they crafted the Constitution.  It is not there and they specifically wrote, in the 10th Amendment, that if it is not there it can not be added.  "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."  This means that the States can offer health insurance, as well as various types of welfare programs, but not the Congress.  What the Congress has power to do is enumerated in Article 1 Section 8 of the Constitution.  Among the powers delegated to Congress is the power "To regulate commerce ... among the several states... .  This Commerce Clause is extremely important and has been used to mandate or allow all kinds of Government policies over the years.  It is interpreted very broadly and usually has trumped a strict or narrow reading of the 10th Amendment.  Supporters of mandatory Federal health insurance plans for all use the Commerce Clause to prove their case is "constitutional".  I fail to see how my health care is a matter involving interstate commerce that needs to be "regulated" by Congress.

My conclusion is that there is no Biblical or Constitutional Mandate whatsoever for Federal Health Insurance for all (or for any) citizens, let alone for single payer or public option insurance coverage.

Christians and Health

Many Christians are far more interested in being healed when sick, than in being healthy.  Reform of health care begins with us living healthy. 3 John 2 says, "I pray... that you may be in good health."  Christians must make living healthy a priority!  That is basic.  The only Christians that comes to mind that make this one of their official core values is the Seventh Day Adventist Church.  To them, living healthy is an essential part of the Christian life, of discipleship.  It is a matter of being faithful stewards of the life God has given them.  I know of no other church or group of Christians that make health a true priority and a part of what it means to be a Christian as such.  (Yes, many individual Christians try to stay or be "in shape" and be healthy, but as a personal goal not a Christian one and, yes, there are conservative churches that require members to renounce alcohol and illicit drugs and nicotine; but they tolerate or enjoy many other habits and activities that are unhealthy.)  It remains for Christians everywhere to make Health a priority.

What is odd about this widespread neglect of health among Christians is that "health" is another word for salvation.  The Greek and Hebrew words for salvation mean complete wholeness and well being.  Jesus came to bring fullness of Life.  A full Life includes Health.  Jesus ministry on earth was a ministry of healing.  The Gospels are full of stories in which Jesus had compassion for the sick (including the demonized) and he healed them.  Healing is more than the elimination of disease.  The healings of Jesus were demonstrations of the presence of the Holy Spirit or the power of the Kingdom at work.  And that is for deliverance from Sin, Satan and Death in order to have and enjoy Eternal Life or Salvation.  Healing is in order for the sick to have true Health and to glorify God.  This is obviously the ideal and it is absent from all discussion of Health Care.  Christians must not be content with the removal of cancer cells alone.  They must be concerned with the total Health of the Person who has the cancer. 

Matt 8:16 That evening they brought to him many who were possessed with demons; and he cast out the spirits with a word, and cured all who were sick. This was to fulfill what had been spoken through the prophet Isaiah, “He took our infirmities and bore our diseases.”

Certainly Jesus set the example for our own compassion and care for those who are in need of health care.  Preaching the Gospel is our top priority.  That Gospel brings Life. Life includes Health. Preaching the Gospel ultimately includes preaching Health.  By His wounds (the cross) we are healed (I Pet 2:24)  Christ came to earth to defeat Satan and undo his works.  They include disease and death.  Every healing (and exorcism) Jesus did was a occasion of this.

1 John 3:8 The reason the Son of God appeared was to destroy the works of the devil.

Acts 10:38 God anointed Jesus of Nazareth with the Holy Spirit and with power; he went about doing good and healing all who were oppressed by the devil, for God was with him.

Hebrews 2:14 Since, therefore, the children share flesh and blood, he himself likewise shared the same things, so that through [his] death he might destroy the one who has the power of death, that is, the devil, 15 and free those who all their lives were held in slavery by the fear of death.

1 Cor 15:25 [Christ] must reign until he has put all his enemies under his feet. 26 The last enemy to be destroyed is death.

Rev 21:4 "He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning nor crying nor pain anymore, for the former things have passed away."

Of all people, Christians should practice healthy living and promote health care. This does not preclude the reality of sickness and disease for Christians.  We are mortals and our bodies will ultimately break down. But, it should preclude those illnesses that can be avoided by living a healthy life.  And doing this will cut down on the needs and costs of health care for most of us. 

Health Care and Moral Issues

Much talk about Health Care Reform is actually about Health Insurance Reform and curtailing the costs involved.  Obviously related, they are not the same thing at all.  Health Care is far more broad than Health Insurance and should be reformed first.  Lower costs should follow. Two major areas of  high costs involve the Elderly, especially those in chronic or long term care facilities and those who are very young, especially children in neonatal hospital units. 

If we are concerned about the amounts of money being spent on these two groups we must question why they should receive expensive medical care in the first place.  Is there good or valid reason for it?  One reason newborns and the elderly live longer is that technology and medicine make saving or extending lives increasingly possible.  The reason we value the extension of anyone's life at all costs is a personal, moral issue, not a medical one.  Valuing the extension of a new born's life or of a very elderly person's life at all costs in not a medical issue.  Insisting that the Insurance Company, the taxpayers or the Government cover such costs for all who demand them is a moral issue.  Is it Biblical to believe everything that can be done for a patient must be done, regardless of costs, ability to pay or even undesirable consequences.  Moral or ethical (and therefore, Christian) issues greatly determine health care on every level including the matters of cost and insurance. 

Christians must rethink end of life issues both for themselves and everything involved in the care of their elders at various stages of their lives.  They must come to terms and plans, as Christians,  concerning home care by family members, long term care facilities (nursing homes), hospice care and dying as well as Insurance and costs and level of care.

See "The Case for Killing Granny" http://www.newsweek.com/id/215291/output/print  This article raises many issues that need discussing

Christians must not obsess with prolonging life in face of terminal illness- 25-30 % of Medicare goes 5-6% of patients who die within 1 year.  Christians may utilize pain management, but should avoid heroic measures to prolong life rather than allowing nature [God] to take it's course unimpeded when the end is obviously near.  (Feeding by tube is not an heroic measure, it is feeding the patient and to stop doing that is to starve them to death.)  "Pulling the plug" is turning off machines that are keeping the patient "alive" artificially.  This is not Euthanasia. 

Euthanasia is the deliberate act of suicide with the dominant motive to avoid suffering from a fatal disease in its terminal stages. Euthanasia is also the intentional act of suicide to avoid suffering from a debilitating old age or disease for which there is no known cure.  Pain management should remove the suffering in either case and remove that reason for the suicide.  Of course, people may rationalize the suicide for other reasons.  Obviously, assisting a suicide is wrong, too.

Christians must rethink beginning of life issues involving reproduction (the when, why and how of child bearing).  I have in mind the use of both birth control on one hand, delaying conception until late in life or for "personal" reasons and thus endangering the baby when it is conceived or carried as well as the use of artificial insemination or in vitro fertilization (embro implantation).  The consequences of doing the latter can be very costly for the to the babies and parents involved.  Of course, abortion is out of the question for most Christians, but artificially prolonging the life of babies who will not not survive on their own naturally must be at least questioned.  

Christians must reconsider the costs
of health care for themselves and members of their family of all ages.

What is morally fair or reasonable treatment or cost?  If there are limited funds for unlimited needs, who decides allocation and on what basis?  What is fair to every family member, not only the patient?  The difference between extension of life and quality of life is ethical or moral, not medical.  Who decides what "quality of life" is and where the line is drawn between minimal and maximum quality of life and of care?  Christians need to face these moral issues and seek guidance from the Lord about them.

Christians must clarify what their civic responsibilities are as Citizens.

What is the common good?  What is fair for all citizens.  They must realize that there are more than 300 million citizens and that Health Care must compete for funding along with Education, National Defense. Aid to Cities and Towns, Entitlement Programs, Bailouts and Stimulus Plans and maintenance of Infrastructure among others.  The sky is not the limit for tax payers money.  What costs are we as a Nation  willing and able to sustain to achieve all the our goals?  Who makes those decisions? Christian citizens must make their views known as Christians.

Specific Cost Cutting Possibilities: Major Biblical Principle- Good Stewardship

Optimal and equal health care and outcomes according to need (desire) for all individuals  is not a Right and is not feasible.  Biblical stewardship calls for wise spending and avoiding debt.  In these matters we must move out into research of facts and data and make reasonable and unselfish decisions as citizens.

One of the serious problems pushing up health care costs is greed (which is not the same as profit). There is a lot of money to be made in the Health Care Industry.  The broad field of Health Care is a business in every aspect from research to delivery.  Health care itself is a Christian ministry, but Christians in the business, at every level, must be sure of their motives and that greed is not one of them. 

There are many specific proposals to be considered that the Bible does not mention and so are beyond the scope of this paper.  They are matters of common sense and good business practices. In these matters we must research facts and data and make reasonable and unselfish non-political decisions as citizens.


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