Encouraging accountability: Evangelicals and American health care reform

Although scholars have thoroughly assessed American Evangelical Protestants’ beliefs about government intervention in addressing socioeconomic stratification and racial discrimination, they have paid considerably less attention to interpretations of health care reform. Especially important is that American Evangelicalism in recent years has incorporated personal accountability in such a way that makes this group distinctive when considering social responsibility toward others. Whereas earlier Evangelicals were instrumental in furthering the social gospel, American Evangelicals today prioritize matters of personal accountability ahead of social action. The cultural toolkit available to Evangelicals includes a rationale for caring for others, but an emphasis on personal accountability shapes how they evaluate government health care interventions. This paper employs qualitative methods to understand how Evangelicals link such individualism with strategies for caring for others in the context of health care. The findings suggest that Evangelicals emphasize personal accountability, especially when evaluating government programs. However, personal accountability is accompanied by a conflicting ethical responsibility to provide care to others. The priority given to personal accountability or an ethic of care, however, varies according to the situational context or social location of white Evangelicals. These findings may be helpful in framing future health policies to draw Evangelical support.