Thursday, April 8, 2010

Healthcare for All

I want to try to simplify this rather complex issue by asking this question: Should we provide health coverage for people who cannot afford it? Without consideration of the politics of the matter, is it a morally acceptable notion that people with resources ought to provide for the disadvantaged?

In terms of daily practice, we seem to believe that this is the case, since we in fact do this already. Any person with serious health issues can in point of fact go to a local emergency room and will not be turned away. Why is that? Can you imagine a nation in which we essentially told a person who was bleeding to death that to receive life saving care, payment must be settled first.

This leads me to believe that regardless of the rhetoric on both sides, we seem to hold to a collective conviction that we do have some moral responsibility to provide at least some level of healthcare to all people.

Perhaps there is here at least the beginnings of philosophical clarity with respect to the healtcare mess. Can a distinction be drawn between essential healthcare and the all too fashionable and deeply specialized "preventative" care we see in modern day American "medicine?" Is it possible that we have some moral responsibility to provide the former and not the latter? Surely there is a fundamental difference, in terms of moral responsibility, between providing food for all people and providing filet mignon for all people.

The following may seem an unrelated question, but I think it crucial: Do we do more for someone's health by providing more specialist doctors or by encouraging healthy living? To what extent is health a simple matter of wise choices? And perhaps it is fair to imagine the community providing "emergency care" for immediate and life threatening health conditions, but is it fair for the community to pay for all medical care for those who make miserable life choices?

The way the apostle Paul speaks of this is to say that "those who do not work should not eat." He was speaking about lazy people within the Christian community living off the generosity of others. If a person will not contribute something, then that person should be cut off from "services," at least as I understand Paul.

Paul is basically arguing that grace is not a contingent phenomenon, but blessing (or generosity) is, especially after a length of time. Food (or healthcare) is offered, but if it is received under pretense, and it becomes clear that the generosity of others is being used unfaithfully as an entitlement, then it must be withdrawn, at least until good faith is restored. Think of the poor man who is provided with emergency healthcare for a heart issue. This same man returns to his meager job where he shirks his responsibilities, is fired, and then does little to improve himself or to find other work after he recovers. He does not exercise, eats terribly, smokes and drinks and the like. Is this man entitled to a full complement of health coverage supplied by the faithful majority? By analogy, are students who throw away myriad opportunities to be educated entitled to the gift of even better educational opportunities?