During the 1980s, with the help of Fulbright fellowships, I spent two separate years in Germany, along with my wife and three children. Before departing, I received some informational materials about German laws, culture, etc., from the Fulbright association. I found it interesting that the German Constitution provides for a right to healthcare, in something like our Bill of Rights.
On my first trip, I was forced to take advantage of these resources because of a knee fracture, with multiple complications. I ended up in a German hospital for four months, receiving daily physical therapy, consultations, medications, etc. I paid nothing, but when I returned to America. I received an invoice, which was covered by my U.S. health insurance.
Almost all Germans are required to pay for health insurance, with rates proportionate to their income. I was surprised to find out from some of my fellow hospital patients that the German system even sometimes pays for weeks at a spa for rehabilitation.
One could argue that healthcare is related to natural rights, specifically to the right to life. And there’s a certain irony in this perspective, as Congress debates healthcare reform, given that the Democratic Party, which has for all practical purposes become the Abortion Party, prides itself in being the champion of universal healthcare.
In other words, for many Democrats, there is no right to life for a baby emerging from the womb; but a universal and expansive right to life and healthcare begins if and when the baby survives birth.
What could be the motive for such a glaring disconnect? It’s quite difficult to account for it in purely logical terms. How compassionate people were convinced to embrace such a crude and violent solution to problem pregnancies because of political loyalties is deeply distressing.
But Republicans, those who are pro-life, also need to go beyond mere party loyalties and expand their commitment to the right to life throughout childhood and adulthood.
Of course, this general ideal requires some serious discernment about how it is to be put into practice. For every right has a corresponding duty. So, granted the right to life, who in specific cases has the duty to respect and further that right?
For example, individuals require food to live. Charitable organizations exist to make sure that indigents have access to food pantries. Recipients may be physically or mentally unable to provide for themselves, or maybe just lazy. But, usually, need is enough to qualify.
Governmental assistance is something different. Welfare payments, food stamps, etc. legitimately may have requirements regarding work or marriage – or what kinds of things taxpayer funded programs can be used to pay for.
In all of this, however, there is no self-evident principle concerning who must supply the food for anonymous indigents. Who has the duty – the local community, the state, the federal government?
Healthcare has somewhat similar features. Obviously, parents and close kin need no rulebook telling them where their duty lies. A child is sick, and parents or grandparents or other relatives do what they can, within their resources and capabilities, to help out. Outside of families, the duties become murkier.
And it’s worth drawing a distinction between ordinary and “Good Samaritan” healthcare.
In Jesus’ parable (Luke 10:3–35), a priest and a Levite passed by a man who had been robbed and beaten. Was this a sin of omission? Maybe the priest or Levite was rushing to other important duties. Possibly they didn’t know how to treat a sick person. And the parable doesn’t say whether, like the Samaritan, they had a beast to carry the injured person to an inn.
Jesus is obviously commending the Good Samaritan, and recommending we do likewise, when possible.
But it doesn’t appear that there is a moral duty to be a Good Samaritan. And, in fact, we have “Good Samaritan” laws in many states protecting individuals who, with the best of intentions, ended up injuring or even killing someone they were trying to help in an emergency.
There is also a very important distinction between ordinary and “extraordinary” care – using massively expensive procedures and machinery in borderline cases. And let us not forget the distinction between normal healthcare and “cosmetic” or serendipitous care – operations to fix a nose that seems too long, or to “reassign” gender, etc.
President Donald Trump has on numerous occasions expressed support for basic healthcare rights, implemented largely according to the principle of subsidiarity by state and local governments, with minimal involvement of the federal government:
Everybody’s got to be covered. This is an un-Republican thing for me to say because a lot of times they say, “No, no, the lower 25 percent that can’t afford private”. . . .I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.
Of course, even with the best intentions, this is something that could never be accomplished by presidential directives or executive orders. Even for a wealthy nation like the United States, major financial hurdles exist for implementing even basic universal medical care: the frequently outlandish costs of prescriptions and medical fees that are much higher in the U.S. than in other developed countries – and no easy way to fix them.
As usual, the devil is in the details; and for Congress the details do not, as so many assume, lead quickly to a “single payer” system, but to working out a plan involving constructive competition among pharmaceutical giants and private health insurance companies, interested in the “bottom line,” but also interested in staying in business.
Healthcare understood as a natural right in the proper sense certainly involves thinking through practicalities. But perhaps above all, it must preserve freedoms and moral principles by large doses of fundamental social goods such as subsidiarity and limits on the ever-expanding state.