In short, conservatives think it is not the job of the government and progressives think it is the job of the government. But it is not merely a debate over the role of government. It is also a religious debate, a rhetorical skirmish over the role of the church.
The two parties seem to be talking about the church’s relationship to health care in different ways. The conservative view is based on a less powerful federal government. That side sees a system of health care institutions that meets needs, with the church the primary provider of health care. The progressive view does not rank or prioritize these institutions, instead arguing that the government has values that align with the church and so both institutions are in the same “business.”
And while acts of mercy are not limited to religious people or groups, for the purposes of this rhetorical analysis, let’s look at how different religious stakeholders in the health care debate see the role of the Christian church. [Two conservative religious sects — Jehovah’s Witnesses and Christian Scientists — have histories of disavowing some if not all broadly accepted health care practices. I am setting aside those for this article. See here for more on the Scientists and here for more on the Witnesses.]
A collection of Baptist groups — members from all races and genders — warned in a statement that “the proposed American Health Care Act (AHCA) would have a ‘dire’ effect…” because of its cuts to Medicaid. Such cuts would go against their religious traditions that “leave no doubt that providing for the health and dignity of people is among the most important duties of a just society.” Those groups rallied in DC at the Capitol in March on the issue. One pastor at the rally said: “When you feed the hungry, you feed Jesus. When you heal the sick, you heal Jesus. But when you take health care coverage of 24 million Americans who are denied fundamental rights, you are denying the rights of Jesus.” In a similar vein the Rev. Michael Brown, minister at the Universalist Unitarian Church of Peoria, at a rally in that town against the proposed GOP plan, said: “Where in the world is our moral compass? What are we thinking about that we think kicking people off health care somehow improves our country?”
These examples imply the federal government should operate on a moral framework that gives particular attention to the poor. Such action is dignified and improves us all because health care is one of the fundamental roles of government. The government here is the provider. In short, the government spends tax dollars driven by or grounded in the church’s moral code.
On the other side, Fox News contributor Father Johnathon Morris responded to “Is it the government’s job to heal the sick?” on Fox & Friends by claiming that while access to basic healthcare is a “human right,” that does not mean the federal government provides it for everyone for free. He said that while society — this includes government and religious charities — should “organize itself” to give access to health care, people should not “absolutize” the (government met) right of healthcare. Such absolutism “diminishes” the obligation of individuals to “look for good health care” and the societal obligation to organize “in such way that everyone can have it.” See the full clip here.
In this view, if the right to healthcare is absolute (or mandated by a governmental philosophy), the government must meet it. But if it is not, if the right is instead to “access” in any place, the church can meet that need. Or in the words of the conservative magazine The Federalist, “Americans need health care. Universal health care could happen for every American in any number of ways that do not involve universal health insurance and all of the problems that it entails.” The Federalist adds that “it would be wiser and more efficient for the government to position itself as a promoter of and a backstop to” charities, a kind of “benefactor for the best charitable efforts, rather than their replacement.”
This philosophy has been criticized not just for its “meanness” to paraphrase President Trump, but also because it assumes a larger role for an institution that may not be able to meet the demand placed upon it. According to Bread for the World, a group that calls itself “a collective Christian voice urging our nation’s decision makers to end hunger at home and abroad,” the nation’s churches, synagogues and other religious congregations would “have to add $714,000 to their annual budgets each year for the next decade to make up for” the cuts found in President Trump’s federal fiscal year 2018 budget proposal. This proposal is tied to the health care debate because both houses of Congress, controlled by the GOP, want to deeply cut Medicaid, end or cut the subsidies for health care coverage found in Obamacare, and generally reduce government spending. This is why Bread for the World also estimates that “the healthcare cuts alone under [the GOP bill to replace Obamacare] will take away $2,000 a year in healthcare services from every man, woman, and child in or near poverty for the next 10 years.”
The GOP health care bill is usually described as giving choices to people. One of those choices preferred by the Federalist argument is what are called “health-sharing ministries,” in which “participants submit their health expenses, and fellow members contribute to the expenses,” with defined monthly contributions. Full disclosure: a member of my family participated in one of these ministries but now she receives insurance through my employer.
But those who run such ministries offer a slightly different opinion of their abilities. Catholic Charities, the umbrella group that represents numerous charities funded in part by the Catholic Church, echoes part of that conservative philosophy — “the work of CCUSA is rooted in the Church’s moral and social teaching that holds, in accordance with human dignity, health care is a basic human right.” But in a letter to Congress it “lamented the risk” to the poor with cuts in Medicaid. It noted how many people rely on its services for health care (more than 860,000 annually), and the “devastating consequences of inadequate health care” nationwide. The United Churches of Christ agree, writing in its rationale for a denomination-wide effort toward health care through the church: “However, [churches developing health care programs] is an increasingly important [action] as health care funding and services gradually shrink. Local churches can help address the need for more appropriate and accessible health care services and the inadequacy of our health care system.”
One side views the government as a supporter not replacement for the church. The other side would not disagree that the church can and should provide health care; they would add that the government can be formed as to live out church values.
To say that health care is a matter of Christianity is not merely to say that Jesus commands his followers to heal the sick. It is also to say what role institutions of that religion — primarily through the donations of its members — play in health care.