It’s easy to criticize Obamacare, both in its principles and practices – in fact, it’s doing a good job of criticizing itself these days. But what about the far more difficult work of constructing an alternative? There’s no question that at least some of the motivation behind Obamacare was good – the desire to reduce costs, widen access, and help those with pre-existing conditions. So how would a Christian healthcare alternative (ChristCare?) grapple with these problems? Let me propose twelve biblically based principles.

1. Charity: As part of our Christian duty to love our neighbor as ourselves, ChristCare would provide some level of healthcare for those who are uninsured or uninsurable. Although none would be denied basic healthcare, a just distinction in services offered would be made between those who are sick and poor through no fault of their own and those whose personal choices have made them ill.

2. Responsibility: ChristCare would call people to take personal responsibility for leading a healthy lifestyle. It would prioritize health education, disease-prevention, and financially incentivized accountability.

3. Reality: We cannot all get access to every medical treatment. Just because a drug is available does not mean its affordable. Just because something can be done does not mean it should be done. We need to recognize that we are mortal, that we are not going to live forever, and we must also learn to live with some measure of pain and discomfort at times. Otherwise, we could easily spend every last cent on medical treatment. ChristCare would propose realistic basic levels of care for different ages and illnesses.

4. Liberty: Although basic levels of care would be available for all, ChristCare would allow people the freedom to choose the level of health care and cost that suit their situation and circumstances.

5. Morality: ChristCare would not fund birth control or abortion. It would also reduce expenditure on diseases that have been brought on by sexual immorality, drug abuse, and other sinful choices.

6. Efficiency: ChristCare would be vigilant in driving down waste, inefficiency, and corruption in the provision of medical services and the associated administration.

7. Locality: As the “cultural mandate,” Babel, and the Great Commission demonstrate, God opposes centralization. Probably due to the increased dangers of corruption, God encourages the spread and sharing of power. Churches, schools, and other local organizations would be encouraged to be involved in health education and even the provision of some basic services.

8. Fallibility: While holding doctors and nurses accountable for serious malpractice, ChristCare would accept that a level of mistakes and errors are always inevitable in a fallen world and would implement policies that would minimize lawsuits and reduce excessive compensation payments.

9. Simplicity: Obamacare’s major accomplishment to date has been to make an already complicated healthcare system even more so. My wife is a doctor and even she is frequently baffled by the complexity of the American healthcare system. For even the simplest of procedures there seems to be a blizzard of paperwork and bills. ChristCare would aim for a streamlined simplicity.

10. Honesty: Hospitals seem incapable of estimating even to the nearest thousand dollars the cost of routine operations and even of basic tests like colonoscopies. Ask for a quotation and you’re told you have to phone about a dozen hospital departments to figure out everyone’s slice of the pie. This lack of transparency means that patients cannot compare prices in a way that would create a competitive market. ChristCare would be open, honest, and transparent about costs in order to drive prices down.

11. Equity: Without going down the Obamacare route of national price controls, there needs to be some way that patients can get redress when overcharged for medical services. Recently my wife had to take our baby to the local children’s hospital. She was there for about 20 minutes, questioned by a nurse for about 5 minutes, and the baby examined by a doctor for about 2 minutes before being given the all clear. Cost? $750! Thank you. Don’t mention it. ChristCare would establish independent mediators to advocate for patients and establish fair pricing.

12. Spirituality: ChristCare would take the spiritual dimension seriously and provide holistic care for the body, the mind, and the soul.

These are only principles of course; the practical details would take a huge amount of time and thought to work out. (See Dr Carl Ellis Jr.’s Alternative HealthCare System  for a much more detailed proposal). However, by measuring every proposal and practice against these principles, I believe we would get much closer to a universal and affordable healthcare system.

  • Kevin Halloran

    Great post, David. On point with every thought. Healthcare/insurance matters are complicated and expensive…and only getting worse. Even in complicated and uncertain times, Christians can act on these principles and shine the light of Christ.

    Thanks for sharing!

  • St. Steve of Northern Lights

    Pastor Murray, I found your first blog posting on the Mandated Healthcare, and the opportunities for the church to serve because of it, refreshing! Since then I have continued to follow your thoughts!

    Would you be willing to address any issues related to church deaconal works etc, as the Lord allows you time and thought? I was desirous to ask you before this whole national health rig-a-ma-rol, but it seems like a good time to throw in the request! I know you have studied Edwards, and there may be others, who have thoughts on church deaconal ministries, but as the Lord provides you insight or a burden for discussing that section of church ministry, please feel free to share!
    You or your wife may enjoy the author Atul Gawande, a doctor who has a chapter in his book “Better” about the topic of medical liability, etc. He is easy to read and covers some interesting topics as a surgeon. He is also gifted as a writer too!
    Preach, Teach, Write, and Minister on… Brother! Thanks

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  • Jeff Kessler

    Perhaps this fits under one of your proposals, but one of the simplest things to do would be to remove regulations prohibiting health insurance companies from competing across state lines. Why shouldn’t health insurance be allowed to compete on a national stage like auto insurance. Competition wouldn’t solve every problem in health care, but it would go a long way towards lowering costs.

  • Jeff Kessler

    This probably fits under #2 above. Americans understand the difference between catastrophe and maintenance with their houses and cars. We don’t call the insurance company when we change wiper blades or furnace filters. We could use some of the same understanding on medical issues. Parents with some kids are going to have cases of strep throat or a simple cut needing a few stitches. Save the insurance for when a kid gets leukemia.

  • Ryan

    Dr. Murray, I found this very helpful and stimulating. Thank you!

  • Donald Mackay

    5. Morality: ChristCare would not fund birth control or abortion. It would also reduce expenditure on diseases that have been brought on by sexual immorality, drug abuse, and other sinful choices.

    The first question that came to mind on reading this is did Christ modify His healing ministry according to the sinful consequence of the disease presented to Him? I don’t know the answer but it seems key to the principle.

    Also, as a Scot, whose own nation has plenty health problems caused by sinful choices, how are these sins that qualify for reduced expenditure to be qualified. It’s easy to focus on the headline sins of sexual immorality or drug addiction, but for instance, would gluttony leading to heart disease be included, or smoking leading to lung cancer? Reducing expenditure due to sinful choices necessarily leads to a gradation of these sinful choices and a decision as to which sinful choices should be covered and which not covered. Do we have the right to make these judgements? Does every sinful choice negate the policy?

    I am wondering if the justice system is not the better place to penalise sinful choices and to leave healthcare to mercifully treat the consequences? These are questions. It’s not a issue I had considered before. They are not questions we often face over here with our NHS.

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