Thursday, July 23, 2009

What to do and conclusion [part 3]

When faced with something as vast and complex as the U.S. health care system and with the biblical challenge to do something about it, one inclination can instead be to retreat into despair and inaction; this is obviously not the answer, and the Bible’s numerous exhortations to “Fear not!” are evidence that God does not intend his people to be paralyzed by fear. Change can be effected; change must be worked for if we believe in and serve a God of justice; and change will need a collective effort, requiring the energies of:
  1. Individuals. As much as we’d self-centeredly like to think that we live “in a world described and defined by the necessity of autonomous choice, freely made, most people actually live in the relational, obligatory, and interconnected world, a world far messier and heavily freighted, far more passionately loving and passionately hating than that described in philosophic texts.”[1] This being the case, we cannot simply sit on our hands, ignoring the interconnection that means that loving our neighbor may translate into reforming a health care system that denies him or her adequate health care coverage. As individuals, we can contribute by researching the issues, by paying attention to policy goings-on, by talking with friends about these topics, or by raising awareness of the direness of the health care crisis.
  2. Churches. In the church, we can point beyond what is politically possible or what can be legislated, to what the Spirit can achieve through the distinctive community that is the body of Christ. Lawrence Brown suggests that institutions that mediate between policymakers and the public, such as churches, may serve to “help their members to get acquainted with the complexities of social choice and build trust in the intentions and intelligence of those who press for innovation.”[2] Churches can contribute to health care reform by contributing to the education of its members regarding the issues involved, or by organizing writing campaigns to Congressional representatives—those who are accountable to us as voters—pressing for expansion of Medicaid or more minority doctors and nurses who, studies show, are more likely to return to minority communities. In addition, churches can engage in direct health care services, running faith-based clinics, or programs to inform, enroll and translate for the poor in our neighborhoods. As Ron Sider points out, nations may choose to offer services to its citizens and not to foreigners, but “the biblical concern for the alien and stranger compels Christians and Jews to offer health care to millions of illegal immigrants.”[3] One could easily add that the biblical concern for the poor compels Christians and Jews to campaign for health care for the millions in poverty who are not, for whatever reason, covered by Medicaid.
However, individuals and organizations alone will not be able to effect this change. According to Kaiser State Health Facts, Medicaid alone cost a total of $303.9 billion in 2006.[4] The fiscal force of employers and governments will also need to be brought to bear in order to effectively face the challenge of insufficient health care, and individuals and organizations may play a part in pushing for such employer and government action. After all, “What is politically possible, of course, changes quickly when enough people demand action.”[5]

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4. Concluding Thoughts

The issue of the U.S. health care system is an imposing malady, imposing enough that it has never been successfully addressed despite significant deterioration in the last few decades.
As President Obama pointed out recently, “When times were good, we didn't get it done. When we had mild recessions, we didn't get it done. When we were in peacetime, we did not get it done. When we were at war, we did not get it done. There is always a reason not to do it. And it strikes me that now is exactly the time for us to deal with this problem.”[6] Framed in biblical terms, the call to image God in love, justice, mercy and concern for the poor and oppressed is too important to not do anything about the health care crisis.

Superficial change will not be sufficient. I would join the chorus of voices seeking change that takes root at a deeper level as well, advocating for a more foundational reform, such as Rebecca Todd Peters’ appeal to a new economic model “that is rooted in a moral framework of compassion and the elimination of poverty … that does not focus on growth and trade as its primary indicators of success,” but focuses on biblical priorities such as justice and the affirmation of human dignity.[7] Or Laurie Zoloth-Dorfman’s challenge for “a change in the ideological paradigm of health care itself, along with a change in the process and language of the discourse of public policy. There must be a change in how Americans perceive health and illness, cure and death.”[8] As Christians, our calling is to consider these issues—as well as those of justice and poverty and treatment of the alien—from a biblical perspective and to speak them into society and into being, seeking to see the kingdom of God come on earth. The challenges we face will be great in addressing the reform of the U.S. health care system. But the need is too great to ignore. And we may take heart from the reminder that the God we serve—the God of justice, the God of the poor, the God of healing—is a mighty God, and he can do anything.


[1] Zoloth-Dorfman, “First,” 24.

[2] Lawrence D. Brown, “Health Reform in America: The Mystery of the Missing Moral Momentum,” Conservative Judaism, 51 no. 4 (Summer 1999), 111.

[3] Sider, Generosity, 188.

[4] Kaiser State Health Facts, “Total Medicaid Spending, FY2006”; accessed from http://www.statehealthfacts.org/comparemaptable.jsp?ind=177&cat=4 (March 14, 2009).

[5] Sider, Generosity, 181.

[6] Barack Obama, “Closing Remarks by the President at White House Forum on Health Reform, followed by Q&A, 3/5/09,” The White House; accessed from http://www.whitehouse.gov/the_press_office/Closing-Remarks-by-the-President-at-White-House-Forum-on-Health-Reform/ (March 14, 2009).

[7] Peters, “Economic Justice,” 106-107. She goes on to say, “This new economic model need not eschew profit, or growth, or efficiency, but it should recognize the ways in which it values these goals. And it will balance them with other moral considerations, such as sustainability, justice, and the social well-being of people and communities.”

[8] Zoloth-Dorfman, “First,” 26.

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