David W. Swanson

Pastor and Author

If not this health care law, than what?

I’m going to carefully wade into the murky waters of the recent health care reform hoopla.  Not being a policy expert, I’m not interested in debating the nuances of the new health care law.  We’ll leave it to the pundits to spin the law to be either the ultimate demise or salvation of our nation.  I am, however, interested in the very negative response by many Christians to this new law.

Image source: http://www.nytimes.com/2010/03/24/health/policy/24health.html

To be clear, there are plenty American Christians who think the new health care law is a wonderful development.  Many  whispered prayers of thanksgiving throughout this past week.  Some will see the law as clear evidence that God has answered prayer.

Many other Christians, particularly (from my non-scientific observations) middle and upper-class white folks, have seen the passage of this version of health care reform as a devastating blow to our country.  [See the Christianity Today blog for a list of these types of reactions by Evangelical leaders.]  While the level of their rhetoric seems a bit out of proportion to me, I understand that certain elements of this new law will be troubling to those of certain political ideologies.  Fair enough.  So here is my question to those Christians friends and colleagues who so strongly oppose this law:

As a person whose allegiance is primarily to Christ, how do you suggest the needs of those without access to health insurance be addressed?

In other words, as those called to love God and our neighbors and to place their needs ahead of our own, how do we address the disparity of health care access?  If this law isn’t the way to do this, what are some realistic alternatives?  No need to tell us what’s wrong with this law (we can easily find those opinions elsewhere); share your thoughts about a better way forward.

I look forward to your charitable comments, especially those that can address these questions from the basis of your devotion to the way of Jesus.

David Swanson

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23 responses to “If not this health care law, than what?”

  1. Tim Avatar
    Tim

    Your question suggests you have been a sucker for the lie that those with no health insurance have no access to health care. There are multiple existing avenues for those with no health care insurance to obtain health care for a very small fee or for free. Do you have any statments to make regarding your awareness of existing access to health care by the poor or are you clinging to the notion there is no access to health care for the poor in this country?

    Reply
    1. David Avatar
      David

      Tim- would it be a fair assumption, based on my original question, that your Christian faith leads you to believe that the previous system of health care insurance should have been left alone?

      Reply
      1. Tim Avatar
        Tim

        David
        You ignored my question but I will answer yours.
        I am in favor of many changes to the current health care system where it remains a free-enterprise system, not a government controlled system. Many of the problems with the current systems is due to existing government control, and solutions coddled by lawyers. Other perceived problems with the system are driven by jealousy or people who sucker for philosophical progressivism – which is disguised socialism which is disguised totalitarianism. Will you answer my question?
        The fact that you would ask me the question you did leads me to think you think there are only two options. Is your mind limited to only two options here – keep the original or go government health-care?

      2. David Avatar
        David

        Hey Tim. I may not have been clear enough in my original post, but we really try to keep the conversation civil around here. This is why I ended the post with, I look forward to your charitable comments, especially those that can address these questions from the basis of your devotion to the way of Jesus. I may have misinterpreted your original comment, but asking whether I had been a “sucker for the lie that those with no health insurance have no access to health care” seemed neither charitable nor a serious response to the original question. I do hope you’ll continue to read and join in the conversation, but I’d ask that you treat this virtual conversation with the grace and kindness we expect from our face-to-face conversations.

        To your original question, my knowledge about the accessibility of health care comes personally from times when I couldn’t afford health care. Additionally, my wife has spent years working in the social work field assisting clients who couldn’t afford or were ineligible for health care. Perhaps the types of cheap or free health care you referenced exists in some places, but in her experience good health care came down to having good health insurance. Finally, as a pastor I’m privileged to know many who are serving the under-resourced in our city. My conversations with these dedicated social workers, community organizes, and school teachers all points to the need for a more just system of health care.

      3. Tim Avatar
        Tim

        It is duplicitous for you to complain about my part of the dialogue as uncivil or uncharitable when you load up your post with nuanced deprecations of those who oppose government posturing as compassionate when it is really interested in control and manipulation to buy votes for power. Your suggestion that those in higher income brackets and certain political positions might be opposed to this bill, but certainly anyone thinking purely in the way of Jesus would see this as good is uncivil and uncharitable. You made yourself very clear. Do I need to apologize and reform because I call you on your very false suggestion that some have no access to health care or no access to health-care insurance? I’m sure you’re aware that progressive/anti-capitalist pundits have been preaching the “no health-care insurance = no health care” line for years and yet you parrot it here as if it’s true and Jesus would see this “reform” as what He would want.

        A simple question:
        If equal health care for every American is a right, and something Jesus would want, than we must extend that assumption to include the whole world, not just Americans. We must conclude that we should arrange the finances and health care of the whole world so that health care is equal all the way around the world because Jesus loves the whole world equally. With this approach to health care, what kind of health care to you think will be available to you and those you love?

        I think we both know the answer to that question and that no one in this country really wants that. No one has proposed this extension of the current logic because they are only thinking about themselves and someone else to be forced pay for their “needs” as long as there is someone with enough money to do it.

        This reality leads me to think that the initial assumption that every body in this country has a right to any health care they want and someone else pays and Jesus would want it that way is really a false assumption.

      4. David Avatar
        David

        Tim, I’m going to exit this conversation at this point. It seems we are talking past one another.

    2. Larry Eisner Avatar
      Larry Eisner

      As someone who has two family members absolutely depending on “Access DuPage” healthcare, which is government-supplied, welfare-style healthcare, I can tell you that while the care is low-or-no cost, it is also absolutely terrible. No doctor wants to see you. No doctor is genuinely interested in helping you. I have a family member who was recently diagnosed with cancer. This is after nearly three years of issues that were ignored, mis-diagnosed, and ultimately lead to a very very dismal prognosis. Of course, I do not know whether or not a different doctor in a different healthcare system would have helped more, but I know for a fact, that when I am sick, I can make an appointment “like that” and I’m in. And since they see my insurance, they treat me well (Not great, mind you, but well). And when I am unsure of a diagnosis, or that I feel unsatisfied, I trust my doctor to either walk through it with me, or that if they don’t satisfy, that I can simply change doctors. This is NOT an option for my family members involved with this current system.

      Now, I am not actually for or against the new healthcare system. However, IF it provides better care for those in situations like my family, then I guarantee I will support it. If it does not, then I will rail against it.

      But until then? What damage is done, other than an attempt to level the playing field (regardless of the process by which that happens)?

      I think anyone declaring this the bane of the world, AND anyone saying it’s going to save is all is ignorant, and politically minded. I’m all for change. Luckily, we live in a wonderful country where democracy rules. If we don’t like the current system, we can vote in new people, change things, until it’s as we see fit.

      But in the interim, I’m with David here in saying that whether or not this is the BEST implementation of healthcare reform, I agree that the system NEEDS reform. And some change is better than none, especially for those without the power to fight for themselves.

      Reply
      1. Mitch Avatar
        Mitch

        Larry, you make a great point here, all-be-it incidentally. Health Care Reform can not, under any circumstances, improve how you are treated by your doctor. Low/no cost health care, from many doctors, sometimes solicits poor treatment…no level of reform will fix that.

      2. Dan VDM Avatar
        Dan VDM

        Larry, I feel sorry for the struggles that your family members are going through. My father also was misdiagnosed and died 10 weeks after a proper diagnosis. Better access to quality health care may have made a world of difference in the situations you refer to. In my fathers case he had good insurance, had preventive checkups and could have afforded just about any treatment available but still was misdiagnosed. Beyond that he literally had hundreds if not thousands praying for him. Even for the wealthy and faithful life at times just doesn’t seem fair.

  2. jasdye Avatar
    jasdye

    Tim,
    There is only access for acute problems for the poor, via ER’s. There is, of course, Medicaid/care for the extremely poor and seniors. But to think that ER treatment is adequate or even cheaper for the system than preventative care is to be missing a bigger picture of what health and care is really about.

    Further, I the combative tone (“sucker” “lier”) is unnecessary. We’ve already spent a week + with massive and hurtful rhetoric flying every which way. It’s not conducive to actually understanding the other’s side or humanity.

    And I have to constantly remind myself that we’re all in the same boat. We’re all messed-up, broken members of humanity, looking for something to hold onto, looking for some redemption.

    Reply
    1. Mitch Avatar
      Mitch

      jasdye, you too bring up a great point, what health care is really about…the prevention of illness. The major problem with Americans (not in contrast to the rest of the world, but they are the context in which we are dialoguing), is that they don’t take care of themselves. Illness related to our lifestyles is a massive, massive problem and unfortunately, no amount of health care reform will fix that either. You can’t force people to go to their doctor and even if you could, most people don’t listen to them anyhow. We need a lifestyle reform more than anything!

      Reply
    2. Tim Avatar
      Tim

      Calling out long term lies is not combative in my book. Maybe, like Jesus it’s time to turn over a few tables (Matt. 21) on those who posture as godly but are a den of thieves. I”m more concerned about whether what I say is true or not than whether it is the right tone to match up with everyone’s expectations. Did you not see the nuanced deprecating going on that I did? I guess someone who is deeply into the other side of the issue would not care about that and just agree because it feels good to them.

      Your generalization about “we’re all messed-up…looking for some redemption” is only partially true. We are all on this earth and we all have a sin nature but we are not all in the same boat. A few are on a journey where they are not as messed up as others, are working on further fixing, have found the one to hold on to and have found redemption. Some have light to offer others walking in darkness. Some love the darkness and hate the light that is offered to them.

      Do you see any of those leading”health care reform” walking in the light or throwing out lie after distortion after denial after obfuscation, after corrupt deal, etc? Bad trees don’t produce good fruit.

      Reply
  3. Josh S Avatar
    Josh S

    Clarification–the ‘reform’ passed last week was mostly a health INSURANCE bill. It did little to affect health CARE as it is practiced.

    Now, reforming health INSURANCE is a good thing, as that is a significant part of the problem. IMO, not enough was done to regulate insurance companies, and too much was done in mandating private insurance (via employer/group coverage and/or Medicaid expansion). A step in perhaps the right direction, but will likely also cause as many problems as it solves.

    Toward Tim’s point, there IS currently universal health CARE access, although there is a huge disparity in the amount and quality of that access. People are not allowed to be denied ER care based on inability to pay (although they sometimes are), and in Chicago, have access through Stroger and other Cook County medical facilities for very low cost (out-of-pocket to the patient). But this is NOT good health care, and does not answer the concerns that David addresses.

    As a person whose allegiance is primarily to Christ, my belief is that it is necessary that (first) the Church, (second) the community, (third) the local government, and (lastly) the federal government to provide adequate access to health care.

    The Church (as a body of Christians) ought to be providing money for the costs of those who have medical needs and cannot afford them. They have the greatest relationship, offer the most accountability, and can best manage the costs involved, while offering love, generosity, and hospitality in the process.

    The community, in a similar way, can be greatly involved in providing for the needs of the underprivileged. However, because the community may not have the calling of Christ or the desire to act unselfishly, this may be less effective than the Church’s call to action (when that call is properly acted upon).

    Local (meaning city and state) government can regulate requirements for what adequate health care might look like, and can ensure the professional qualifications of health care providers more effectively than church/community. However, as the size and scope of organization grows larger, the process becomes more dependent upon rules and bureaucracy, rather than on human needs and meeting those needs.

    Federal involvement, in my opinion, ought only be exercised when the previous actions have failed. Indeed, it is the failing of the church to take care of its community, the failing of local communities to stand up against deceptive and exploitative practices, and the failure of local government to effectively regulate the health care system that have caused the necessity of federal involvement at this point.

    It is incumbent upon the church to reclaim its role as the front-line provider of care, love, and support for both its members and the community at large. As much as I regret the involvement of the federal government, it is only because of our own failure that it has been necessary. And that must change if we are to change health care.

    Reply
    1. Leigh Kramer Avatar
      Leigh Kramer

      Josh, I’m very interested in your response. A century ago, the church was the primary (or often sole) provider of health care/aid to the poor and needy/other social services. The church gradually took a backseat as the government took on a larger role, especially around the time of the Depression. Some churches have stayed committed to the community around them- Humboldt Park UM in Chicago is a good example of this. As a social worker, I am biased towards social service agencies but I am also well aware of our limitations, especially given the budget crisis Illinois currently faces. IL is behind on payments for Medicaid, grant money, and county funding, among others. This of course affects the local government’s ability to continue health care services through the county and even free clinics on some level. I’m intrigued by your idea that the church provide money towards people’s medical needs. What would this look like? Would this be for members of the congregation or anyone in the community?

      Reply
      1. David Avatar
        David

        Josh and Leigh- are you suggesting that the church is in a position to provide the care required by those who currently don’t have adequate access to health care? Can the services/access provided by the new legislation be met instead by the American church?

        Also, how would you distinguish the roles of the church and the government? I imagine there are some services that you’d like to see the government (local and/or federal) provide for its citizens. How do you determine which service ought to be provided by whom?

    2. Larry Eisner Avatar
      Larry Eisner

      Josh, I 100% agree with you that the healthcare system, more than the insurance system, needs the more immediate and drastic change. Universal electronic records, a thorough and strict oversight of existing practices needs to be examined, and doctors need to be put on a “score card” system that is publicly vetted to ensure that good doctors are being rewarded for doing good work, and bad doctors are made public so they are motivated to change their behaviors. (Especially in the operating room.)

      I believe there is responsibility of the patients to not simply follow, sheep-like the call of every pharmaceutical advertisement, and jump from medication to medication, regardless of whether the old one worked just fine. (And doctors need to grow some backbone and resist the money from the pharma-cos and stop prescribing unnecessary medicines.)

      Sure, insurance reform is necessary as well. But I don’t think it’s the most pressing need. However, as I said earlier, change is good, when things are getting worse and worse, as they are currently.

      But the entire healthcare system needs reform, not simply the way bills are paid and negotiated.

      Reply
  4. Dan VDM Avatar
    Dan VDM

    The question I find myself pondering is why doesn’t God provide us with universal good health? I understand in many areas there is a level of personal responsibility if you smoke you increase your chance of lung cancer, if you are over weight and don’t exercise you increase your chance of heart attacks, if you are promiscuous you increase your chance of stds. Couldn’t God protect us at least against the catastrophic illnesses were there seems to have little connection to our behavior. Why the young child with cancer, why the good soul imprisoned with depression, why the faithful servant taken in the prime of life?
    Apparently my concept of fairness and equality don’t necessarily match God’s. Although I agree that we are to care for the sick and feed the poor I am not convinced that we are to focus our energies on creating a man made system to do this.
    Just maybe God would call us to use our time and money in such a way to get the most bang for the buck. Should we spend billions to create relatively small increases to a United States citizens life expectency or use the money to make a far greater difference by developing good water supplies and food crops in other nations. To a Christian wouldn”t providing health care through food and water take precedents over free preventive care visits? As a Christian does my duty stop at the borders. Do you think God would prefer a world with a billion people with a life expectency of 85 years or one with 10 billion and a shorter life?
    I think Christians are doing many things to impact those in need of care in a way that honors Jesus. The retired man who starts a community organization called DONKA that meets the needs of disabled individuals to use adaptive devices paired with computers to gain employment. Or the woman who provides housing for pregnant teenagers to allow them to bring their babies to term thus providing health care to the unborn. There’s the group of parents who purchased a green house to provide jobs for autistic kids to work along side their parents.
    I think the list of opportunities is endless for Christians and non christians to get involved in the health care of those around us many that provide richer opportunities to spread the love and grace of Jesus that are not available in an impersonal health care system.

    Reply
  5. Guest Avatar
    Guest

    I had a conversation with a friend today about something I did not know. First it made me wonder is it really true and if it is could this be a way or helpful to somebody to manage his own medical expenses without crossing any legal boundaries…( which I think will be a christian way of dealing with the paying your medical bills issue…as of Jesus’s words to give “the cezar what is to cezar and to God what is God’s” )

    So, are there two different prices for the same medical procedure: one higher for insured patient and one lower for uninsured patient?

    Also, is it the doctor or dentist legally free to bargain with the patient the prices of the service he is providing. I mean, can the patient expect or feel free to discuss the price he was given from the doctor ( before the service is provided) and can the doctor feel free to offer lower prices to the patient ( when he is willing to do that)?

    Also, I understand that the hospitals are not a grocery stores and can not post their prices with big numbers on the windows of their buildings but some more efficient way of letting the patients know in advanced the prices of the services would be helpful for their own arithmetic and the arithmetic of those who are willing to help.

    Reply
    1. Dan VDM Avatar
      Dan VDM

      I believe legally they are required to charge everyone similar rates but they can offer insurance companies discounts. So each time we had a child the hospital charged us over 2 times what a couple with insurance would be charged since we didn’t have maternity insurance on our policy. Each time I had to negotiate with the hospital and insist that I just be required to pay what an insured person would pay. I found it amazing that we had first rate medical care but it ended with us bargaining over the price like we were in a third world country bargaining over a price of beads. It is true and they play with words calling it a discount while insisting the charge everyone the same.

      Reply
  6. Elizabeth Smith Avatar
    Elizabeth Smith

    I know that you don’t want this discussion to be about the particulars of THIS healthcare bill.However, I feel very strongly about THIS healthcare bill as presented (all 3000 barely decipherable, and certainly not accessible until a very short time before being voted on) bill, and avoiding that issue really biases your question.

    I am not against healthcare reform in the least. I want it to be accessible for more people, more easily. But I think that government run programs are generally a very bad idea, especially when they involve this much debt and confusion. Surely, given the systems already in place (my mother worked for public aid [medicare/medicaid] for many years), there would have been a simpler way to expand the program?

    Furthermore, I think the question really comes down to this: Who’s job is it to make sure people are taken care of properly? Our GOVERNMENT’s job, or OUR job as Christians?

    It’s interesting to me to note that the Catholic Church has been establishing hospitals (and schools) for many many years. But now, because so many of us look to the GOV’T to take care of us (INSTEAD of the Church), many of these hospitals are closing, or relying on gov’t income which means that many are also being forced to expand their policies on abortion.

    I just think we did better (as a nation) when Christians stood up and served as the hands and feet of Christ with their time, money, and talents, rather than relying on the government to do so.

    The Government will grow in it’s ability to make decisions FOR US about issues of morality, mortality, and conscience if we rely on it too much.

    I don’t want the Government to have that kind of power of my life and my children’s lives. Especially when every effort is being made to keep God (or even Judeo-Christian values) out of any decisions regarding morality.

    Reply
  7. Linda Avatar
    Linda

    A current example from a very compassionate, young, small church: One of the members is dying of cancer–but this is a death that could take 3-4 years. The cancer has impacted how this young woman is able to live–she no longer can care for herself or her home. Church members are driving her to several medical appointments each day while also cleaning her home, bathing her, shopping for her needs and bringing in meals. After just a few months of this level of intense care, the church is reaching for outside resources–social services that could help meet her needs.

    The church members have full time jobs, and their own family responsibilities. And, though they want to care–they honestly see the need as too big for them as a church. They want to partner with professionals who know how to care for someone dying a slow death, with those who have medical expertise to give her, and with each member in the church to find creative ways to support her.

    From my own experience of dealing with health care and social services–I believe this church needs a map reader to show them the way. Insurance, medical care and social services are so complicated. It takes up rare resources like time for good-hearted people to learn and operate in these systems.

    Part of the reform we need is to help our medical and social systems operate in a way that ordinary people can access them and leverage them to help all people in each of our communities have the health care they need. I’m not sure that writing a new law that is so long and complicated as the one just passed accomplishes this goal, or makes it possible for us to serve one another well.

    A deeper question that I have–is why do we turn to a level playing field to provide the answers? Yes–we do want everyone to have access to the best medical care–if not elective procedures like plastic surgery for vanity’s sake. (Yes–breast reconstruction surgery after a mastectomy, no for the model who is pressured to be bigger, rounder, firmer than she already is.) My question though doesn’t have to do with leveling the field of people receiving care. It is more about us–the people who could be more involved. Do we want the government to do our charity so the playing field will be more level? After all–if we give more than our neighbors to those in need, than we will probably have less in our garage than they have in theirs and we’ll have to grapple with envy, covetousness and contentment. It is much easier to make sure we’re all paying the same taxes and starting at the same point in building our kingdoms of toys and expensive indulgences than risking having less cause we give more to care for those in need. I’m afraid I’m not expressing myself well here–but I can’t help but wonder if this is one of the hidden motives of our hearts when we look to the government to do what we could do ourselves. What if we took what we would have been taxed and started those neighborhood clinics, or funded medical care scholarships, or set up community groups to educate, exercise, reform our bad health habits…. I know–we’re afraid that only a few of us would do this and the rest would vacation in the Mediterranean.

    Reply
  8. Byron D Avatar
    Byron D

    I echo Josh’s belief that the church is ideally and the primary support for the poor and needy – providing financial support to help pay for health insurance, and our own labor to care for the sick and infirm. Is the church currently in a position to take this on? I don’t think so! Question is, how do we get there as a church? Answer is: sharing the gospel to grow the church! Preaching community and accountability to members of the church! Getting more of Jesus in us so we can better be his living embodiment in the world. Tithing. Absolute commitment on our part. Unrealistic? Absolutely not. Just extremely challenging, given our personal greed and fear.

    In the meantime, we need the gov’t to help.

    Reply
  9. Leo Wong Avatar
    Leo Wong

    Jesus and Health Care Reform http://bit.ly/dncuwa

    Reply

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