Is universal, government run healthcare "free"?  Well, like many things, reality differs radically from rhetoric. Many political issues have costs – even severe costs – that people do not stop to consider.  Government healthcare is one of those issues. Contrary to popular belief, it is not free in the least; rather, it simply exacts payments differently than in the voluntary patient/physician relationship. 

And also contrary to popular belief, the costs of "free universal healthcare" far exceed the benefits. Below are 10 reasons why.

1. Medical Progress is Stifled. 
As the state supplants the free market in any given area, competition and profits are stifled, and along with it, incentives to excel. In the case of government healthcare, this means the decline of medical breakthroughs – life-saving breakthroughs included. 

Regarding countries with global influence (e.g., America), government healthcare has negative ramifications for medical progress not just domestically, but internationally as well.

2. Higher Prices. Two ways the state funds "free" healthcare is by high taxes and increasing the money supply (which causes inflation). But when there are high taxes and/or the dollar is devalued by inflated currency, then companies must charge more for their products to stay in business. 

The prices of everyday products, such as food and gasoline, then go up in order to accommodate the irregular "free" doctor's visit. Everyone pays more for these everyday expenses, the poor included.

3. Shortages and Low Quality Treatment. When "free" government healthcare is made available to everyone for all kinds of treatments, there is an enormously high demand for products and services. To maintain its budget (no matter how ambitious that budget might be), the state must keep costs down via 1) smaller quantities of high cost, high quality treatment (at least as high quality treatment that is possible in this system) and/or 2) larger quantities of low cost, low quality treatment.

The former especially requires rationing, and results in longer waiting periods to get necessary treatment (in which case the treatment may be too late; patients can even die waiting). And, since you get what you pay for, the latter results in minimal, poor, or even dangerous treatment (in which case the treatment can result in patients getting sicker, or even dying). 

Of course, given the inefficiency of government programs, one can expect the worst aspects of these two possibilities: long waiting periods for low quality treatment. This problem only escalates as the costs of "free" healthcare spirals the nation into more and more debt, which progressively diminishes the amount of quality treatment the state can afford.

Shortages of physicians also occur. The high workload and non-competitive pay that comes from government healthcare is a disincentive to become a physician. It is also an incentive for practicing physicians to pursue their work overseas, or to quit the profession entirely.   

4. Medical Malpractice. In government healthcare the state, instead of the patients, pay the physicians (at least directly). In this way, physicians answer to the state instead of their patients, which creates a relational separation between the physician and the patient. The physician loses his incentive to provide high quality services in order to retain paying customers, and with it, the carefulness that reduces medical malpractice. 

Also, consider this: in government funded healthcare, politicians pay impersonally with other people's money for services that don't affect their own livelihood; they have no financial or physical stake in the matter. Here there is less incentive for politicians to try and rectify bad situations related to those services (e. g., medical malpractice) than there would be if their own finances and livelihood were at stake. 

And even politicians who would sincerely want to rectify those bad situations would have a hard time doing so with intervening layers of government bureaucracy. Indeed, government bureaucracy makes it hard enough for politicians to even know about – let alone rectify – medical malpractice that relates to government healthcare.

Medical malpractice is further provoked by the flood of patients that physicians must deal with. People have incentives to take as much advantage as possible of "free" services, and thus, in the government healthcare setting, to make appointments to see physicians for such trivial things as colds and headaches. The result: overworked physicians more prone to making mistakes. 

Such overwork is exacerbated by the shortage of physicians caused by government healthcare (as discussed in number 3.). This increased ratio of patients to physicians means more patients – and therefore more work – per physician.

5. Poverty. Government healthcare fosters poverty in the name of helping to alleviate it. The high taxes needed to fund healthcare hurts businesses financially, which in turn results in job losses. And when the state inflates the currency to fund healthcare, the dollar devalues, which in turn decreases one's salary and savings. With more government healthcare the well-off become poor, and the poor become poorer. 

And as we noted in number two, government healthcare results in higher prices of everyday items, which further contributes to poverty. Ultimately, government healthcare can play a large role in bankrupting the country – and thus not foster equality of prosperity, but equality of poverty. Hence government healthcare not only hurts poor people – it produces more of them.

6. Class warfare. With government healthcare comes class warfare. Socialism often relies on portraying those who oppose any given socialist policy as wanting to oppress the poor. This provokes hate and hostility in the minds of poor people. Class warfare begins with slanderous and covetous rhetoric, but can easily lead to violence.  Historical examples of violence related to class warfare include the French Revolution, as well as the Soviet Union and other communist regimes. 

7. Slavery. Because of its expenses, government healthcare tends toward heavy taxation, borrowing, and inflation – all of which the people ultimately pay for (the poor included). The resulting astronomical debt contributes to the enslavement of the entire nation. As "the borrower is the slave of the lender" (Proverbs 22:7b), in government healthcare the state acts as the lender, and coerces the people into becoming enslaved borrowers. 

Thus in national, universal healthcare, citizens must spend a large amount of their life working off the debt as the slave labor force for a nationwide federal plantation. And, as the massive healthcare debt cannot be paid off by one generation, this slavery is inherited by future generations. 

8. Tyranny. The state is an instrument of coercion. The larger it grows, the more power it has to coerce. With universal, government healthcare comes a radical expansion of the state. And with a radical expansion of the state comes tyranny.

While the state's power of coercion is good in its proper, biblical place, universal, government-run healthcare is, biblically speaking, well beyond the state's lawful jurisdiction (see appendix below). By the nature of the case, anything beyond the state's lawful jurisdiction is tyrannical. In being "universal," government healthcare is a far-reaching, universal tyranny.

And "free" government healthcare can be a means to achieve all kinds of tyranny. For instance, it gives the state access to a citizen's medical records, granting the state more potential control over a citizen's life. It can also be used to monopolize healthcare and to criminalize seeking alternative healthcare – even when that alternative can make the difference of life and death. 

And, government healthcare can be used to force citizens to take dangerous treatments (e.g., dangerous vaccinations) in the name of "public health"; indeed, the vague and noble-sounding notion of "public health" gives the state a blank check to radically suppress an individual's freedom – and even to take his life – in the name of society's "greater good." 

Government healthcare is also a way for politicians to bribe citizens to vote for them – despite any dangerous and tyrannical policies those politicians might back on the side. The lure of "free" healthcare blinds its supporters to the big picture. 

9. Government-Sanctioned Murder. In secular humanism, life is cheap. Thus in secular government healthcare, the state is prone to fund the murder of anyone that its secular worldview deems unfit to live. 

Many of the same politicians pushing for government healthcare already advocate the "right" of citizens to execute children in the womb in the name of a mother's "health." Since such politicians link murder with health, it follows that they would use healthcare to advance murder, whether of an unborn child, or of any other group of people deemed detrimental to the health of others.

And so while healthcare is provided in the name of helping the needy, it also threatens to execute the neediest of the needy. The dollars that citizens pay to fund government healthcare then becomes blood money. Let us also not forgot the possibility of blood money being used to fund voluntary euthanasia, which, despite being voluntary, is still murder. 

10. Death panels. Since government healthcare has a limited budget, rationing is required. With rationing comes the possibility of a group of bureaucrats, or death panels, to decide who is worth keeping alive. After all, murder is less costly than expensive, life-sustaining surgeries. Healthcare then becomes deathscare. 

Among the prime candidates of such panels are likely to be the elderly, whom could be considered a drain on – and thus detrimental to – the health of society. 

(And so if you support government-run healthcare, know this: one of these days, death panels may deem you a useless eater, and thus unfit to live. Better work to legally overturn government-run healthcare now before it is too late.)

Appendix: The Bible and Wealth Redistribution

Since God requires civil governments to base their laws on the Bible, then wealth redistribution policies such as government healthcare must be sanctioned by the Bible's civil code. So then, does Scripture authorize civil rulers to enforce generosity and redistribute wealth?  

Let us begin with the Old Testament. Nowhere here do we see such an authorization. While helping the poor is commanded, none of the laws regarding helping the poor are explicitly backed by a civil sanction. 

For instance, the law about leaving gleanings from the harvest for the poor and the sojourner (Leviticus 23:22; cf. 19:9) is not accompanied by a penalty to be enforced by the state if the law is violated. 

Moreover, we are not aware of texts that explicitly or implicitly sanction civil rulers to use taxpayer money to redistribute wealth. Thus it seems in the Old Testament, wealth redistribution is out of the civil ruler's lawful jurisdiction.

(One might argue that Genesis 41:33-36 teaches principles for some kind of state compensation and distribution of resources in certain emergencies, but I would have questions before I would accept it as applying today, starting with whether it is to be taken as a one-time historical example, or whether it is to be taken as normative. In any case, food – not healthcare – is the focus of the text.)

Now, what about the New Testament? There is not a lot here about the duties of civil government. One important New Testament text, however, is Romans 13:1-7, which discusses a civil government's general duties. 

And what is the state's duty, according to this text? Is it to rob from the rich and give to the poor? No. It is to terrorize and kill evildoers. (Not to terrorize and destroy the free market, as socialism does.) 

The state's duty to terrorize evildoers is found in verse 3a: "For rulers are not a terror to good conduct, but too bad." The state's duty to kill evildoers is found in verse 4b: "he [the ruler] does not bear the sword in vain." (Obviously not every evil act can be considered a capital crime – the Bible is our sole authority for determining what warrants capital punishment, Deuteronomy 4:2, cf. Matthew 5:17-20, 15:4.) 

These duties are why we pay taxes (Romans  13:6). Thus as far as Romans 13:1-7 is concerned, taxes are intended to subsidize terror and destruction of the wicked – not to subsidize healthcare.

Of course, while the state is not to punish the sin of neglecting the poor, God nevertheless does. Whenever we neglect the poor, we risk God's judgment in this life (cf. Deuteronomy 28:15), and we must answer to Him for it on judgment day (2 Corinthians 5:10). Societies then that neglect the poor can expect God's judgment.

Now, there are Christians – theonomic Christians included – who do make arguments from Scripture to say that the state should redistribute wealth. For instance, these arguments from Samuel Simms from the excellent site, Reformed Covenanter. (Note: this is just an example; and the opening comments are explanatory remarks and not a comprehensive defense of the position.)[1]

These and other arguments employed by some theonomists do not convince us that wealth redistribution is the state's role, but they may be worth checking out. 

However, even if we are missing something and these theonomists are to some extent correct – and the state even has a legitimate role in even funding healthcare – surely there would have to be major differences between government healthcare as advocated by the secular state and government healthcare as supposedly advocated by Scripture. 

Considering biblical principles, such a form of healthcare would have to be dealt with in a more discretionary, limited, and responsible basis on all sides (patients, doctors, civil rulers). It would not contribute to the problems mentioned in this article. For example, it would certainly not have death panels and legalized murder. 

And, it would have to be much less ambitious, without the excessive expenses. After all, 1 Samuel 8 implies a limit to state taxation. In this text, when the elders of Israel rejected God for a king like that of the pagan nations, Samuel warned of several acts of tyranny by their future king, including ten percent taxation:

He will take the tenth of your grain and of your vineyards and give it to his officers and to his servants. (1 Samuel 8:15)

He will take the tenth of your flocks, and you shall be his slaves. (1 Samuel 8:17)                                                                                                

Note the wealth redistribution mentioned in verse 15, which the Bible does not cast in a good light. Also note how verse 17 ends—"and you shall be his slaves." Ten percent taxation or more is – or at least contributes to – national enslavement. Such enslavement socialism, with its excessively high taxes needed for wealth redistribution and "welfare" programs, fosters. (Ten percent taxation is actually modest by today's socialist standards.) 

Since then the text considers taxation at this rate tyrannical, then by implication, Scripture disapproves of such taxation. And only God can sanction the rate of taxation, for "The earth is the Lord's and the fullness thereof, the world and those who dwell therein ..." (Psalm 24:1). God owns all things, including money; man is but a steward, and can only use it as God sanctions. In the civil sphere, this means the state cannot tax beyond that which God authorizes.

This is all to say that for argument's sake, even if somewhat correct (I don't believe it is), state-funded healthcare as advocated by Christians must be constrained by Scripture's limitation on taxation. After paying for primary expenses (e.g., courts of justice, national defense), the state might not have much left to pursue socialistic policies. And even if it did, it could only do so in a very limited fashion before reaching and exceeding ten percent.

Of course, love of one's neighbor alone should compel Christians who advocate wealth redistribution to refrain from advancing ambitious healthcare policies that contribute to bankrupting the nation, creating national debt enslavement (remember, the Bible discourages debt) and economic instability that fosters crime, riots, and even civil war.

Finally, let us note that government healthcare is one of the main tools by secular humanists to foster blind allegiance to the state. It tempts people to look to the state as an all-powerful god and provider, instead of the one true God. It seduces people to seek the slavery of Egypt, instead of God's daily provision; to serve mammon instead of God.

But seek first the kingdom of God and his righteousness, and all these things will be added to you. (Matthew 6:33)

Consider how this text applies to man's needs – healthcare included.

For a thorough critique of government health care, see "The Ethics and Economics of Health Care" by John W. Robbins

    
Notes
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[1] There is also this interesting case from The Economic and Social Thought of Calvin by Andre Bieler (in our opinion, this at the most has civil implications for our day in regards to the particular matters the Scriptures cited address, namely, matters of land and debt):  

"To understand the limits of biblical revelation fixed property, which it is a well both sacred (as it is entrusted by God) and relative (the man can do what he wants, since it is never the absolute owner), we must study the significance of the institution, in Israel, the sabbatical and jubilee. Customs that were attached were intended to convey to the Israelites as well the divine origin of their property as its purpose: service to others [...] The periodic redistribution of land [every fifty years, cf. Leviticus 25] and release of claims [every seven years, cf. Deuteronomy 15] was to maintain all between an "average state" of wealth and prevent property from becoming, by grabbing rich source of social oppression. [...] The land of Canaan was their common heritage, they had to feed mutual brotherhood, and they had all been of the same family. And for what God had given them freedom that they might be free forever, so this was very good to feed them through a state, to prevent that very few people do all attirassent them to oppress the masses. [...] God has dampened any excess power that Act." 

(Bieler, p. 381, including Calvin, Commentaries on the Five Books of Moses, 1564. Cited in Selected Excerpts from "The economic and social thinking of Calvin" of Bieler by The MonarchomaqueNote: because this quote was translated from French to English via a computer program, there may be some translation mistakes.)

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