When Sarah Palin suggested that Obama’s health-care plan will give bureaucrats the right to decide who lives and dies, she raised a legitimate concern. After all, a health-care system that is limited by meager financial resources must ultimately decide who gets to benefit from it and who doesn’t.
However, the debate over life and death issues has obscured a more fundamental concern. The system will not only have to make decisions over who is allowed to die, but the government will also be faced with the God-like responsibility of telling the rest of us how to live.
At least, that is the precedent that has been set by those countries already providing national health care, particularly the U.K. If the example of Britain teaches us anything it is that when there is a direct link between the physical health of a populace and the nation’s fiscal integrity (which there obviously is when government promises to pick up the tab on everyone’s medical expenses), the state cannot help but develop an inordinate interest in keeping its citizens healthy.
In short, a government that promises to provide health care for its citizens begins to take a deep interest in the minutiae of their personal lives. At first, this manifests itself in mildly intrusive ways, such as the U.K.’s campaign to get citizens to exercise while waiting for the bus or their more recent scheme to use taxpayers’ pounds to subsidize “fat camps” where infants will be put on “weight management” courses. But it quickly accelerates into a full-scale policing of individual health.
Consider that British parents are routinely threatened with having their children removed if they are too fat, while the “health and safety” cult increasingly restricts the range of legitimate activities Brits may or may not perform. Any behavior that might lead to disease or injury – from tree climbing to eating shellfish – becomes a matter, not merely of private health, but of public “health and safety.” The reason these things are a concern is because preventive action is seen as the most effective way to reduce the costs of an over-stretched health-care system.
Because every aspect of our lives can, in a general and indirect sense, be connected to our health, universal coverage quickly becomes a blueprint for government micromanagement. In the end, there is literally nothing that falls outside the concern of a government that has taken upon itself the mantel of public health. Even the books we let our children read and the movies we let them watch become the concern of the health-conscious state. Consider that in 2004 Hillary Clinton urged us to think about children’s entertainment “from a public health perspective” and even used medical terms such as “contagion,” “epidemic” and “public health” to describe it.
But it even goes beyond that. Living under a government that has promised to provide nationalized health care also cannot help but change the way we view each other. This is because, in a very real and tangible sense, we all begin to compete for the limited resources the state has promised to provide. Consider that the funds being allocated to treat your lung cancer and heart disease are funds not available for my grandfather’s surgery. Therefore, the person who puts cigarettes and red meat into his mouth is not merely unhealthy: He is being selfish. He is a parasite, acting against the common good since every meal and every cigarette unnecessarily sets him up to draw on resources that might otherwise be allocated to someone more worthy. My health and your health cease to be private matters, because the limits of economics ensure that all of our health is related in a web of connecting implications. Obama’s conviction that “the promise of America” is “the fundamental belief that I am my brother’s keeper; I am my sister’s keeper” could be realized with particular exactitude in such a society, with the end result being what Faith Fitzgerald, professor at the University of California at Davis Medical Center, suggested in The New England Journal of Medicine when he wrote:
Both health-care providers and the commonweal now have a vested interest in certain forms of behavior, previously considered a person’s private business, if the behavior impairs a person’s “health.” Certain failures of self-care have become, in a sense, crimes against society, because society has to pay for their consequences.
Eventually, the demand for responsible “self-care” will extend beyond the matters most of us associate with “health.” The template for this has already been set when the World Health Organization defined “health” as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” It is hard to imagine any area of physical and even intellectual life that would fall outside the scope of this broad definition. In the end, we reach a state of affairs that was anticipated by Robert Meenan, professor at the University of California School of Medicine in San Francisco, when he noted in 1976 that, “virtually all aspects of lifestyle could be said to have an effect on the health or well-being of society, and the decision reached that personal health choices should be closely regulated .” (Italics mine.) Such a state of affairs was actually reached in Nazi Germany as Hitler used the banner of public health to justify the Nazi principle of “Gemeinnutz geht vor Eigennutz” (“the common good supersedes the private good”).
At best, universal health care orients both the state and its citizens towards a meddlesome posture. At worst, it speeds up the progression from utopian ideals to totalitarian policy, culminating in the type of caring totalitarianism where everything is inside the state and nothing outside. By giving government the responsibility to provide for our health, we are handing the state authority over our health and, by extension, our very lives. Obama’s recent injunction to school children to wash their hands a lot and stay home from school when they’re not well may be just the beginning.
So what could be worse than Sarah Palin’s fears of a “death panel” making decisions about who has access to life-saving treatment and who is left to die? What could be worse is a state that has become a de facto “life panel” – making decisions, under the auspice of “public health” on how we can and cannot live our lives.
Robin Phillips is a contributor to the Kuyper Foundation’s biannual Journal Christianity and Society, the Christian Voice magazine and Salvo Magazine’s Signs of the Times blog. Phillips lives in Post Falls, Idaho.