Barack Obama signed the controversial US healthcare bill into law today after months of heated debate.
US Healthcare has been under the spotlight in recent years and gained international focus after Michael Moore released his documentary, "Sicko" three years ago. In it, he focused on the failure of the American healthcare system. Particular attention was given to the Insurance Companies and how their purpose was not to help people in need but rather to increase profits. The solution proposed was to have a public healthcare system similar to those in Canada, Britain, France and Cuba.
With an economy in disarray and the rising costs of the Iraq and Afghan wars, you may wonder what is wrong with the US's priorities? The debate over health care in the US centers on whether there is a fundamental right to healthcare, or who should have access to healthcare and on the quality achieved for the high sums spent.
Medical debt is cited as the single biggest factor in 62% of all personal bankruptcy in the United States.
50 million Americans do not have health insurance.
Approximately 18,000 of the 50 million die every year because they do not have health insurance.
The US does not view health as a basic right, but as a privilege. Barack Obama is challenging this view through his reform bill to provide universal health care through health insurance for all. This has been met by wrath from the right wing,
The US does provide a government funded programme the biggest being Medicaid and Medicare. But generally it is up to individuals to obtain health insurance. Most get coverage through their employers, but others sign up for private insurance schemes. Under the terms of most plans, US citizens pay regular premiums, but are required to pay part of the cost of their treatment before the insurer covers the expense. This is the situation of the 250 million people who have health care. It has become a common occurrence for those with health insurance, having to incur much debt after the deductibles for health insurance are removed, causing a significant number to even sell their homes.
So how will a future Khilafah address the issue of healthcare?
Taking care of people's affairs
Islam is a unique system revealed by Allah سبحانه وتعالى that provides the needs for both the individual and society. Allah سبحانه وتعالى being Al-Khaliq - The Creator of all that exists - will evidently know what is best for us. With His infinite knowledge, His system will be able to provide solutions to any problem that human beings have or will encounter. With regards to governance, the Khalifah is entrusted in applying the laws of Allah سبحانه وتعالى. The Khalifah is directly responsible before Allah سبحانه وتعالى for any issue that affects citizens in the Islamic State.
The Messenger of Allah صلى الله عليه وآله وسلم said, "He who has been ruler over ten people will be brought shackled on the Day of Resurrection till justice loosens his chains or tyranny brings him to destruction." [Tirmidhi]
The ruler does not only have to respond to the people under his care but must also answer to a higher authority, Malik-al-Mulk (The Owner of All Sovereignty). As such, he must fulfil the obligations placed upon him as this is not only a mandate of the state but is the Ahkam of Allah سبحانه وتعالى. Therefore the Khalifah must care for every citizen's need and ensure that they are not facing any undue hardships such as lack of access to healthcare or even long wait times.
The Messenger of Allah صلى الله عليه وسلم said: "Whoever is put in charge of any of the affairs of the Muslims and remains aloof from them and pays no attention to their needs and poverty, Allah will remain aloof from him on the Day of Resurrection, and will pay no attention to his needs and poverty." [Abu Dawood, Ibn Maajah, Al-Haakim]
The above hadith clearly shows the weight that lies on the shoulders of those in authority. When Umar ibn Abdul Aziz became the Khalifah, he was seen to be rather gloomy. His servant asked him why he was so sad and worried. Umar replied, "Anyone in my shoes should be so; I must deliver and grant all the nation's citizens all their rights, whether they demand them or not."
The care of those under the authority of the state is not judged based on the annual budget or political aspirations but rather it is based on the rights afforded to them by Allah سبحانه وتعالى. This obliges the Khalifah to provide them with the utmost care to the best of his ability regardless of whether the citizens are aware of this right or not and whether they have asked for it or not.
Healthcare in the Khilafah
The Prophet صلى الله عليه وسلم said: "Each of you is a guardian and is responsible for those whom he is in charge of. So the ruler is a guardian and is responsible for his subjects." [Bukhari & Muslim]
The Imam is responsible for managing the affairs of the people. One of the basic needs that the Khilafah must provide for is healthcare. When the Messenger of Allah صلى الله عليه وسلم as head of state in Medina was given a doctor as a gift, he assigned him to the Muslims. The fact that the Messenger of Allah صلى الله عليه وسلم received a gift and he did not use it, nor take it, rather he assigned it to the Muslims is evidence that healthcare is one of the interests of Muslims.
Since the state is obliged to spend on providing a free healthcare system for all, then part of the Bait ul-Mal's budget must be for healthcare. If insufficient funds are available then a wealth tax will be imposed upon the Muslims to meet the budget deficit.
Unlike the Capitalist system, the Islamic system views the provision of healthcare to its citizens from a human perspective and not an economic aspect. This means that the leader of the Islamic State looks to provide adequate and good quality healthcare to the people, not for the sake of having a healthy workforce that can contribute to the economy but for the sake of fulfilling his duty of looking after the needs of the people in obedience to Allah سبحانه وتعالى.
Medical excellence in Islamic history
When Islam is implemented as a complete system, it provides a means to excel in all fields such as science and technology. In the past, individuals under the Khilafah made a tremendous contribution to the medical field.
The Khilafah was blessed with many first class hospitals and doctors in several of its cities: Baghdad, Damascus, Cairo, Jerusalem, Alexandria, Cordova, Samarqand and many more. Baghdad alone had sixty hospitals with in-patient and out-patient departments and over 1,000 physicians.
Public hospitals like the Bimaristan al-Mansuri Hospital, established in Cairo in 1283, had accommodation for 8,000 patients. There were two attendants for each patient who did everything for his/her comfort and convenience and every patient had his/her own bed, bedding and vessel for eating. It treated in-patients and out-patients giving them free food and medicine.
There were mobile dispensaries and clinics for the proper medical care of the disabled and those living in the villages. The Khalifah, Al-Muqtadir Billah, ordered that every mobile unit should visit each village and remain there for some days before moving to the next.
From the above historical accounts, we see that when the Khulafaa' properly implemented the rules of Allah سبحانه وتعالى, then and only then did a society truly thrive and succeed. However, it is important to keep in mind that material advancement does not equate with true success - seeking the pleasure of Allah سبحانه وتعالى. For the Khulafaa' it was not about simply providing medical services, rather it was to fulfil the needs of the citizens entrusted to them for which they will be held accountable for.