• Human beings are created in the image of God, body and soul, and have been called as such “very good.” Our bodily nature reflects God’s goodness to us and the embodied acts that we participate in (eating, sleeping, work, communicating, sexual relations, etc.) are expressions of honoring our Creator as He intended us to live.

  • Our bodies are a gift from God and we are called to care for our bodies as given things, just as we would steward any other gift that God has given us.
  • Caring for our bodies implies a recognition of our physical limits as human beings; even in God’s original good creation human bodies still required food and sleep.
  • The existence of sin in our world has begotten a great number of potential physical harms to our bodies. Trauma, infections, exposure, neoplasms, autoimmune disorders, and other forms of internally or externally induced illness threaten our bodily integrity, our ability to carry out embodied acts of worship and service, and ultimately our lives.
  • Our flesh will see decay and we will all eventually die as a result of the curse of sin, but our physical bodies will be miraculously transformed into glorious heavenly bodies in the Resurrection.
  • Caring for our bodies requires making use of the other gifts God has given us. God has seen fit to provide miraculous protection from hunger, the elements, or disease in many cases, but the vast majority of human beings will require stewarding the resources in our environment appropriately and participating in acts of physical care for one another for the sake of human life. Health is stewardship of our resources so as to adhere to the physical limits of the human body.
  • Caring for our bodies does not consist in solely maximizing the length of time any one particular body is alive, but in allowing each human life to glorify God by minimizing the degree to which illness participates in the embodied acts of worship. Each life has a trajectory or arc with limits particular to each human being; a body which is properly cared for must be given what is necessary in order for that arc to avoid sudden and otherwise preventable interruptions or degradations.
  • It is not possible to predict, prevent, or cure every illness that affects every human body. There will always be unforeseeable accidents or hidden conditions; our scientific knowledge will always be limited such that not every condition once diagnosed can be readily treated to restore physical function or prevent death.
  • It is possible to screen for, prevent, and treat many illnesses that affect most human bodies and thus care for one another such that many lives that would otherwise be cut short or suddenly degraded by disability are permitted to continue their trajectory. The scientific knowledge and the physical resources that makes this care for human bodies possible are always changing, but there exists sufficient knowledge to say that certain interventions can reasonably be expected to help the population prevent or ameliorate many illnesses. These “essential interventions” will vary from region to region based on the health needs of any given population and the existing medical infrastructure available to that population, but it is reasonable to use metrics such as Quality Adjust Life Years to delineate such interventions.
  • To honor the image of God in one another, we are obligated as human beings created by God to steward our resources towards the end of maximizing the essential interventions accessible to our fellow human beings. Failing to steward the resources that God has given us such that any fellow image-bearer lacks the medical care that would reasonably be expected to prevent or ameliorate disabling or deadly illness is an expression of disdain for God’s created order and a failure of love towards neighbor.
  • God has granted human government the power over life and death; while a government and its citizens may attempt to do any number of things, from a Christian perspective the basic measure of a just government is one that protects human life.
  • Both the natural evils of the fallen world and the volitional evils of human cruelty are capable of doing harm to human bodies; thus, any human government should do what is necessary to ensure that none of its citizens are denied those interventions that can reasonably be expected to prevent or ameliorate illness.
  • There is no health care system that is perfectly able to deliver said interventions, but any health care system in which a citizen under their government could die or be disabled for lack of said interventions is unjust and must be reformed in order that all citizens can access this basic level of health care.
  • Citizens of any government with an unjust health care system should work to ensure that all of their fellow citizens are afforded the basic goods of health care necessary to preserve life.

Posted by Matthew Loftus

Matthew Loftus teaches and practices Family Medicine in Baltimore and East Africa. His work has been featured in Christianity Today, Comment, & First Things and he is a regular contributor for Christ and Pop Culture. You can learn more about his work and writing at www.MatthewAndMaggie.org

  • Jonathan James

    Thank you for this. We need Christian thinking on this that isn’t merely partisan.

    I think, though, there may be an equivocation in “God has granted human government the power over life and death.” This is true in a sense, God gives governments the power to bear the sword. This is often taken to mean that governments (in most circumstances) have the exclusive right to violence. It’s wrong for a man to slay his neighbor, but not always wrong for the state to do so.

    But it doesn’t seem that governments are given the same exclusive power over life (if life means medical interventions here). The power of medical treatment is not reserved for the state. It isn’t at all wrong for a man to treat his neighbor’s wound. In the parable of the Good Samaritan, the brigands usurped state power in beating the man, but the Samaritan certainly did not in curing him. Governments have the exclusive right to the sword, but no equivalent right to the scalpel, so far as I can see.

    I also have a little thought experiment, which may not really be that far from the truth. Imagine Metropolis, USA, pride of the nation. It has the finest medical care in the world. On the other hand, Podunkville, Hickstate has few medical facilities, and its residents lack the same medical interventions that the Metropolitans have. Airlifts work to a degree, but some care needs to be given on the spot. The problem is simply that, despite government incentives, no Metropolitan doctors want to move to Podunkville. Their families live in Metropolis, and many are elders in Covenant Metropolitan Church. First Baptist Church of Metropolis would send a missionary doctor, but they’ve already sent doctors to Plebeton, Erehwon, and Rust City, so they’re fresh out.

    Now, according to your manifesto, the government should “do whatever is necessary” to ensure the residents of Podunkville have the necessary medical interventions. Would they, therefore, be just in forcibly relocating doctors from Metropolis? Other incentives have failed, remember.

    • I think the government should raise the level of financial incentives for doctors to move to Podunkville, or else pay to help the residents of Podunkville move closer to Metropolis.

  • disqus_4HyKCNMzD6

    Why shouldn’t the government provide our daily allotment of food, and all seasonal clothing? After all there’s a clearer biblical mandate for that isn’t there (Matthew 25:34-40). You say a just government protects human life. Shouldn’t the government prohibit smoking and all drinking to excess. Shouldn’t the government outlaw fatty foods, and sporting activities where a person could get hurt, finding themselves in need of this medical care you’re referring to. Why stop at physical harm. Shouldn’t the government also protect people from mental harm? Ideas that are hurtful or offensive. Radical forms of thinking that could lead to violence. So what if freedoms are lost because the government must curtail them in order to protect us from harm, or protect us from ourselves! It creates a just government after all! Oh, I know, I’m guilty of a slippery slope argument. It’s true. That could never happen as I’ve described it. No one would suggest any of the options I’ve described. Would they :(

    • hoosier_bob

      I didn’t see anywhere in Matthew’s manifesto where he suggested that the “government provide” anything, although he does suggest the possibility that a government may regulate healthcare in a way that leads to unjust results. That said, there’s a reasonable economic argument to be made that providing healthcare, like providing bridges and roads, is the sort of thing where transactional costs are minimized when the government does the providing.

      I had a minor medical issue earlier this year that involved a quick ER visit and a follow-up visit to a physician’s office. The total cost was about $2700. I spent 4-5 hours sorting out hospital bills, insurance paperwork, reimbursement from my HSA, etc. I’m a lawyer who bills at $775/hour. Thus, the handling the ensuing paperwork cost my firm more money in lost revenue than the total bill for the stay. The whole experience convinced me that some kind of modified single-payer system has to be more efficient than what we currently have.

      I spent a couple of years working out of my firm’s Tokyo office. At that time, Japan had a two-tiered system. The basic level of care was available to everyone. Then, if you wanted, you could buy into a supplemental plan that came with more bells and whistles. That plan had a fee, but I could offset some portion of the fee by keeping my weight down (known as the “metabo tax”). At my height, you had to keep your BMI below about 21.0 to avoid the tax.

      • disqus_4HyKCNMzD6

        I realize Matthew didn’t argue for government to provide everything. My point was that his argument, reached through a series of premises, concludes that it should provide healthcare. I’m just pointing out that it is biblically more straightforward to say that it should provide food and clothing, so why not argue for that.

        What I’m really wondering is why is it argued that a just government from a Christian prospective needs to provide this or that, rather than arguing that a just government from a Christian perspective should provide incentives for its citizens and business entities to behave justly and disincentives for when they behave unjustly? Give government the power and authority to “do justice” rather than ensure justice is done, and that’s why my slippery slope scenario starts to look a lot like our current landscape.

        • The government doesn’t have to provide food and clothing because no loaf of bread necessary for survival is ever going to cost $50,000, but a really effective cancer drug might. But if a government ever found itself in a situation where 5% of its population was starving for lack of bread, it would be incumbent on that government to do something to keep its citizens from dying.

  • Physiocrat

    A Christian Manifesto on Healthcare and the State: no compulsion in religion, no compulsion in healthcare.

  • James McClain

    Maybe someday someone at Mere-O will write something, anything, that will highlight the realities of how things are actually produced in a world of scarcity before compelling this or that from the citizen. Like it or not, health care is a good just like anything else and it is produced through efforts resulting from planning, investment, risk-taking – you know, stewardship of resources.

    • Somehow every other Western country in the world has figured out a way to plan, invest, take risks, and steward resources in such a way to meet the criteria I’ve outlined above. And they spend less overall on healthcare than America as they do it!

  • wassup402

    Can anyone, Christian or not, explain to me how healthcare is a “right” in the same way and fashion as those guaranteed by the U.S. Constitution enumerated in the Bill of Rights? Unlike what we find in the first ten amendments, the issue of healthcare is not a political issue, though it has been politicized. Healthcare, more than anything else is a service or a product and is produced by the work of others in providing that service. The same thing can’t be made to apply to freedom of speech or that of the press or the right of the people to be secure in their persons, ect. So how is healthcare a “right” like those mentioned?

    • I don’t think healthcare is a right in the same way and fashion as those guaranteed by the U.S. Constitution, which is why I never said so in the OP.

  • And when health care and health become godless idols? What about when health care becomes a means of mitigating the wrath of God on intentional and unrepentant sin? Are Christian obligated to give aid and comfort to the enemies of Christ? “It is not meet to take the children’s bread, and to cast it to dogs.”

    • Daniel Hindman

      Did not Christ heal the 9 lepers who never gave thanks? Was it not only 1 who came and expressed gratitude? Did he not do this knowing full well that they would not worship or thank him for it? Is not this part of his wrath agains them (Romans 1-2)? Will it not testify against them on the day of judgement?

      In the Sermon on the Mount, is not the definition of being a Christian when one gives aid and comfort to those who are enemies of Christ, those who persecute us and in so doing persecute him? Is it not Christ, in Matthew’s recitation of Isaiah, who is spoken of as taking our illness and bearing our diseases, and this when we were yet still his enemies?

      To whom has Christ shown mercy that was not his enemy? Are we as servants somehow greater than our master?