It is sadly ironic that two noble words “health care” have recently seemed to conjure up political controversy that has been neither healthy nor caring. This is especially true in the United States, where President Obama's Affordable Care and Patient Protection Act-signed into law in March 2010 and recently affirmed both by the Supreme Court and the President's reelection-has led to a vigorous and often bitter debate.

In this context, Willard Swartley's analysis of the biblical, ethical, and practical issues at stake in the area of health care provides a welcome contribution and a distinctly Christian voice in the current debate. Swartley, professor emeritus of New Testament at Anabaptist Mennonite Biblical Seminary, undertakes an audacious task as he seeks to articulate both a theology of healing and health care (chs. 1-9) and a biblically informed perspective on the U.S. health care system and its current overhaul (chs. 10-12).

At the heart of Swartley's main thesis is the distinction between “healing” and “health care.” Healing, he argues, is the restoration of shalom, the well-being that is God's ultimate purpose for human beings. This well-being encompasses much more than just good physical health. Drawing on the Psalms, the author shows that the psalmists's complaints are almost always related to a loss of this shalom due to a number of adverse circumstances: gloating enemies, broken relationships, shame, and illness (p. 52). Swartley extends this paradigm to a broader biblical theology: “God intends shalom and community for humans and all creation, but sin and Satan play adversarial roles against us and against God's intentions for us” (p. 27). The book's first five chapters reaffirm the prominence of healing in this broad sense of “restoring shalom” both in the OT and NT.

In part 2, Swartley narrows his focus onto the subject of health care, articulating the relevance to this issue of key NT concepts, notably love, grace, and community. He also draws on church history to show that providing and facilitating health care was one of the distinguishing characteristics of the early church (pp. 149-50) and remained a priority in much of church history (pp. 151-53).

Part 3 describes the U.S. health care system, succinctly explains the nature of the Affordable Care Act, and outlines its implementation (pp. 190-92). Moving beyond this political issue, the author describes the successful efforts of some hospitals, churches, and health care providers to promote and practice health care in ways that are competent, accessible, and affordable.

There is much to applaud in this book. Swartley successfully sets the current debate within the bigger picture of God's purposes and the church's mission. I found the distinction between healing and health care to be legitimate and helpful. Other qualities include its lively style, as well as its irenic tone. The author shows that he is also sensitive to the global reality of the church, as he frequently cites non-U.S. examples. Lastly, Swartley succeeds in conveying a sense of mission: how could the church not be at the forefront of the effort to provide health care and promote physical and spiritual well-being?

There are nonetheless some weaknesses, three of which I consider to be major flaws.

First, the book lacks gospel-centeredness. It could place much more emphasis on God's initiative to deliver sinners from their sins and grant them new life. This is the most fundamental healing of all and the essential reason why God, both in the OT and in the incarnation, acted as Healer toward his people. Swartley thankfully assumes the gospel in many ways, but in my opinion should have made it the center of his theological analysis. Among other aspects, it would have been interesting to explore how the free nature of God's healing might have theological implications for the U.S. health care debate and the ethical issue of whether access to health care should be market-driven.

Secondly, Swartley shows surprising sympathy toward almost any form of purported “Christian healing,” no matter what its theological underpinnings. For instance, a native American who among other things promoted a “Ghost dance” aimed at receiving visions of deceased relatives, is given an exclusively positive portrayal (p. 82); the insistence that the Reformation went too far in its disavowal of many medieval healing practices (pp. 153-54) is not counterbalanced by any questioning of at least some of these practices, not even relics or devotion to saints (p. 151-53)!

Lastly, Swartley completely ignores one philosophical and theological issue that is central to the health care debate: How should one view the respective roles of government and church? Should the church encourage and promote some government intervention to reduce poverty and promote access to health care? Should it rather defend strictly limited government and claim the mission of healing and health care as its exclusive domain? Swartley assumes the former but fails to ever make the case for it. No doubt it is a defensible view, and one to which the present reviewer happens to be favorably inclined-but surely the matter ought to be argued carefully and biblically.

Despite these significant shortcomings, Health, Healing and the Church's Mission is a valuable contribution to any theology of health care, and one can only hope it will help generate a renewed theological discussion of this immensely important issue.

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