–– Mark Christopher

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Over the last 10 years, there has been a great deal of discussion and debate concerning the recently adopted National Health Insurance (NHI) legislation here in South Africa. One of the many overriding concerns of the NHI bill is its hefty price tag and how to pay for it in a country with a limited taxbase. According to a recent article, every tax-paying South African will have to add an additional 30,000 rands in annual taxes to implement NHI. 

The discussions and debates will no doubt continue over the cost and other contentious aspects of the NHI. One recent court case this past week calls certain provisions of the legislation unconstitutional. So, NHI will now face its first constitutional court appearance and may have to be significantly amended. From a biblical perspective, what should Christians think of nationalized healthcare bills like NHI? The simple answer is the Bible does not directly address the issue of healthcare and the associated political issues surrounding it. Yet, that said, there are some general biblical principles that can be applied to this topic. Key among them are matters related to the role of government, economics, and the personal responsibility of the Christian for his or her own personal health preservation. 

A necessary question that every believer should ask is what is the role of God-ordained government? The real question here is whether God intends for government to provide cradle-to-grave healthcare for people of any nation. Romans 13:1-7 and 1 Peter 2:13-15 while commanding submission to one’s government, do so within a defined purpose of government of providing a safe and secure environment protected from enemies both foreign and domestic. There are various facets to this, but it is legitimate to ask whether God intends for government to micromanage the health of every citizen. Or is it better to provide an environment where everyone has access to some form of healthcare? 

The problem with government-run healthcare is that cumbersome bureaucracies are created and serve as an obstacle to cost effectiveness and efficiency. All of which impacts timely medical treatment. Invariably these governmental bureaucracies are forced to ration healthcare, deciding who gets what treatment and when. A former member of my own congregation was denied medical procedures at a local government hospital and died because of this. 

As part of Christian stewardship, the cost does have to be considered and is not unimportant. An estimate for NHI from 2010 put the cost at 257 billion rands annually. With inflation factored into that original estimate, the cost is now over 470 billion a year with some independent estimates placed at 859 billion a year. Is this feasible in SA’s current economic climate? Is it sustainable over the long haul as prices continue to climb? With this kind of money at stake, it does have to be asked what safeguards will ensure there is no governmental corruption and squandering of these funds on politicians and vendors concerned only with self-interest?  

What are the alternatives then? There are always alternatives. Any alternative that is entertained will always have tradeoffs in a fallen world. In the instance of SA’s government, they could significantly cut the costs of what is presently proposed by reforming and renovating existing state-run hospitals and clinics. This could include privatizing the management and day-to-day operations of these facilities for better efficiency and improved care for those who make use of these facilities. Tax incentives and other benefits could be offered to medical practitioners, private clinics, and hospitals that are in poorer areas. There are many other alternatives that independent thinktanks could propose to the government, if the government would listen. 

From a biblical perspective, one thing is clear — the Bible promotes personal healthcare responsibility without guaranteeing good health for all. In 1 Corinthians 6:19-20, the Apostle Paul reminds the Corinthians that as believers our bodies are the temple i.e., dwelling place, of the Holy Spirit. Therefore, every believer has a stewardship to maintain his or her body to the degree they can. For this reason, adequate rest, proper nutrition, exercise, and other health preservation strategies play an important role in healthcare. Throughout the Bible, we see wounds being bound, topical creams, oil, and wine being applied to various medical situations. Those in antiquity used what they had available at that time to try and alleviate pain and suffering and promote good health. Paul even advised Timothy (1 Timothy 5:23) to take some wine for his stomach’s sake. Apparently, Timothy had a stomach issue which the wine of the day might help. 

None of us are promised good health forever, but we can take some individual preventative measures while avoiding detrimental habits like overeating, smoking, drugs, and inadequate rest. As the old saying goes, an ounce of prevention is worth a pound of cure!  

Even though Scripture promotes individual responsibility for one’s health, it bears repeating that in a fallen and sin-filled world there is no easy answer to the universal healthcare question. There are also no promises of a long healthy life for all in equal measure. Job reminds us in chapter 14:1 and 5  that “Man, who is born of woman, is short-lived and full of turmoil … Since his days are determined, the number of his months is with You; And his limits You have set so that he cannot pass”. So, as you pursue individual healthcare, bear in mind that care for the physical body serves as a compelling illustration for spiritual soul care in preparation for eternal life to come. After all, what does it profit a man if he should gain the whole world, including good health and fitness, and yet lose his own soul!