Is Government-Run Health Care a Good Idea?

It may be true that you can’t fool all the people all the time, but you can fool enough of them to rule a large country.
— Will Durant, American writer, historian, and philosopher (d. 1981)

There is a huge debate across our nation as to whether government-run health care is a good idea. Those who believe that government should be involved in providing medical care for citizens see healthcare as a basic right of the people. If so, then government should provide this service in the same way it provides other services, like police and fire protection or other community services.

On the other hand, others are convinced that government should not be in the health care business. They are convinced medical concerns are best left in the hands of individuals and their doctors. They say that private charities, not government, should help those who cannot afford medical treatment.

How should we think about this debate? Is there a right side to this issue, or is it just a matter of personal opinion? Are there biblical principles that can help us decide?

To answer these questions, it is helpful to keep in mind a comment made by Alexander Hamilton, who not only signed the Declaration of Independence but also penned many of The Federalist Papers in support of the new Constitution. Hamilton wrote, “In disquisitions of every kind there are certain primary truths, or first principles, upon which all subsequent reasoning must depend.”

A worldview perspective provides unique insights into how first principles relate to any issue at hand. Therefore, whether government-run health care is a good idea or not can only be understood in light of other, more fundamental, primary truths; specifically, an understanding of human nature, the purpose of government, and the basis for legal rights. Only when the primary truths of these three areas are firmly in mind will we be in a position to arrive at the best answer to the question.

Human Nature and Two-sided Coins

First, there is a primary truth about human nature. According to the Bible, humans are like a two-sided coin. One side reflects how we are wonderfully made in God’s image. This means, among other things, we are capable of doing much good in the world.

However, the other side of the coin reveals a deep moral failing. Not only does the Bible present this picture of fallen human nature, but all of recorded human history confirms it. Even President Obama, during a speech this past December in Oslo, Norway, referred to “human imperfections.” Of course, the result is the full range of man’s inhumanity to his fellow man, from the seemingly trivial to the grotesque.

Human nature being what it is, we are led to a primary truth about government. James Madison, the chief architect of the U.S. Constitution and our 4th President, provided great insight when he wrote, “What is government but the greatest of all reflections on human nature. If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on the government would be necessary.” 1 Put differently, since we are not angels and not governed by angels, we must find ways to control the passions of those who rule over us.

Any system of government that seeks to secure individual freedom must take into account these first principles of human nature and government. Therefore, to minimize the potential for abuse, the founders of the United States designed their new government with three built-in safeguards. First, the Federal government was limited in what it could do. Only twenty-one responsibilities were specifically listed so there would be no misunderstanding.

Second, the various powers of the national government were distributed into three non-overlapping branches. For example, the branch that passes laws does not have the power to enforce them. Those who judge cannot create the laws. The executive branch may propose a budget but cannot appropriate the money for it. Separating powers further limits the likelihood for any one individual or group from gaining too much power.

Third, the U.S. was designed as a Republic. A Republic is characterized by the rule of law, not the rule of man. The rule of law establishes what are legitimate rights. The Founders grounded these rights not in the changing whims of politicians but in the unchanging character of God. This brings us to the primary truth about God-given rights.

Legal Rights and Dodo Birds

The Dodo bird truism: “That bird was never made to fly!”

Because of its design, it is obvious that a dodo bird was never meant to fly. In a similar way, government was never designed to do certain things. To find out what government should and should not do, we must consider the difference between two kinds of human rights: negative and positive.

Negative rights are those that cannot be negated, or taken away, without diminishing our fundamental humanity and freedoms. In The Declaration of Independence, these rights are listed as life, liberty, and pursuit of happiness. Further, human rights are considered “unalienable,” meaning they are basic to our human condition as creatures made in God’s image and, therefore, cannot be taken away or manipulated by government.

Genesis 9:1–6 records God’s mandate for establishing civil government; to protect our right to life and liberty by bringing evil doers to justice. The government, therefore, is the social organization designated to protect God-given rights from being abused or taken away by others.

Positive rights, on the other hand, are aspects of human life that contribute to our basic needs for survival. Examples are food, shelter, education, and medical care. These needs have traditionally been the responsibility of the individual, the family, and local community groups, such as the church and charitable organizations. This has been the teaching of the church and comes from a number of biblical passages. Jesus said, for example, to help the poor and the sick, but this was spoken to his disciples, not the Roman government. 2 Jesus also taught that Caesar’s authority was subordinate to God’s.

We find, then, a primary truth about social order — sphere of sovereignty. This means that different social institutions are given differing responsibilities. The family, being naturally the fundamental unit of society, is for nurturing children and preparing them to be responsible adults. The Church has the task of spreading the Gospel, gathering in corporate worship, and teaching Christians to live Godly lives. The State is required to maintain social order by protecting human rights. As the church should not interfere with the responsibility of the State, the State must not usurp the responsibilities of the family or the Church.

Government is your Uncle, not your Sugar Daddy

Back to the central question; should government try to provide positive rights? Based on the primary truths of human nature and the role of government, we find at least two reasons that government is not designed to provide positive rights.

First, positive rights involve too many variables. An individual’s positive needs (for food, shelter, etc.) vary from year to year, even day to day. For example, an able bodied 32-year old has different needs than a 31-month old or a feeble 93-year old. A bureaucrat sitting in an office somewhere cannot possibly know the changing needs of every individual citizen or how best to meet them. The most a government agency can do is try to enforce general guidelines, a one-size-fits-all approach, and because it cannot anticipate the variables of day-to-day life, there will inevitably be shortages, inefficiency, and waste of manpower and money.

This principle is clearly seen when government intervenes in economic matters. As Thomas Jefferson wrote, “Were we directed from Washington when to sow, and when to reap, we should soon want bread.” Jefferson understood the limits of what government is capable of doing. It is not designed to orchestrate people’s basic needs, even one as fundamental as food.

Second, the only means government has to accomplish its goals is the use of force. George Washington put it this way, “Government is not reason. Government is not eloquence. It is force. And, like fire, it is a dangerous servant and a fearful master.” Force works well when it comes to protecting negative rights, which is the reason for the military, police, and the courts. But to place the power of government over the day-to-day lives of citizens sets up a tremendous potential for abuse. People begin to demand more services. This is a formula for creating shortages, leading to unmet expectations by citizens, which creates social unrest. This is the opposite of the state’s responsibility for maintaining social cohesion and order.

Not only that, but special interest groups begin lobbying for a larger piece of the government payout, which not only diverts money from helping those in need to pay for the lobbyists, but also it pits one group against another, thus producing discord among the citizens. We change from being a nation united to a nation of special interests demanding their “rights.” The role of government morphs from protector of rights to provider of favors and we end up replacing Uncle Sam with Daddy Starbucks.

Government’s Power is Strictly Limited

The Founders of the United States understood these first principles and built safeguards into the U.S. Constitution by restricting the Federal government from engaging in legislating positive rights. Thomas Jefferson wrote, “Congress has not unlimited powers to provide for the general welfare, but only those specifically enumerated.” Article 1, Section 8, of the Constitution lists the specific duties of the Federal government. Each of the 21 duties involves either protecting negative rights, such as establishing a national defense and a Federal judiciary, or concerns practical matters like standardizing the national coinage, weights and measures, establishing a national postal system, and issuing patents.

In listing responsibilities of the Federal government, the Constitution does not name one “positive” right, such as providing for education, food, housing, or retirement benefits. That is why, as early as 1794, James Madison, the Father of the Constitution and our 4th President, railed against his fellow politicians who were seeking to redistribute the wealth of its citizens:

I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence, the money of their constituents. . . . If Congress can do whatever in their discretion can be done by money, and will promote the General Welfare, the Government is no longer a limited one, possessing enumerated powers, but an indefinite one, subject to particular exceptions.

Like Madison, Davy Crockett sought to preserve the rules of the Constitution that he swore to uphold when taking the oath of office. On April 2, 1828, Crockett, as a representative from Tennessee, stood to challenge the constitutionality of one of the earliest welfare spending bills. A piece of legislation was submitted to provide for the widow of a distinguished Navy officer. Crockett got it right when he said to his fellow legislators,

We have not the semblance of authority to appropriate [Federal money] as charity. Mr. Speaker, I have said we have the right to give as much money of our own as we please. I am the poorest man on this floor. I cannot vote for this bill, but I will give one week’s pay to the object, and if every member of Congress will do the same, it will amount to more than the bill asks.

But, some may ask, can’t the legislature, elected by the majority of citizens, pass laws providing for national healthcare? The answer is “No,” because in order to change what Congress is allowed to do, the Constitution must be changed. The Constitution allows for change, but the procedure involves amending the constitution by a vote of two-thirds of the state legislatures. It cannot be changed by a simple act of Congress.

Unless and until the Constitution is amended, the Congress does not have the authority to pass laws regulating or establishing a national health care system. To do so would be to break the contract ratified by the people of the United States as embodied in the Constitution. But not only that, if the Constitution was amended to include providing positive rights, it would be a bad idea for the reasons mentioned above.


Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.
— John Adams, U.S. Diplomat and Politician (1735–1826), “Argument in Defense of the Soldiers in the Boston Massacre Trial,” December 1770

There is one undeniable fact: mankind is morally flawed and tends to abuse political power. Based on these fundamental truths, we can deduce the following:

  1. It is a good idea to limit the power of government.
  2. Government-run health care does not limit the power of government, in fact, it greatly enlarges government’s scope and power over the people.
  3. Therefore, government-run health care is not a good idea.

It’s as simple as that! Or, as humorist P.J. O’Rourke sagely phrased it, “Giving money and power to government is like giving whiskey and car keys to teenage boys.” ‘Nuf said!

In the next installment, we examine why keeping medical care out of the hands of congress is the most moral and compassionate means for helping those in need.


  1. James Madison, Federalist No. 51, “The Structure of the Government Must Furnish the Proper Checks and Balances between the Different Departments.” The entire article can be viewed at
  2. See, for example, Luke 10:8; Matthew 25:31–46.