A welfare state is defined as a system whereby the government undertakes to protect the health and well-being of its citizens, especially those in financial or social need, by means of grants, pensions, and other benefits.
For this system to work, you need three components:
1. Taxpayers or some other source of revenue.
2. Government Officials
3. Beneficiaries, those who receive the money.
The system is only sustainable as long as people are able and willing to pay into the system, and both government officials and beneficiaries do not demand and take more than the system can handle.
Venezuela built their social services of subsidized food, education, and welfare on profits from oil prices. Government officials were relatively faithful in their responsibilities in allocating money into their proper departments. The common people, for a while, benefited from these programs.
But when oil prices fell, the whole system collapsed and the people of Venezuela suffered from starvation and poverty. The money left in the system were seized by President Maduro, and distributed amongst himself, military officials, and political allies. All at the expense of the people that the programs were initially built for.
Social Security is where people have been paying into the system in their younger years and reap benefits from it in their retirement years, starting at around 66 years old, at least on paper. Because there is such a large number of potential retirement-age beneficiaries and few young taxpayers paying into the system, there is a danger that the system could collapse. To save the system, young people would have to pay more through higher taxes, or beneficiaries have to receive less money than promised, or the minimal eligibility age would have to be raised. There is also the concern that the government officials overseeing this program may have been pocketing money for themselves on the side at the expense of the expected beneficiaries.
In a nationalized healthcare system, everyone would have to pay more money than now through taxes, higher premiums, or health care plans covering services that they have no use for. Even if taxes are placed initially on companies making a lot of revenue, they may eventually have to cut costs elsewhere by closing down branches, letting go of employees, or providing low-quality goods and services.
The beneficiaries of a nationalized healthcare system are hospitals and doctors but if the government only agrees to pay a certain amount of money below market value in an attempt to make healthcare affordable, that policy effectively becomes a price ceiling. The overall outcome would be medical services demanded will exceed medical services supplied. In other words: an overburdened medical system.
Hospitals, doctors, and nurses would have triages to determine patient priority. Patients would have to wait long periods of times from months to years to see a family doctor. Basically, in an attempt to keep healthcare costs to a minimum, there will inevitably be rationing. There will be a shortage of medical services.
Now naturally if the government paid more money into the healthcare system, hospitals and doctors would be able to provide better services, but the government has the authority and power to withhold money from us even when it is needed. Instead of giving taxpayers’ money to the hospitals that need them, government officials could be pocketing that money for themselves.
Even as hospitals may suffer from inefficiency because of being underfunded, the government could take advantage of this situationto ask the public for more money by raising taxes to help out. More money may go into the system, but still not help hospitals out, because the money just went to further enrich the government officials.
Additionally, precisely because the government is in charge of the payments and have the power and authority to punish dissenters, the hospitals and doctors would essentially have to tailor their services to government standards.
For example, you might have a doctor that only gets paid by the government if he performs abortions, performs euthanasia on an unwilling patient, or prescribe some other treatment that goes against patient wishes. The government could potentially authorize all of this in the name of saving healthcare costs. Ideally, we would have a government that would not do this, but I doubt we live in such an optimistic world.
As I mentioned before, a welfare state comprises of the following:
1. A source of revenue.
2. Government Officials
Biblically speaking, we do have an idealized version of this.
1. A source of revenue: voluntary donors
“As for the rich in this present age, charge them not to be haughty, nor to set their hopes on the uncertainty of riches, but on God, who richly provides us with everything to enjoy. They are to do good, to be rich in good works, to be generous and ready to share, thus storing up treasure for themselves as a good foundation for the future, so that they may take hold of that which is truly life.” (1 Timothy 6:17-19)
“Speak to the people of Israel, that they take for me a contribution. From every man whose heart moves him you shall receive the contribution for me.” (Exodus 25:2)
“You shall give to him freely, and your heart shall not be grudging when you give to him, because for this the LORD your God will bless you in all your work and in all that you undertake.” (Deuteronomy 15:10)
“For if the readiness is there, it is acceptable according to what a person has, not according to what he does not have.” (2 Corinthians 8:12)
“Each one must give as he has decided in his heart, not reluctantly or under compulsion, for God loves a cheerful giver.” (2 Corinthians 9:7)
From the above passages, you can see that rich people should donate money to help the poor out, but this money given into the welfare system is a willing gift and not an exaction. Not only that, but they are able to give according to what they have, not according to what they do not have. Taxes, then, contradict the biblical model. Taxes are money given under compulsion. If you do not pay them, you get thrown into jail. Also, they may be set at a rate that exceeds the taypayer’s ability to pay them.
Should the super-rich pay their fair share? They are certainly encouraged to do so, but the government should not force them to do so. Ideally, the Holy Spirit would work in the hearts of the super-rich and give them a heart of generosity so that they would decide to give to the poor on their own. Barring that, they should still cultivate a culture of philanthropy where they invest in helping pay people’s medical bills, building more hospitals, and renovating existing ones.
Taxes would completely undermine this process, as the super-rich would be giving money under compulsion and sometimes at a rate greater than what they have available. If too much money is taken from them through high taxes, a super-rich individual would not be able to invest in philanthropy and even have to close up successful businesses, let go of employees, or provide low-quality goods and services.
2. Government officials
“Moreover, look for able men from all the people, men who fear God, who are trustworthy and hate a bribe, and place such men over the people as chiefs of thousands, of hundreds, of fifties, and of tens.” (Exodus 18:21)
“Therefore, brothers, pick out from among you seven men of good repute, full of the Spirit and of wisdom, whom we will appoint to this duty.” (Acts 6:3)
“Tax collectors also came to be baptized and said to him, “Teacher, what shall we do?” And he said to them, “Collect no more than you are authorized to do.” Soldiers also asked him, “And we, what shall we do?” And he said to them, “Do not extort money from anyone by threats or by false accusation, and be content with your wages.” (Luke 3:12-14)
From the above passages, government officials can and should play a role in the efficient redistribution of wealth to their appropriate beneficiaries. They should be trustworthy, hate bribes, be full of the Spirit and of wisdom, and collect no more than needed. They should not abuse the system and thus extort money from the common people.
Maduro abused the system and essentially extorted the people of Venezuela, enriching himself, military officials, and political allies at the expense of the people. The American government through Social Security, Medicare, Medicaid, and Veterans Affairs could also potentially do the same. The issue of corrupt officials is where Republicans and other conservatives have issues, and for historically good reasons.
When government officials simply keep tax money for themselves, then the beneficiaries the programs were designed for will suffer from poor or absent services.
Government officials should be content with their wages, but unregenerate human nature is greedy and will demand more. It is as true today as it was back in the days of John the Baptist with the Roman government through tax collectors and Roman soldiers.
“If any believing woman has relatives who are widows, let her care for them. Let the church not be burdened, so that it may care for those who are truly widows.” (1 Timothy 5:16)
Beneficiaries ideally should be people who truly need the help that the program is designed for. They would be people who did not lie about their need for help, and are content with the money they receive.
Since we are talking about free money, it is easy for people to lie to government officials in an attempt to qualify for money that they do not deserve. In addition, beneficiaries may ask for more money than they actually need, thus putting pressure on the source of revenue, such as voluntary donors and taxpayers. For example, hospitals and other subsidized businesses may negotiate with the government to give them more money than needed at the expense of another hospital that provides higher quality services at lower costs. Another way pressure can be placed on the source of revenue is when the number of beneficiaries outnumber the number of people paying into the system, as seen in Social Security.
In conclusion a biblical model of a welfare state would comprise of the following:
1. Voluntary donors, including rich individuals, who are generous and give according to what they have.
2. Government officials or other leaders are trustworthy individuals, who do not exploit the system to take more money for themselves than needed, manage the money well, and actually give the money to benefit their intended beneficiaries.
3. Beneficiaries are those who actually need the money, and generally do not ask for more than necessary, and receive the money promised to them.
Perhaps social services programs, like Medicare for All, could work like the biblical model where taxpayers are in place of voluntary donors if tax rates approximate what taxpayers such as large corporations are able and willing to give. They could work if government officials use the money well and think like a consumer to seek low cost and high quality healthcare services. They could work if hospitals receive money close to market value, and use that money to improve services.
But Medicare for All would fail because it is difficult and undesirable for people to pay a lot of money into the system at a constant rate, government officials could take more money than they need for themselves, and use their authority and power to go against market forces and force hospitals and doctors into undesirable positions, and hospitals and doctors could take advantage of the system to obtain money that does not actually go into lowering costs and improving quality.
Ultimately, I feel a welfare programs can work if morally upright and effective individuals are in power. They can help a lot of people if used well. Otherwise, a lot of people can suffer. The programs are not inherently wrong, excluding the use of taxes, where people are forced to pay and sometimes at rates beyond their means. Right now, I am wary about taking a gamble and giving the government that much control over healthcare which could do a lot of good or cause a lot of harm for everyone. My thoughts could be concluded by this proverb:
When the righteous increase, the people rejoice,
but when the wicked rule, the people groan.