Monday, August 17, 2009

Thy Will Be Done...The Biblical Call for Health Care Reform

By Stephen Tickner

The health care debate in this country has ratcheted up to the likes of an accidental discharge at a fireworks stand in July.  Ever since members of Congress went back to their districts for the August recess and started holding Town Hall meetings to hear from their constituents, the obscene, absurd, ridiculous, and frightening have bared their ugly faces.  A frighteningly small amount of discourse and debate on health care reform has taken place-if any at all-and been replaced with scare tactics and a propaganda war on both sides.  With four bills floating around the House of Representatives waiting for a fifth, and no official bill floating through the Senate, now is the time to return to rationality and have that debate.  

Unfortunately, I am afraid that the essence of the problem is getting lost.  This country’s health care system is broken and needs to be fixed with true reform and I, as a Christian, believe it is a moral issue that God cares deeply about.  

I came to this belief after being challenged by friends on the question of Biblical imperative and observing various Christian organizations making the claim of the moral need for health care reform.  So, I wanted to see for myself.  A journey through the New Testament as well as visiting some Old Testament prophets ensued and provided me with some pretty interesting answers. 

To begin, I want to lay the groundwork for what God demands of his children.  Jesus began his ministry with the “Sermon on the Mount.”  In the middle of his first sermon, Jesus he teaches his followers how to pray by providing us with the Lord’s Prayer (Luke 6:9-13).  The prayer opens up by saying, “your kingdom come, your will be done on earth as it is in heaven.”  So Jesus is telling us that God wants the Kingdom of Heaven to be brought to earth and have God’s will be done here. 

Which leads us to the question, what is God’s will?  It would be wrong of me to definitively say that I know without question what God’s will is, but Jesus gives us a good clue in Matthew 22:37-40 when he responds to a question from the Pharisees about which is the greatest commandment.  “Love the lord with all your soul and with all your mind.” he says. “This is the first and greatest commandment.  And the second is like it:  Love your neighbor as yourself.  All the Law and Prophets hang on these two commandments.”

“Love your neighbor as yourself.”  Throughout the entire New Testament Jesus tells parables that damn the powerful for not loving their neighbors, for loving money more than the poor and the sick, for having the ability to care for the "least of these" and ignoring them, for holding on to ancient traditions rather than showing mercy in fear of breaking such traditions.  In fact, in the parable of the Rich Man and the Beggar (Luke 16:19-31), the rich man goes to hell because he refuses to feed, care for, or take in Lazarus despite his ability to do so.  

So how does this relate to the health care debate?  According the International Monetary Fund and World Bank, the United States has the highest Gross Domestic Product (GDP), the market value of all final goods and services from a nation in a single year, in the world.  That being said, the United States is also the only wealthy, industrialized nation that does not ensure that all citizens have health care coverage.  Today in America there are nearly 46 million people without any kind of health insurance according to the 2007 U.S. Census Bureau statistics.  In addition, the Institute of Medicine of the National Academics has stated that there are roughly 18,000 unnecessary deaths every year in the U.S. due to lack of health insurance.  To put these statistics in more staggering terms, that is like the tragedy of the World Trade Center occurring every other month in different cities around the country!  As shocking as these statistics are, we haven’t even addressed the underinsured or skyrocketing costs that cripple families on a daily basis (60% of bankruptcies this year will be due to medical bills and 75% of that number actually had some sort of insurance). These statistics do not coincide with me to “Loving your neighbor as you would love yourself.”  

I fear our country is like the Rich Man in Luke 16.  We wear fine clothes and feast sumptuously everyday.  We are provided for and are happy with where our life has led.  But we also know there are millions of people out there that need help and can’t get it.  It's impossible to pretend ignorance, we can see them daily at our gates like Lazarus to the Rich Man.  We can’t let our hearts harden to those who struggle in our society because as Jesus tells the Pharisees in this parable, we will be held accountable for our actions.

As the month of August continues, so does the argument over health care reform.  Like many problems, there are many solutions.  The Bible doesn’t provide a simple answer.  That is why the debate is so important, it is the only way we will ever develop a just solution that covers every single person and honors the sanctity of life.  Health care is a biblical issue.  If we keep that in mind, we can eliminate the obscene, absurd, ridiculous, and frightening and return to a vigorous and helpful debate that will result in a sustainable and just plan.


  1. Stephen,

    Great research, and I am glad to see that you are thinking with your God heart, but now lets get you thinking with your God head as well.

    Jesus also said before the Lord's prayer, "Take heed that you do not do your charitable deeds before men, to be seen by them...Therefore, when you do your chartable deed, do not sound the trumpet before you as the hypocrites do in the synagogue and in the streets, that they may have glory from men." Jesus was very concerned that we had a choice in our giving, and that we did so out of our servitude for God. It is our own personal relationship, provided by free will, that God desires. I do not believe the Government will act in such a way as to give our money privately.

    "Love your neighbor as yourself" is a far cry from the forcible removing of my funds to be given to someone who could do for themselves. Also, again it comes from a personal perspective. By my desire not to see my property be forcibly removed from me, and by my fighting for it not to, am I not also helping my neighbor? Could I not better determine who needs my charity? Is it not better for me to give of my own free will, then to be forced to do so? Which will God honor more?

    Finally, you mention that Jesus said, "that as much as you do to the least of these my bretheren you do it unto me." This statement is based on a series of charities that Christians are supposed to do in order to be considered faithful. Yet, it is not my tax dollars or my tithes that fulfill this requirement. I am to do it myself. the Apostle James said "Faith without WORKS, is dead." The works are the listed requirements Jesus gave in Matthew 25:31-41. I can tell you that having the Government or the Church do it for you is not what Jesus was refering to.

    Jesus on this Earth was about personal relationship. He came here to show us, how that we can be forgivien of our sin, and enter into a personal realtionship with His Father. Even in Jesus' words, "render unto Caesar what is Caesar's, and give God what is His." was not a command to bow to the dictates of a tyrrant. It was simply to say that Chrisitans are to respect the laws of the land, and to follow them, even in paying taxes (which is why I hate tax exempt status for Churches). However, it never said that we could not try to prevent a law from happening. Yet, if it is passed we will have to follow it. That being said, know this. Many on the left want to demean Christians and accuse us of legislating morality; however, to use Christianity to say that we should bow to the subjigation of the people, by the Government, is to twist our morality to fit theirs. Which is worse, Millions of people encouraged by their faith to give of their own free will to those who need it, or the Government taking millions of people's property (which money and pay is property) under the force of imprisonment and ruin?

  2. Stephen, nice article. But I would have thought that Jesus' statement of the love commandments DOES give us definitive knowledge of God's will. I think you can be a bit more assertive there! You're right, though, the Bible doesn't give us an answer, but it sure gives us the right questions to pose.

    Joe, it seems to me as if your God head has a few screws loose. Let me try to tighten them for you.

    First, you quote the initial verses from Matthew 6 and then write that Jesus' concern there is our relationship with God, namely, that we give freely out of service. Doesn't it seem that Jesus' point is actually to discourage doing works "before men" for the purpose of receiving human approval? (I also noticed that you skipped the part where it says, "for then you will have no reward from your Father who is in heaven," which, by offering a compelling motive other than service, seems to militate against your thesis.) The great thing about providing for the needy through publicly funded programs is that it makes it so easy to obey the point of the passage. Indeed, everyone could be paying the same taxes and some will do so cheerfully, knowing that it provides aid to the needy, and some will do it grudgingly--and there's no way to know the difference (only our Father who sees what is done in secret will know)!

    Second, loving our neighbors as ourselves is not actually about us and our own merits, it's about imitating the God who graciously provides for our needs out of divine abundance. In other words, it's not about getting honor from God, it's about giving honor to God! As Proverbs 14:31 says, "Whoever oppresses a poor man insults his Maker, but he who is generous to the needy honors God."

    Third, I would think that those who are truly concerned about looking after the needs of others would want to deliver the most aide in the most effective way. As far as the most aid is concerned, I think we can all agree that government taxes combined with private charitable giving produces more aid than if charitable giving alone were to be the sole source for social welfare, and I can't imagine that Jesus would rather see people starve to death, freeze to death, or die from lack of medical attention than that they should receive aid from the government. As far as the most effective way of giving aid is concerned, your point about giving money without any mediating institutions--like churches, the government, or, I take it, other aid agencies--totally boggles me. I have a hard time imagining that that will be as effective in apportioning money to wherever it's most desperately needed.

    But why sweat these points? The great thing is that even if health care reform passes and the government wickedly uses tax dollars to help finance medical care for the poor, we will still be free to give as much of our cash away as the government leaves in our possession, and in fact, I hope we do.

    Finally, as far as your references to forcible removal of property, tyranny, and the subjugation of the people by the government--do you realize that we live in a democracy? The government is us (through our representatives). If, as a society, we decide to provide health insurance coverage to the poor, that's not tyranny, that's a society acting ethically. Deciding to pay taxes (at various governmental levels) is deciding to use our money for things like potable tap water, roads, schools, national parks, defense from foreign invasion, health care for the elderly (Medicare--we already made that decision) and for everyone else too, I hope. All of these things are too big or too dangerous to have in private hands. Would you want an army of private mercenaries defending the country, or, more likely, extorting protection? Likewise, some of us don't want profit oriented enterprises determining whether or not they want to pay our medical bills without any regulation to curb the economic incentive for corruption.

  3. Why are you asking Washington to do what we should do individually and in our churches? Jesus didn't ask the Roman government to assist others, he was charging his followers and the church.

    If you feel the church has failed, please put your energy into fixing the church, not empowering Washington.

  4. pdijk, are you suggesting that the church should relieve the government of all social welfare obligations? Should churches pay for elderly health care (assume all Medicare costs), for elderly pensions (assume all social security costs), for food, disability, and housing subsidies (assume all Welfare costs), etc., as part of our obligation to care for the sick and the poor? Do you really think the churches can afford it, considering most members don't even tithe? Would Christians put as much money in the offering plate as they would save from taxes if they assumed the financial burden of all these government programs? But even that wouldn't be enough. They would have to make up for the tax revenue lost from all the non-churchmembers in this country as well. Your suggestion seems like a recipe for creating mass penury, indigence, and suffering.

    Why would we not rather rejoice that God has given us a government that concerns itself with aiding the needy rather than a government, like the Roman empire, that would just as soon maintain its power by threatening and slaughtering its citizens as by helping them?

    Since our government, unlike that of the Roman empire, is an instrument of the people's will, don't you think it reflects well on our nation's moral compass that we have collectively decided to take on as much social welfare as we have through government programs?

    Nevertheless, I deeply appreciate your suggestion that we put energy into fixing the church. I would rather that we christians gave far more than we do. I just don't see why the condition for our giving is a government that doesn't do anything. Can you explain why that would be necessary, or even possible? Can you explain why we shouldn't have both?

    Believe me, I'm not saying that your church should stop paying for strangers to receive CAT scans and triple bypass surgery, if that's what it does, I'm just thinking that the important thing here is that the needy should be assisted, not where the assistance comes from.

  5. I am discouraged by the tone of this conversation. Stephen invited respectful dialogue, and the first two comments jumped in by disparaging others. In a conversation about how to "love your neighbor as you love yourself", is it manifest in the tone of our conversation? Should anyone take us seriously if we don't do what we say?

    Instead of arguing about conclusions, I'd like to ask some questions that expose assumptions that underlie this conversation - and are not often discussed.
    1. What is the proper purpose and role of government? Clearly Marcus and Stephen part ways on this question before arriving on the issue of health care.
    2. Does free health care promote individual or public health?
    Do people tend to value things for which they do not pay? Does access mean that people make wiser, healthier decisions? If someone else pays for your risky behavior, will you be more, or less, likely to indulge those behaviors?
    4. There seems to be consensus that health care is broken. What is the nature of the breakdown? Cost? Insurance? Litigation? Malpractice? Something else?
    5. What is the desired outcome? A friend who worked with Alan Greenspan said that Greenspan was accustomed to ask Washingtonians if they would choose 1950s health care at 1950s prices (which virtually everyone could afford), or twenty-first century care at twenty-first century prices. Virtually all answer that they want state-of-the-art care. The problem (as evidenced by the bankruptcies cited) is that it simply isn't possible. State-of-the-art care is simply too expensive for the vast majority of us (myself included). A realistic solution must involve realistic assumptions.
    6. Are justice and equity the same thing? I hear a strong theme of equity through this conversation, but is that synonymous with justice? In the public discussion I'm not sure that human responsibility is affirmed.

    Let me give one illustration. My wife is a doctor whose patient population does not pay for their medical care. Their no-show rate for appointments is so bad that one of the clinics books EVERYONE for a 9am appointment. That means EVERYONE has to come and sit and wait in line for a good part of the day to receive care. Why? Because doctors and hospitals cannot run a practice in which 50% of the patients do not come for their appointments.

    It simply doesn't work when the government payment per visit is a fixed sum - and is already lower than an insurance payment for the same procedure/visit. So doctors who care for these patient populations face several choices: (1) Refuse to see patients who skip appointments. Then they can run a business that serves government-insured patients, and they can book a REAL appointment time rather than having to spend the entire day at the Dr. However, they are refusing medical care to patients who do not show for appointments. (2) Maintain patients who skip appointments. Then you have to (at least) double book appointments in order not to lose money - which penalizes the responsible ones who come for their appointments. This is the PRESENT reality of clinics that see primarily or exclusively government-insured patients.

    Does public health policy promote both responsibility and reciprocity of relationship? If it doesn't, can we expect the underlying issues of public health to change?