Saturday, November 18, 2006

Health Care and the Church: Starting to Think it Through

I was listening to the radio this morning - Air America, WCPT out of Chicago - and there was discussion concerning Health Savings Accounts (HSAs) and the current state of the American health care system. I got to thinking that this is an issue about which I have given almost no thought - despite gall bladder surgery, watching my wife deliver two beautiful baby girls, and the inevitable medical exams that accompany reaching "a certain age" - but feel should be given serious thought from a theological perspective. I use the terminology "theological prespective" because I find it more terminologically exact than the bland, and meaningless, "Christian perspective". Theology is what the church does - it thinks through the experience of God, God's revelation to humanity, and our response to it. "Christianity" is a generic description of a religious group that may, or may not, have certain things in common.

That digression aside, because I believe whole-heartedly that it is time to set aside the politics of the Mayberry Machiavellis (h/t to Jon DiIullio) and deal substantively with serious policy questions, I think it is time I wrestled in some detail with questions surrounding health care. I think these are questions about which the various Christian Churches should care deeply. Catholic hospitals, Presbyterian hospitals, United Methodist hospitals, and of course Adventist Hospitals are among the finest in the nation. The history of the church providing care to those ill and injured is as old as the church itself. That the economics and politics has become infinitely more compllicated should not distract us from the real concern Christians of a variety of persuasions should have over how medical care is delivered, and more importantly, how it is delivered.

Before we enter that arcana, however, I feel it necessary to deal with something that has become, for better or worse, part of the conversation. The claim by many that access to health care is a "right" has created much confusion and heightened the stakes in the debate. While "rights talk" is far different today than it was first coneived during the heyday of the English and Scottish Enlightenment, it is easy enough to say that most Americans envision a right as something to which they have a claim regardless of the exigencies of society. Most Americans are correct in their understanding that a right is something that exists prior to the creation of the state, and therefore is something over which the state has no power of interference. They are wrong, however, to see health care as a right. Rights exist not in individuals as individuals, but only so far as individuals are part of a society. They are a part of the social understanding of humanity. They are pre-social, but they express the limit of social interference. They do not concern individuals in the everyday experience of their life; rights are about the practice of social and political life.

As such, it is hard to see health care as a "right". It might be an essential duty, in line with the Hippocratic Oath, to provide medical assistance to others without regard to how those others can pay; this is not the same as a right, and to claim it as such is to do violence to the heritage of natural rights that Americans, more than any other people, cherish. To think of health care as a right creates confusion, clouding an already difficult debate with the baggage of rights talk and all it seems to entail in our self-obsessed time. It would be better to discard it before we begin so the debate can move forward in a more positive and fruitful manner.

To say that health care is not a right in no way means that I do not believe Americans should not have access to the finest possible health care. To say that health care is not a right in no way means that I believe our current system of health care delivery is fine. It only states that, as it does not pertain to our political and social existence per se and en se, it is not a right.

Virtual Tin Cup

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