Constitution of the Caliphate State / Economic System
- Category: Economic System §123-169
Article 164:The State provides free healthcare for all, but it does not prevent the use of private medical care or the sale of medicine.
Healthcare is part of the interests and utilities which the people cannot do without and so it is considered to be from the essentials. The Messenger ordered people to take treatment:
«جَاءَ أَعْرَابِيٌّ فَقَالَ: يَا رَسُولَ اللَّهِ، أَنَتَدَاوَى؟ قَالَ: نَعَمْ، فَإِنَّ اللَّهَ لَمْ يُنْزِلْ دَاءً إِلاَّ أَنْزَلَ لَهُ شِفَاءً، عَلِمَهُ مَنْ عَلِمَهُ وَجَهِلَهُ مَنْ جَهِلَهُ»
“A Bedouin came and said: O Messenger of Allah, should I make use of medical treatment? He replied: Make use of medical treatment, for Allah has not made a disease without appointing a remedy for it, the one who knows it knows it and the one who is ignorant of it is ignorant of it” (reported by Ahmad from Usama Bin Shareek). And in another version from Al-Tabarani in Al-Mu’jam Al-Kabir, reported from Usamam b. Sharik:
«كُنَّا مَعَ رَسُولِ اللَّهِ ، فَأَتَاهُ نَاسٌ مِنَ الأَعْرَابِ فَسَأَلُوهُ، فَقَالُوا: يَا رَسُولَ اللَّهِ، أَنَتَدَاوَى؟ قَالَ: نَعَمْ، إِنَّ اللَّهَ عَزَّ وَجَلَّ لَمْ يُنْزِلْ دَاءً إِلا أَنْزَلَ لَهُ شِفَاءً».
“We were with the Messenger of Allah, when some desert Arabs came. They asked: Messenger of Allah, should we make use of medical treatment? He replied: Make use of medical treatment, for Allah has not made a disease without appointing a remedy for it.”. And in Al-Tirmidhi also from Usamah b. Sahrik with the wording:
«قَالَتْ الأَعْرَابُ يَا رَسُولَ اللَّهِ، أَلا نَتَدَاوَى؟ قَالَ: نَعَمْ، يَا عِبَادَ اللَّهِ تَدَاوَوْا، فَإِنَّ اللَّهَ لَمْ يَضَعْ دَاءً إِلا وَضَعَ لَهُ شِفَاءً، أَوْ قَالَ دَوَاءً إِلا دَاءً وَاحِدًا، قَالُوا: يَا رَسُولَ اللَّهِ، وَمَا هُوَ؟ قَالَ: الْهَرَمُ»
“Some Bedouins asked: 'O Messenger of Allah (s.a.w) shall we treat (our ill)?' He said: 'Yes, O worshipers of Allah! Use remedies. For indeed Allah did not make a disease but He made a cure for it' - or - 'a remedy. Except for one disease.' They said: 'O Messenger of Allah (s.a.w)! What is it?' He said: 'Old age.'”, and Al-Tirmidhi said this narration is Hasan Sahih. Al-Haram (Elderliness) is the end of life, which is usually followed by death.
This indicates the permissibility of seeking treatment. Through treatment, benefit is gained and harm is prevented, so it is considered to be an interest, and on top of that the clinics and hospitals are a utility which the Muslims use for the sake of seeking treatment and cure, and so healthcare is, therefore, part of the benefits and utilities. The State is obliged to provide the benefits and utilities, because it is part of what the State must practically manage due to the words of the Messenger :
«الإِمَامُ رَاعٍ وَهُوَ وَمَسْؤُولٌ عَنْ رَعِيَّتِهِ»
“The Imam is a guardian and he is responsible for his subjects” (reported by Al-Bukhari from ‘Abd Allah Bin Umar). This is from the responsibilities of guardianship and for that reason it is obligatory upon the State to ensure it is provided to the people. From the evidences for that:
Muslim reported from Jabir who said:
«بَعَثَ رَسُولُ اللَّهِ إِلَى أُبَيِّ بْنِ كَعْبٍ طَبِيبًا، فَقَطَعَ مِنْهُ عِرْقًا ثُمَّ كَوَاهُ عَلَيْهِ»
“The Messenger of Allah sent a physician to Ubayy b. Ka'b. He cut the vein and then cauterised it”.
Al-Hakim narrated in Al-Mustadrak from Zayd b. Aslam from his father who said: “I fell severely ill at the time of Omar Bin Al-Khattab, and so Omar called a physician for me, and so he warmed me up to the point I would suck on date pits due to the intense heat.”
Based upon this, it is obligatory upon the State to provide free medication and medical facilities, since it is part of the expenditures obligated upon the Bayt Al-Mal from the angle of being an interest and utility without recompense, and accordingly the State must provide all the health services without cost. This is the evidence that healthcare is part of what the State is obliged to provide to the people for free.
As for the permissibility of hiring a doctor, and paying him a fee, this is because seeking treatment is permitted (Mubah); as mentioned previously the Prophet said:
«يَا عِبَادَ اللَّهِ تَدَاوَوْا»
“O Slaves of Allah seek treatment”, and since treatment is a service that the one paying for can achieve, therefore, the definition of hiring is applicable to it, and there has been no prohibition narrated regarding it. Above that, it is reported from Anas:
«احْتَجَمَ رَسُولُ اللَّهِ حَجَمَهُ أَبُو طَيْبَةَ، وَأَعْطَاهُ صَاعَيْنِ مِنْ طَعَامٍ وَكَلَّمَ مَوَالِيَهُ فَخَفَّفُوا عَنْهُ»
“Allah's Prophet was cupped by `Abd Taiba, to whom he gave two Sa of food and interceded for him with his masters who consequently reduced what they used to charge him daily.” (reported by Al-Bukhari from Anas), and what is intended by master was his owners since he was owned by a group, as indicated by the report in Muslim. It is reported by Ibn ‘Abbas:
«احْتَجَمَ النَّبِيُّ وَأَعْطَى الْحَجَّامَ أُجْرَةً، وَلَوْ كَانَ سُحْتاً لَمْ يُعْطِهِ»
“The Prophet was cupped and he paid the wages to the one who had cupped him If it had been haraam, he would not have paid it.” (reported by Ahmad with this wording, and by Muslim and Al-Bukhari with a different wording). In those days Hijamah was part of the treatments that people would care for their health with, which indicates that to pay a fee for it is permitted. And similar to the fee for a doctor, is the selling of medicines since it is something permitted encompassed by the words of Allah (swt):
((وَأَحَلَّ اللَّهُ الْبَيْعَ))
“And Allah has permitted trade” (TMQ 2:275), and there is no text narrated to forbid it.