Healthcare for children: a moral imperative

By George Clifford

Last week I attended a meeting in Raleigh where those gathered brainstormed about ways to provide healthcare coverage to all North Carolina children. About 87,000 North Carolina children currently lack healthcare coverage. (Nationally, 8.7 million children lack healthcare coverage.) Children without healthcare coverage receive less medical attention, suffer, in comparison to children with healthcare coverage, from a greater number of serious health problems that early intervention could have averted, and cost taxpayers more.

A member of the NC State House of Representatives, Verla Insko, has sponsored a bill in the current legislative session to provide subsidized coverage to parents of the 38,000 uncovered children when family income falls between 200% and 300% of the federal poverty guideline. Children in families below the 200% level are already eligible for healthcare coverage through Medicaid and North Carolina Health Choice.

Someone in the brainstorming session inquired which would cost taxpayers the least, the state directly funding healthcare for all children whose family income is less than 300% of the federal poverty guideline or administering the subsidy program and then directly paying for the approximately 50% of the children – some 19,000 – whose parents would choose to not participate in the program. Surprisingly, the least expensive option is the former, having the state directly provide healthcare for all children from families whose incomes fall between 200% and 300% of the federal poverty guideline.

Then one of the state’s foremost healthcare advocates spoke. He said that option made sense and would benefit taxpayers. However, the option was a political non-starter. For a North Carolina family of four, 300% of the federal poverty guideline is over $40,000 per year. The legislature, declared this experienced and dedicated advocate of healthcare for all, would never adopt a program of free care for children in families of four with an income of $40,000. The consensus among those present was that the advocate was correct.

As I traveled home after the meeting, I thought about that discussion from a gospel perspective. First, I remembered Jesus instructing his disciples to “Let the children come to me.” Surely, Jesus loves children. Our children, all children, are precious. The Episcopal Church rightly takes steps, such as background checks and ensuring adequate supervision, to guarantee the safety of children while they are at church or involved in church programs.

Second, Jesus healed the sick. Theologians, biblical scholars, and Christians debate how Jesus healed. Yet even the most radical scholars acknowledge that Jesus healed the sick. Since Jesus loved the children and healed the sick, then surely we who are Christ’s feet, hands, and voice can do nothing less.

Third, I remembered Jesus’ saying “You cannot serve God and wealth.” I am amazed that making healthcare coverage free for all North Carolina children whose family income falls between 200% and 300% of the federal poverty guideline saves the taxpayers money but is nevertheless politically a non-starter. The only explanation of that anomaly which makes sense to me is that some legislators and voters love wealth more than they love God. Idolatry has so warped their judgment that the idea of paying for children’s healthcare without requiring parental contributions is unacceptable even when to the taxpayers’ financial advantage. In other words, the legislature does not want to create the appearance of these children getting a free ride. I cannot believe that many families would voluntarily limit their income to 300% of the federal poverty guideline in order to obtain free healthcare coverage for their children.

My reflections on those three points caused me to rethink what I as a Christian believe are government’s proper functions. Libertarians argue that the best government is the government that does the bare minimum. Libertarianism does not cohere well with Christianity. Christianity teaches that God created humans to live in community with one another; our concept of the Triune God models that community for us. At the other end of the spectrum, some communitarians contend that government should manage most aspects of life. Extreme communitarians fail to take sin and evil seriously; primitive Christianity’s early experiment with socialism, recorded in the book of Acts, teaches the need to balance community with individual initiative.

Like the Christian tradition’s mainstream, I found my thoughts gravitating toward a philosophy of government that falls somewhere in the middle of the spectrum between extreme libertarianism and communitarianism. Government is the clear provider of choice for certain services, such as national defense, law enforcement, fire protection, and most transportation infrastructure. We may not enjoy paying taxes but know that funding those basic services is important. Conversely, the majority of agricultural, industrial, and commercial activities function more effectively and efficiently when shaped by market forces within broad legal parameters.

Healthcare, it seems to me, falls into an ambiguous middle ground, partly an individual and partly a communal responsibility. Individuals who have to pay something for their healthcare coverage have an added incentive to adopt healthy lifestyles (as if anyone should need an added incentive!). Healthcare providers exercise more initiative, creativity, and responsibility within a system that allows some market forces to function. Conversely, all people, especially children, should have equal access to healthcare.

What does any of this – talk of healthcare and one’s philosophy of government – have to do with Easter? After thirty plus years of ministry, hearing hundreds of sermons and reading thousands of pages of Christian materials, I well understand why Karl Marx wrote that religion is the opiate of the masses. Too often, Christianity focuses on matters ethereal rather than earthy. Christianity offers the watery gruel of stoic counsel, grin and bear your problems, instead of the living water of real help. Jesus the healer becomes Jesus who promises of paradise.

The gospel reading for the fifth Sunday of Easter seeks to plant our feet firmly back on the ground. “By this everyone will know that you are my disciples, if you have love for one another.” (John 13:35) The reading on the sixth Sunday of Easter reinforces that message. Jesus’ commands those who love him to follow his teachings (John 14:23). The Church does not need to propose a panacea for the nation’s healthcare woes. Living in London for two years and multiple conversations with people on both sides of the Atlantic leave me firmly convinced that no nation has yet implemented anything near an optimal system for ensuring everyone receives quality healthcare. What we as the Christian Church can do, must do, is insist that our politicians keep working at the problem and that in the interim, as a minimum, every child has guaranteed healthcare coverage.

The Episcopal Church’s General Convention adopted resolutions in 1991 (A099) and 1994 (A057) calling for universal access to quality healthcare coverage. This Eastertide as numerous states begin to address the healthcare system’s failure to provide quality care for all Episcopalians would do well to restore this topic to their primary agenda and to spend less time in futile efforts to preserve church unity.

The Rev. George Clifford served as a Navy chaplain for twenty-four years, with tours at sea, with the Marine Corps, on the staff of the Chief of Chaplains and as the senior Protestant chaplain at the U. S. Naval Academy.

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2 Comments
  1. This, as many will know, is a topic close to my heart. I have written on it several times myself.

    I might point out that the 2006 General Convention also passed resolution B018, “Comprehensive Children’s Policy.” The content of the resolution includes the policy statement, “THE CHURCH AND CHILDREN: VISION AND GOALS FOR THE 21ST CENTURY,” which then includes the specific statement, “Every child and family has a right to guaranteed quality, comprehensive health care.” We are on record as a Church as supporting these efforts, both within the Church and within the larger political sphere.

    Thanks for this post.

    Marshall Scott

  2. jeffrey smith

    I’d like to challenge your statements regarding libertarianism. (I am a libertarian.) Libertarians don’t challenge community: they challenge enforced community (of which government is the most obvious example).

    Ideally, all communities should be voluntary: the Church, I suppose, might be a good model. Using this terminology, the problems arise from people who try to impose their will on the community or endanger it–by means of force or fraud (aggression). In political context, there are two sorts of problems–internal aggression (crime) and external aggression (war). There are two sorts of libertarians–those who think government is necessary to deal with these two things–but only in the most limited manner possible, and nothing else–and those who think government is not necessary even for these two things–that private individuals, cooperating either through free market mechanisms or voluntary community, can satisfactorily deal with them.

    But community plays an important part–a community of people who respect each other as free individuals capable of making their own informed choices.

    The libertarian view of health care is that government intervention actually makes the problem worse, through bad regulation and bureaucracy, and that private initiative will always deliver a better product. There is also the matter that government intervention often empowers the wrong people and institutions–for instance, in our current environment, insurance and pharmaceutical companies. For instance, a charitable group which financed a local clinic would do better, of getting help to those who need help (both in terms of identifying those who need help and actually getting them the services they need) because it would have the initiative and flexibility necessary to make changes as changes are needed. And if it didn’t, other private groups could step in to provide better programs, unlike the situation where government run clinics become the only source of medical care.

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