House Republicans are set to vote this morning on legislation that would replace the Affordable Care Act (ACA). They hoped to vote on their bill yesterday, but too many conservatives and moderates opposed it. Even if they prevail, their legislation faces an uphill battle in the Senate.
Why is this issue so complicated and divisive?
As one medical ethicist explains, we insist on four values that are difficult to reconcile: high quality of care, freedom of choice, affordability, and a system in which everyone shares both costs and benefits.
Contrast our social values with those of other countries. Nearly all the world’s highly industrialized nations—including Canada, Japan, Australia, and western European countries—have health care systems that provide universal access at significantly less cost than in the US. However, to pay for their health care, these societies typically limit insurance options. The UK also restricts the adoption of high-cost medical innovations. And these nations generally impose limits on fees providers can charge and on pharmaceutical prices.
For many Americans, the system prior to the ACA worked well. It offered a wide range of medical options and excellent care at a price they considered affordable. However, this system was too expensive for many others. As costs escalated, the gap between those with coverage and those without health care continued to grow.
The ACA sought to balance our four priorities, ostensibly providing choice and care while driving down costs and expanding coverage. However, opponents claim that it restricted choice, limited care options, and expanded coverage by imposing a financial model that was unfair and untenable. Now critics of Republicans’ attempt to repeal and replace ObamaCare are making similar allegations against their legislation.
This debate will continue because our democratic culture especially values freedom of choice. We are consumers in a consumption-based economy. Yet we believe that “all men are created equal” with equal rights to effective health care. As medical costs grow, balancing our cultural priorities is a true Gordian knot.
Three biblical priorities will help.
One: God values our health.
God made us in his image (Genesis 1:26–27) and has made our bodies the temple of his Spirit (1 Corinthians 6:19). Jesus healed “every disease and every affliction among the people” (Matthew 4:23). Medical care, when practiced within biblical guidelines, is an extension of Jesus’ healing ministry today. Efforts to provide medical care to all Americans are biblical.
Two: We must care for the poor.
We should meet our own needs if we can: “Each will have to bear his own load” (Galatians 6:5). However, God told us how to treat our “poor brother”: “You shall open your hand to him and lend him sufficient for his need” (Deuteronomy 15:7,8).
Three: What is good for one of us is good for all of us.
Describing Christians as the “body of Christ,” Paul noted: “If one member suffers, all suffer together; if one member is honored, all rejoice together” (1 Corinthians 12:26). Ethicist Bruce Jennings: “No individual, no matter how wealthy or powerful, can really be free except in a context of social justice and the common good.”
John prayed for his people “that all may go well with you and that you may be in good health, as it goes well with your soul” (3 John 2). Let’s join him.
NOTE: I invite you to join me for a seminar I am teaching on how to engage the culture for Christ. You can register here for the four-week course. The class meets from March 30 to April 20, 6:30 to 8:30 PM on Thursday nights at Dallas Baptist University. We will develop a Christian worldview, understand trends in the culture, and learn how to speak the truth in love on topics from medical ethics to the LGBTQ community. The class is almost full, so sign up today.