The extent of the common good…from bodies to nations

I cut myself Saturday morning, right on the tip of my first finger, which is not the best place to bleed if you like writing.  Immediately, though, things begin happening throughout my whole body to begin a healing process (you’ll forgive my layman’s understanding of this?):  Elements conspire to stop the blooding.  White cells attack and confine potentially infectious intruders.  Skin is miraculously reconstituted.  Scab falls away.  Done.

This is happening all the time in both visible and invisible ways in our bodies, and while I don’t understand it, I know that the healing of any one part happens because all the other parts get involved.  Success, for the body, is a holistic matter, and interdependency is the only way to get there.

The apostle Paul understood this when he wrote his letter to the Corinthians, and he used the body analogy to express the interdependency that is, or ought to be, the church.  This is where he declares that if “one member suffers, all the members suffer – if one rejoices, all rejoice.” One for all.  All for one.  The church, too, is best served by pursuit of the common good.

We who live in the United States, need to have a conversation about what “the common good” means when applied to our national identity.  The truth is that we already have commitments to the common good.  Everyone pays taxes, so that if your house is on fire some fine people will come with fancy equipment and risk their lives to put it out.  We all understand that the whole community is best served by the collective paying for this because the other option is the occasional pile of ashes on an empty lot that would blight the neighborhood.  Like the whole body kicking in when there’s a cut on my finger, we work together to keep things from burning to the ground.  We have a similar commitment to education, a belief that the whole community wins if everyone can read, write a complete sentence, and understand a few things about math and big ideas.  Because we all win, we all pay.

I’ve not yet heard any arguments from the right proposing that we dismantle fire departments and schools, privatizing them and shifting the responsibility away from the government to the private citizenry.  Thankfully, it seems that there’s some sort of baseline belief that there are services that everyone should subsidize for the common good.

You know where I’m going with this.  We live in a country where nearly half of all housing foreclosures are the result of health care crises.  We “spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system” according to this report.

So here’s my question:  Why does our commitment to the common good, as seen in the human body, and called for in the church, extend only to police and fire protection, and education, but not include health care, a system that works only for an increasingly shrinking percentage of the populace?  Or, if one views the government as both evil and incompetent, why not go all the way, privatizing education, libraries, police and fire protection, and making access to emergency health care illegal for all the uninsured?  How does your faith inform your view – whichever view you hold?

Perhaps we can have a civil discussion about this?

 

About Richard Dahlstrom

As Pastor of Bethany Community Church in Seattle, Richard teaches with vision of "making the invisible God visible" by calling people to acts of service and blessing. It's working, as a wilderness ministry, homeless shelter, and community meals that serve those living on the margins are all pieces of Bethany's life. "We're being the presence of Christ" he says, "and inviting everyone to join the adventure." Many have, making Bethany one of the fastest growing churches in America in 2009 according to Outreach Magazine.

  • Nate Collins

    Interesting thoughts, Richard. I might push back a little, though. By this line of reasoning, we would should also add just about everything to our list of things it would be better to have socialized. Food, housing, clothing, cars, anything that people “need” to live. It doesn’t seem to work well when the government controls distribution of resources. I think it would have been great in the Garden, but since the fall, people have been too self centered for that to work well, or so history suggests. Additionally, Paul is talking specifically about the church, the Body of Christ. He’s not suggesting an empire wide or provence wide system run by the government. But, I wonder if there is another way. The issue here is really for those who can’t afford health care, right? Is this a problem that could be tackled “in house” by the church? Maybe they work with the state, figuring out a way to provide for those who can’t afford health care through a combination of charity and a reduced rate. These ideas are a bit half baked, I guess. I’m not against socialized health care necessarily, I’ve not studied it enough to know all the pros and cons nation wide and long term and all that. I do know I’m glad to be having a hernia operation this thursday on Canada’s tab. I’m just not sure that the line of argument here is a good one or that we should immediately jump to assume that the Government should solve the problem. Thanks for a thought provoking post!

  • Ken

    There’s another fundamental question in all this that isn’t being considered. What is the role of government in these United States? Originally it was conceived that the purpose of the individual state governments was to protect us from one another in criminal and civil matters. The federal government was to protect us from outside invaders. The constitution was created to protect us from the federal government. Let that sink in for moment… Why was the constitution protecting us from our own government? Simply because our founders recognized the danger of absolute power’s tendency to corrupt absolutely. Carry forward 236 years and a constitution that had only a handful of federal criminal laws now has over 4,000 and that’s just federal laws. We teeter on the brink of being overwhelmed by absolute power. With that many laws on the books it is now possible at any given time that anyone can be arrested in our nation. You are always breaking some law.

    So what does that have to do with the health care debate? My question precisely. Police and fire departments operated at the local level have a pretty direct relation to our founding father’s notion of protecting us from one another. Police in criminal issues and fire protecting us from arson, accidents and stupidity among our neighbors. School is an interesting twist on the issue and indeed there are voices that do contend our present form of “public” education is a very bad system. What was begun primarily by individual families, local churches and communities has grown into a behemoth that is bloated with vast wasteful spending and diminishing returns on the investment. Allowing parents to choose where they spend their education dollars and introducing competition into the schooling of our children would go a long way in righting the ship. Instead of shoring up a public system that rewards on merits having little to nothing to do with education and even worse to great retirement pensions that are unsustainable, we should be looking to real long term alternatives to a structure that is rapidly destroying our children’s future.

    Oh yes, health care… Why is it so expensive? We haven’t had a system free from the hand of government for many decades. Similar to schools, our government has declared what is best for all and now requires so many additions to “insurance” policies that they are unaffordable for millions. I say “insurance” policies because that’s no longer what they really are. What they have become are pre-paid health care plans. My family spends over $10k per year for a “catastrophic” policy that covers such things as pregnancy for my 52 year old wife (who had a hysterectomy 16 years ago), substance abuse treatment for a family of non-smoker/drinkers and countless other things we’ll never use. The really sad thing is after spending $10k a year, we virtually never use the policy at all because of a high deductible. We subsidize those needing the baby coverage, substance abuse, etc. We do this not efficiently or by choice but by the force of all powerful government.

    I understand the desire to establish a Godly kingdom on Earth. I understand the desire to care for one another. The desire to protect, educate, clothe, feed, house and on and on. As a society we established certain protective constraints we as that society would enforce and though it has many flaws our justice system is still arguably the best in the world. We have since taken those basic beginnings and stretched them to the limits of what a fallen society can sustain. What I fail to understand in this debate is the naive idea that an all powerful government of this fallen world can achieve any measure of success in accomplishing many of these social/moral goals. As The Church of the Living God we are called to accomplish these things. When we as that Church surrender the acts of God’s calling upon us to an ungodly government I believe we have failed not just in accomplishing our goal but God’s call on us. When in “fairness” we shift the burden of caring for one another to big brother government we surrender to greed, corruption, waste, abuse, etc. in the name of “fairness”.

    I have heard it said that whenever our leadership declares war whether it be on a foreign enemy, drugs, poverty, crime, poor education, the health care crisis, mortgage defaults, or whatever… we willing give up freedom to said government for the duration of that war. If God’s Church gives up its freedom to fight the wars God has called it to fight to a government of man… enough said. I firmly believe that the greatest threat to social justice within and without the United States is the loss of freedom. The freer the society the more justice is possible. The proof is in the very history of all mankind. The Law was given by God and we have proven that laws cannot save us. Free Grace is our salvation. God gave Himself for us and gave us the freedom to give ourselves to one another. If we attempt to codify grace and salvation we have made a mockery of the saving work of Christ. It seems to me if we are choosing our bondage I’d rather we be slaves to Christ and His work on Earth than relinquishing that freedom to government for the sake of “fairness”.

  • BJ Myers

    Great post, Richard. Very brave indeed for a Monday morning.
    I think Nate is smart to separate the church’s role from the systems of government. That’s a familiar line of thinking for me having grown up in a nation bragging of the separation of church and state. That makes me think that the way I view Paul’s comments are highly influenced by my American understanding of church and state roles. It would be interesting to hear from someone with a different background.
    I’m no expert on government policy, but I have experience in two forms of common good delivery: national defense and local law enforcement. In my job as a police officer, my actions are guided by the lines of authority that society has said are appropriate for government agents. We believe it’s good for police officers to regulate speeding motorists in school zones because to do nothing would risk unbearably high costs to the society. But by the same logic, we choose not to allow police officers to stop and search any person they wish (TSA excluded!). Though the police might stop more criminal behavior by this, the severe intrusion into a person’s privacy and liberty would be too high a cost.
    In health care, education, and public safety we must be mindful of what we give up in exchange for government service. Sometimes it is well worth the trade off. And as we invent new technologies and methods for delivering a service, the costs might be reduced or benefits increased so that government action is worth it.
    Though I’ve been talking about government systems, it is important to remember that we are really talking about individuals created and loved by God. This understanding should drive us to improve the systems of our society. For those of us that work in government, I think this is one way that we can show love for God’s creation.
    Glad your injury led to this discussion, Richard!

  • GG

    The reason I find this discussion so fascinating is much of it will be coming from a “Christian” standpoint. I use quotations simply because there will most likely be views that seen extremely liberal, conservative, nationalistic, and everything in between. In my mind, as a person who often wavers between belief and semi-belief, I am curious to know how a Christian can argue to deny someone care due to their inability to pay. It seems extremely un-Christian, but an excuse can always be found in the constitution.

    One of the most fascinating things is the United States government is already the largest purchasing of insurance in the United States. Purchasing and handling health care claims for Medicare/Medicaid, US Armed Forces, not to mention politicians and representatives.

    It is my understanding that these people get quality care at an extremely affordable cost.

    I have a tendency to believe that the U.S. government isn’t the issue as much as it is greed found in corporate America trying to take advantage of the system. Include a powerful lobby for said industry and it spells disaster.

    There is NO free healthcare in Canada, France, Sweden etc…the people pay approximately 2% tax on their income for the luxury of affordable care. This is shared as a people, and as I heard one wealthy person say, it is an honor to be able to help others.

    The question is why is the United States not putting their people first when it comes to health care, especially when there are blueprints widely available that are working for other countries citizens.

    This isn’t a national or constitutional issue. This is simply a human issue.

    As it stands now, I doubt a healthcare system could be put in place that doesn’t take advantage of everybody. There are robber barons at every turn, and until the people demand legitimate change we will always get the short end of the stick.

    In a perfect world people would attempt to protect their own best interest and love thy neighbor even when they are in the most need.

  • sp

    I wonder if this is a “Jesus” issue, or if He would have made this one of His teachings?

    Mark 14:7 almost seems to indicate that we are to accept the “truth” of poverty as it is, and focus our attention on Jesus instead, or at least…more wholly….yet Deut 15:11 seems to teach us to be open handed to those who are poor and needy in our land. For those who argue a single-payer system, perhaps Deut is the guiding light….but it seems that even Jesus had a certain acceptance of the fact that there will always be poor/poverty/hungry around us.

    Indeed, Jesus didn’t share the type of god’like persona, with the resolve and grand-master-plan to rid poverty/hunger/sickness from the world once and for all, the way the Jeffrey Sachs / Bono’s of the world try to do in “solving hunger”. They thought He would have done that on Thursday, and killed Him shortly thereafter, because He didn’t deliver (among many other things)!

    We aren’t so smart, so as to change the fact that we live in a fallen world, by design.

    …and if it IS a “Jesus” issue, then should we Christians try to be influencing our Government to try to take our “Jesus” cause to the masses, to try to enforce our issues on all, because we believe it is “the common good”?

    “The public weal before the private gain” was written by Hitler to US Ambassador Dodd in ’34. He, and many other collectivists over the years, have a long history of touting, and mandating, a “common good”.

    Not everyone on “good”, which makes it less than common.

    • sp

      last sentence was meant to read: “Not everyone AGREES on “good”, which makes it less than common.”

  • Lamont

    Excellent Idea Richard!
    Perhaps the government can put all Christians and their family’s to work 16/7′s?
    That way, everyone else can stay at home and watch Ellen, the Voice, have meals delivered, or, be driven to a 5-star restaurants & etc…
    It worked successfully in Egypt for hundreds of years!
    Of course, you’ll probably get some push-back from those evil so & so’s on the right?
    One should be careful, as the disease of liberalism can be contracted through something as simple as a puncture to ones finger.

    • Richard Dahlstrom

      bummer Lamont… we were doing so well at civil -

      • GG

        I’m not too sure what those television shows have to do with providing quality care to the masses at an affordable cost, but I am guessing you mean that people are lazy and deserve what they get?

        Nobody ever seems to admit or understand that the middle-class are the ones getting crushed into bankruptcy when serious medical care is needed. My son’s broken arm cost our family $4600.00 out of pocket this year. While we were fortunate to have the money, if it was something more serious we could have lost our home.

        It seems, in spite of faith, that many are convinced that an inability to pay for modern health care in the United States is simply a matter of choice. It has reached a level disproportionate to a persons realistic income. So unless you are wealthy, or poor, or are lucky enough to employed by a company that gives premium benefits(many no longer can afford to do so) you are only a catastrophic injury, syndrome, or disease away from homeless.

        The people you may call liberal, conservative or independent I just call my friends and neighbors. We may disagree about some things, but I believe they deserve to be healthy just as the rest of my family.

        Now what I may argue about are the preventative choices we can make to protect ourselves from the negative side of medicine. Over-medicating, but that has much more to do with education than anything else.

  • Steve B

    “I’ve not yet heard any arguments from the right proposing that we dismantle fire departments and schools, privatizing them and shifting the responsibility away from the government to the private citizenry.”

    I try to take your thoughts seriously about how there is a Biblical motivation for why we should let the State to do ever more for us and/or institutionalize Christian charity, but when you make comments like above, I know you are not that serious about challenging your own predilections. Even a cursory reading of some libertarian blogs would provide arguments for privatizing a plethora of government services. To say you haven’t heard ANY arguments indicates you have not really engaged “the right” on the issue. For education related thoughts, try http://www.cato-at-liberty.org/category/education-child-policy/ . You can browse the rest of the site for health care thoughts and even thoughts on fire departments!

    • sp

      Let’s privatize Fire Departments. ? I just hope you have a pile of Benjamin’s next time you’re top floor is falling into your basement…so that they’ll have that profit-incentive to turn on the hoses for you, bro. As for me, I think that’s a tax that is, er….worthwhile!

    • Ken

      Steve B – That is funny that you also saw the not-so-subtle leaning placed upon this civil conversation from the beginning. The simple truth that seems to be completely lost in this conversation is the unsustainable costs of the current and proposed systems. Government is mentioned as the largest purchaser of insurance and that it provides affordable care for those recipients. Anybody here noticed the multi-TRILLIONS of dollars in debt the country is going into? AFFORDABLE? Come on people, there is nothing affordable about any current health care administrated by government anywhere in this nation that I have witnessed. As for those European examples, am I reading about some other Europe in current financial meltdown? I’m being civil here but we need to face some realities.

      As for Richard’s original question of why does common good relate to fire and police (and education to which I hardly agree), but not health care? I’ll put it another way… If the believing Church is called to be the “aroma” of Christ to a dying world how do we accomplish that best? Is it by acting as true Christians reaching out to those in need as our predecessors have caring for those during the plague for example or serving an AIDS, war and poverty ravished Africa or helping our fellow Americans when in need by choice and true charity? Or is it instead by pushing legislation through that mandates government coercion for all to pitch in and “do what’s right”? If the question falls to God’s Church and His expression of His character by that Church, then I don’t see a forced system of law being the proper course. If the question is instead what should a fallen world do to care for there fellow creatures, born of random evolutionary chance in a universe devoid of any true moral origin, then I fear the answer will be that the strongest, greediest, most power hungry will devise a system to manipulate their fellow creatures for their own personal good and make us believe it’s “fair” or “reasonable” or “right” or whatever the latest and greatest catch phrase of the moment is to accomplish their goals and not those of the Creator God.

      Call me cynical. But history is on my side here. Sorry. I say this with all due civility.

  • Richard Dahlstrom

    Thanks all… for the thoughtful comments. Here are some of my thoughts in response:
    1. I continue to wonder why we think think the government is less benevolent and/or competent, than the private sector, when our present world is rife with corruption, environmental degradation, and a sort of cruel economic Darwinian-ism, all occurring under the guise of the free market at the hands of unregulated private industry.
    2. The fact that none of my many European friends would trade their health care system for our privatized one leads me to believe that it’s not a truism that all government is pure corruption and incompetence. And I’ll note in passing that all my European friends are deeply devoted Christ followers, so to be on the left or right on this issue isn’t a question of Biblical orthodoxy. Their systems work well, providing a baseline level of care for all its citizens, paid for by everyone (the healthy and the sick, young and old) contributing to the pool of resources committed to providing the basic care. Everyone understands that someday they too will be sick and need this. One can also purchase, in Germany at least, supplemental coverage to enhance the basic offering. Their system is thus a blend of free market, and government run, and works well. I can give you similar first hand evidence from Austria, the Netherlands, and every Scandinavian country. Is our government uniquely postured, among the developed nations, for corruption and incompetence?
    3. I agree with Ken that we must resist the temptation to build the kingdom of God on earth. However, I don’t know anyone who thinks access to basic health care will bring about God’s reign on earth.
    4. To Nate’s comment about the church buying the health care for those who can’t afford it, I’d still suggest that the system of sharing the load at a broader level is better for everyone. When the man in the good Samaritan story tells the doctor to do ‘whatever it takes’, promising to pay the bill, I honestly can’t think of any individual or church that could say that honestly for the case of someone in their congregation who’d had a heart attack.
    5. SP, I appreciate the dangers of the “common good” as license for totalitarianism, but I don’t agree that the answer is “every man for himself” as you seem to indicate. According to Jeremiah 29, even though I live in a culture that doesn’t uphold the gospel, I’m called to work for the good of it anyway, and my convictions, drawn from God’s vision for Israel in the OT, lead me to believe that cultures work best when the inevitable gaps between wealth and poverty are mitigated. It happened then by gleaning fields, freeing slaves, and the year of jubilee.
    6. Steve B. I suppose I should qualify and say that the mainstream political voice of America hasn’t yet advocated for dismantling public education or the fire department. I’m aware of Libertarianism.
    Thanks for all your insights and contributions….

    • Ken

      I know my last time stamp was after your post Richard, but I was writing while you were posting. I really have to ask about your point #1. That final line, “all occurring under the guise of the free market at the hands of unregulated private industry.” Where in America is there an unregulated private industry? Of any sort? Certainly not in health care. Not in the construction industry I’m in. Not in the street vendor taco stand. The local ski area? No, regulated. A walk in the national forest? No, regulated. Have a dog? License it. Likewise car, truck, trailer, boat, etc. Change a toilet in your bathroom? Regulations. Cell phone? Regulated. Obviously I could carry this on forever. The thing I might point out is that the “private” sector is rapidly approaching extinction in our country at the hands of less than benevolent and/or competent government. This is a simple truth that we must keep in focus when we debate where we place I trust for our personal health care.

      The greatest case for keeping government hands out of health care and everything else does not center on benevolence or competence, but on who has the most at stake in deciding what is best for anyone in any given situation. The further removed the structure writing the rules of the game, the less important are the actual players. They become simple statistics to be sorted and accounted for. When the expense is too great for the “common good”, then some faceless someone will be making decisions for that “common good”. As I said, I’m in construction. Our holy state of Oregon continues to come down with ever more regulations “to protect the consumer”. Does it protect the consumer to require ever more licensing and training or does it protect the large construction companies that send some designated employee out to get the certification then promptly ignore those regulations? Does it help the less financially able when they can no longer afford the “certified” work that needs doing on their home? So they sand the lead paint themselves or take off the asbestos laden popcorn ceiling instead of hiring a professional that would have used the “certified” equipment but that they can’t afford to hire. When all along for decades any reputable, intelligent contractor has been using good practices to do just such work capturing 95% of the nasty substances but not the 99% the certification requires. And so we surrender ourselves. The war on global warming? Even though our current cars give off less pollution while driving than they used to while sitting parked with the engine off just a few decades ago, not enough! It’s war! Regulate!

      Sorry. Still being civil here.

    • reneeg

      I find it difficult to compare the United States to any individual European country. I think the diversity of demographics, socio-economics, climates, cultures, industries, etc found in the US makes it very difficult for the federal government to effectively serve the individual regions’ needs with its broad policies and rules. A more parallel comparison in my mind would be between the US and the EU.

      I had a few good friends who were Swiss and German. My understanding is that their supplemental coverage was very expensive ($100-200). Even the baseline mandatory policies were quite expensive ($100+ for the poorest individuals). Really, in the end, they just had a different budgetary structure: rent ($$$$$), health care, taxes, food, THEN “cheap” stuff made in china.

      I have equal distrust of “big corporations” and “big government” – especially when they’re in bed together. This distrust has probably been encouraged by [liberal-biased!] documentaries/investigations on GE foods, pharmaceuticals, financial collapse, etc. What has struck me is the *very long list* of ex-government employees (USDA, FDA, Fed, Dept of Treas, etc) who go to work for big corporations when they’re “retired” and make $$$$ sitting around a boardroom table. So we see a trend: the more control the federal government has over regulations – the more likely they’ll be swayed by big money. In the end, only the wealthy can afford to find the loopholes to become more wealthy. Why would health care – given the current climate – be any different? Who can we trust? [Obama seems trustworthy... but why did he re-appoint Bernanke? The list goes on....]

      It makes sense to me that the more local the government power is concentrated, the more power we, the people, have. Like local businesses, we can more easily research, audit, and oust corruption. I would prefer an accountable, ineffective government to a corruptible, effective one.

      For now, I’ll take the responsibility and encourage others to the same: VOLUNTEER at the library and local school, buy LOCAL (unless a corporation has really proven itself worthy.) – especially meat (boycott non-organic corn!), give to local food banks, etc…. Perhaps we can put corruption out of business. At that point, I would be more amenable to a collective health care system. [In the meantime, I believe we should take care of the nation's children, no matter what.]

      • Ken

        This is an excellent point you have Reneeg. Also something that Richard should be able to get behind in the buy local idea. The comparison of the US more to the EU at large is good too. We are indeed a very diverse society and to lump over 300 million people into a single plan is a very scary thing. This is where I think equating Romneycare to Obamacare falls flat. One is a single state that has both the constitutional power to decide such a thing for itself and seemingly broad support within that state for the plan. The other is a very partisan decided plan formed by a very narrow margin and not at all supported broadly by the people nationally. That is the glory of these United StateS, plural. That was the plan of our founding fathers to divide power and not allow absolute power to become too concentrated a the federal level. Local is better. Good observation.

    • Paul Creelman

      Having practiced family medicine for 32 years, I am amazed in this health care debate, at how infrequent I hear the word “RATIONING”- the only word that will come close to (but probably won’t) solve this problem of over priced medical care (insured or not) .

      We have outstripped our ability to pay for the high tech medicine we are giving and demanding.
      We can now insert -internally -a mechanical heart to replace a heart that can no longer pump. Price tag??? My guess is over a million dollars to insert and an unimaginable life time cost to maintain. Did the patient “deserve” it – absolutely! But can we afford it ?
      A patient just came back from an outpatient hernia surgery. Door to door – less than 4 hours.” No complications – none.
      Price tag?
      Over $20,000! I saw the bill myself.
      Yes, insurance gets a discount on this bill, no – the private pay patient does not get a discount. If the patient doesn’t pay in full, the cost is added to future bills for everyone else. This exorbitant bill is an accumulation of, at least, the following “feeders at the trough” (others could be listed)
      1. Doctors
      2. Patients
      3. Hospitals
      4. Insurance companies
      5. Attorneys
      6. Bureaucrats

      So who of the partial list above are going to be the first to step away from the trough?
      What about when it’s your child that’s sick with a terminal cancer? Will you forgo the chemotherapy for over $500,000. If it’s your husband that has the headache, will you decide against a head MRI for ?$1500, just in case it is not a migraine? Who’s going to be first to step away?
      Just because we can fly to the moon, doesn’t mean we can afford to go or deserve to go.
      Until there is forced rationing for all of the above parties – we will have no way to control the costs.
      Yes, this will inevitably result in missed diagnosis, shortened lifespans increased suffering.

      You can argue about “right to health care” all you want, but if you can’t find a way to keep the trough full of money AND decrease everyone’s appetite for more – it doesn’t matter. We can’t afford it.
      Look over the Canadian border and ask them about health care rationing – you will find the CAT scan for the evaluation of your mother’s stroke can take months to get done (not minutes like it is in the US.)
      This is not going to be easy!

  • Kira

    Though I’ve had the opportunity to study health care policy somewhat extensively in my graduate studies, I’m afraid I can’t speak very eloquently about the intricacies of the health care system, legislation, special interest groups, or insurance companies- the main topics have already been touched on and the details are entirely too daunting to attempt to touch.

    What I can speak to is my own experience. I’ve been interning as a medical social worker for the past 7 months. There is no more vulnerable time in a person’s life than when their health is failing. Perhaps it’s more minor; surgery for a broken bone. Perhaps it’s terminal; metastatic pancreatic cancer. Unfortunately I have had to sit with these people and listen to them struggle with the reality that they have no idea how they are going to come up with the money to pay for their care.

    The largest portion of the uninsured are the working poor- people who hold multiple jobs to support them and their families but who don’t work enough hours at any one of them to qualify for healthcare. The UN states that healthcare is a basic human right. It’s not a privilege for those that can afford it. I have no brilliant theological points but I believe that Jesus showed us that same desire. He healed people. Regardless of what they could offer him, regardless of their resources, regardless of their faith, he healed.

    I think that healing is what we are called to do and, whether that be through a job, a volunteer position, my financial resources, and, yes, even the way that I vote, I want to advocate for the most vulnerable among us to be healed.

    Thanks for the topic, Richard. And thanks to all for the civil discussion.

  • Nate Collins

    That’s a fair point, Richard, about needing to spread the burden out to a wider group than the church. I guess what this makes me wrestle with is how we as Christians should respond to issues like this, on the individual, person to person level or on the systemic level? Your post seemed to suggest tackling this issue primarily at the systemic level (and of course I know that you do not neglect the importance of our personal relationships and actions there in). I’m often struck in the NT by how little there seems to be about systemic change. Jesus was remarkably unconcerned, as far as I can tell, with changing the government he was under, Rome. Or even Herod. Similarly, the epistles are less concerned with things like abolishing slavery or forcing equality for women than about injecting an ethic of love into the existing systems and, I think, being willing to wait for the bigger changes to come with time. Of course there are political aspects to all this. Some argue that “turn the other cheek” has a strong pacifist, political message in it. There are other examples too. It seems, however, that, by and large, the Bible is mostly concerned with getting us to start living out of love, not so much with getting our governments to live out of love. How does that relate to this issue? To be fair though, Jesus did take a pretty active role against the Temple system, in which he could have a voice. Additionally, I’d wager that the lack of focus on systemic change in the NT is largely due to the lack of power the people had. We’re in a different situation. Of course none of us can change the government or even health care single handedly. Even a thousand of us might not be able to do much. But we do have a voice and we can make change. We don’t have as much power as we’d like, perhaps, but we’ve got enough to make a difference. This leads me to believe that maybe, since we can, Christians should work for systemic change as well as changing how they live personally. But to what degree? How much should we tackle an issue like this on the personal level, letting the government be as good or corrupt as it will be and choosing to be sources of light within that and how much should we tackle it on a systemic level? Seems like it must be a two pronged approach in some degree or another. Systemic change will take a long time at best. What’s our response as Christians in the meantime?

    As far as whether socialized health care is truly better or not I have not done the research so I’ll bow out of that part of the discussion.

    Thanks for your thoughts, everyone.

  • Richard

    Perhaps I could point to two “Jesus virtues” that may pertain here. Making the best use of the resources God has given us for the good of others, and telling the truth. I have worked in health policy in the socialised UK and New Zealand and the privatised US. I have some reasonable knowledge on this subject.

    What sort of system uses resources most wisely? The international evidence is pretty incontrovertible – socialised systems do. US healthcare costs 2-3 times that of every other developed country in the world, and its results are worse. There is now about 20 years worth of research in peer reviewed journals demonstrating this time and again. The US uniquely has a non-socialised system.

    Further, the specific features of the US system (and specifically market features) have a clear causal link to its poor performance. Here are just four examples. Population health is poorer because an actuarially rather than socially based insurance paradigm leaves around 20% of the US population uninsured and probably around a further 20% under-insured. (More problematically still the structuring of health insurance encourages relatively low risk people – the young and relatively health not to take insurance, thus skewing the risk pool and making insurance for those who have it more expensive still, creating a vicious cycle).

    Less noticed, but possibly even more troubling is the use of market paradigms to set financial incentives for doctors -this includes fee for service which increases unnecessary and wasteful intervention. This not only wastes money, it also, because there are risks associated with all intervention directly increases harm to patients. Indeed there is growing evidence that harms caused by treatment may be higher in the US than in other developed countries.

    A further problem is that unpopular specialties and areas are less well served, and this is a direct result of an education system which is built around individual advancement (with a paradigm that is literally an investment of $100,000s in one’s future earning power) rather than the common good.

    Finally the costs of pharmaceuticals are enormous in the US compared with the rest of the world, and this is not, as pharma likes to claim, the costs of research (the basic science underpinning development is, in fact, largely government funded in Universities) but the costs of administration and marketing. The last time I looked the latter two we 3-4 times the cost of research. In pretty much the rest of world a socialised single purchaser uses its monopoly purchasing power to reduce drug costs – Medicare part D legislation actually prevented government from doing this. Put simply to do good to as many people as possible without stimulating greed or going bankrupt as a nation the rest of the world has a better healthcare system than the US. They are very far from perfect, and within the US there is some excellent health (but tellingly one of the best bits is the entirely government controlled Veteran’s Administration which is now taught internationally as a textbook example of how to improve healthcare)

    As for honesty, what is telling is how frequently opponents of socialised medicine are dishonest about what actually happens in socialised systems. Sarah Palin’s “death panels” allegation is notorious and rightly so as it is a blatant and deeply offensive falsehood, but less well known is Rudy Guiliani’s comments about prostate cancer death rates in the UK which have been demolished by epidemiologists in both the US and UK and which were, one has to assume intentionally, misleading. Finally the character assassination of Don Berwick, internationally regarded as one of the greatest figures in contemporary healthcare, which centred on misrepresenting, misquoting and miscontextualising his positions, when he was appointed to head up the CMS was telling.

    I would suggest that Jesus would have approached healthcare in a rational way. What approach does the greatest good? And if there’s an argument, discernment would suggest looking to see which side is lying.

    • Ken

      Thanks for your shared expertise here, Richard (not Dahlstrom). I appreciate what you’re saying and would simply point out that within your analysis lies the traps for the U.S. Like so many of our current systems we see that government and big business are closely wed in their manipulation of how things operate. The current revamp which Obamacare offers seems to me a complicated smoke and mirrors job by the government and big insurance/big medical. It doesn’t fundamentally correct any on the present inequities of health care in our country. Just the fact that congress continues to separate itself from its creation is proof enough. Instead it has more in common with the various medi-care patches that keep being endlessly added. Adding layers of complication for the sake of the system not the user. The great crisis for this country is reworking the entire picture of how we manage the delivery of health services. My fear in the social medicine model here is the massive collusion rampant between Big G and Big B. As it rears its ugly head in more and more venues from banking/mortgages to the financial investment world to education K thru college, etc., we see increasingly the power of the central few controlling all aspects of the majority’s existence at hyper-escalating costs. College is a great example of runaway costs because what the individuals attending actually pay is becoming so similar to going to the doctor. There are scholarships, grants, awards, ethnic and alumni markdowns and on and on so that virtually no one pays the rack rate. There’s also very little chance to properly compare costs between schools which of course handicaps the student making the decision. All those elements together with the college systems continuing disconnect from reality in raising salaries, benefits, pensions, paid furloughs, etc. for staff while the rest of the economy is has to scale back because of the current recession helps illustrate what’s happening in health care. It too is disconnected from its customer and on a runaway course.

      What to do in the United States is the problem. We’re not Europe with nearly 60 years of history beginning with a rebuilding of their society after WWII. Let’s not forget that Europe has been largely free of the cost of self defense since then as well by the graciousness of America. Perhaps if we sent them a bill for those 60 years of services, including freeing Europe in WWII, they would find it difficult to have their social medicine at 2% of income. I don’t intend to sound cruel here, but there are just so many issues that this discussion doesn’t even begin to take into account. Like the whole notion of how to pay for this mess which I now mention again and no one has the slightest courage to address. So come folks, let’s take a BIG reality check and look at the real world as it is and come up with something better than, “we need to be Europe.”

      • Richard

        You are certainly right that Obamacare (although we might as well call it Romneycare as it is largely based on the scheme that Romney put in place in MA.) is underwhelming. I’d argue that this is because of the failure to be radical enough and insist on a single payer system.

        Your comment about Big Government and Big Business acting in concert and your fear of it interests me on a number of levels. First I certainly find it hard to see the Bible as a mandate for small government, at least in the Randian model common in American discourse. The OT sets out a model of society in Israel with a profoundly interventionist government which played a role in both economic redistribution (the Jubilee laws) and public health (mildewed housing, ceremonial cleanliness and dietary laws). So I find the meme that a socially interventionist government is antithetical to scripture to be slightly odd.

        Secondly, I think you may be missing the point about the relationship between government and business. There is no reason why this should be about collusion, unless what you are saying is that the polity is so corrupted that a US government can have no roll except to act as a shill for corporate interests. In the rest of the developed world this doesn’t happen in health (in fact it is one of the few areas where it manifestly doesn’t happen). Government simply says “the purpose of healthcare is the individual good of those who need it, and the common good of society. It’s primary purpose is not for insurance and pharmaceutical corporations (nor for that matter individual doctors) to maximise their earnings, and we shall organise, legislate and fund accordingly”. Provision of good care doesn’t, despite what market theorists would postulate, collapse the next day.

        One final point, before we disparage Europe , recognise that Europe’s approaches are heterogenous. Britain looks nothing like France, which looks nothing like Germany which looks nothing like Spain. Holland even has competing insurance companies, much like the US. But all have held to some version of my statement above as a guiding principle of how healthcare is provided. As an observer, and sometime resident of your country, who finds much to admire in it, are you really saying that it is impossible for government not to be agent of corporate corruption. Because if you are then there really is no hope for the US.

        • Ken

          Sadly, Richard, I would probably admit deep within me your final sentence is precisely where we are at present. That is pretty inescapable as long as no leader steps up with a real alternative throwing away the current mess and starting fresh. Whether we could ever retreat to a true private insurance system that people could afford or move to a single payer public one that didn’t bankrupt us or some hybrid in between is the ultimate question. Right now we’re all trapped in a nether world where we can’t afford to pay and can’t afford the “insurance” coverage. And by that I mean the prepaid premiums we dish out and that still don’t offer real protection from the catastrophic medical issues insurance should ideally be for in the first place. And sadly I know of no real plan (Obama/Romney-care) included, that even approaches a solution, just a much greater mess.

  • Erika Poole

    People are beautiful. Truly. If you are only able to see filth, greed, or the crusted interior, you aren’t looking hard enough. There’s something about people being made “in God’s image” that I just can’t get over. Richard, your original question was “How does your faith inform your view – whichever view you hold?” It feels like many of the comments above have been to support a personal agenda or platform, to claim that “I am right! You are wrong!” It hurts my heart. That isn’t the point. This finger pointing is exactly what turns so many of my friends off to Christ and the church.

    I am an oncology nurse and I have the honor of walking with people during some of their most difficult days. Some of my patients live; many do not. This may be news to some of you, but a cancer diagnosis is accompanied by a steep price tag. Amidst uncertainty about the future, these patients face financial stressors that are beyond belief. I have been surprised by an abrupt change in a patient’s blood pressure, only to discover that they were on the phone with the insurance company moments before I walked into the room. I have seen the tear-streaked faces when coverage is dropped after too many days off work during inpatient chemotherapy for leukemia. And the bills continue to arrive long after a battle with cancer has been lost; fees for x-rays, lab draws, and clinic appointments that must be paid by surviving family members, despite the sad outcome.

    I don’t have the perfect answer. I don’t know if socialized medicine would work here. But the current system isn’t working. There is a common saying about healthcare in the US that goes something like this, “Hospitals have to treat you, regardless of your financial background. They can’t turn you away for lack of insurance.” Well, this statement is partially true. Treat you they will. But you will still be charged, the bill will still arrive to your home, regardless of whether or not you can pay. And if you cannot pay – watch out. Loss of credit and bankruptcy are strong possibilities.

    So how does my faith inform my view? I know that God called me to be a nurse; to care for the brokenhearted and the weary. To share laughter and joy amidst crisis. Regardless of financial background. The homeless man, the prisoner, the CEO exec, the self-employed, the unemployed, the college student, the grandmother, the soon-to-be father of twins – they all get leukemia and I have had the honor of caring for each of these people in the past month. Amen GG, these are our friends and neighbors. SP, you quote Mark 14:7, which says “The poor you will always have with you, and you can help them any time you want. You will not always have me.” So Jesus acknowledged the omnipresence of poverty, yet He did not tell people to ignore it. While Jesus never commanded us to rid the world of the poor, he did have another commandment for us.

    Love. “Love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind’; and, ‘Love your neighbor as yourself.’” Luke 10:27. How’s that going for everyone on this discussion board? How are we doing at loving God and loving our neighbor? How does this commandment impact our political views on whether health care is a right, or a privilege?

  • Ken

    Perhaps what this discussion shows best is just how fundamentally altering for any nation the idea of providing health care for all is. As the Supreme Court appears leaning to rule against the current plan hopefully someone will rise with an alternative that addresses that fundamental change required for our nation to embrace the problem and actually come up with something less than thousands of pages of gov’t speak that virtually no one can or could ever understand.

    Here’s hoping.

  • jeb

    i don’t have the ability to wrap my mind around a fiscal solution to the healthcare issue other than the reality that our country continually increasing it’s debt is not sustainable. hence i sit with the idea that government should be involved in less and spending less. however, i do think it is important to know history. so things like the fact that the constitution was written to protect the citizens from the government is important, as is the fact that the governing people have created a cushy little spot with benefits for themselves outside of the healthcare system and laws they set up for the public, that our healthcare system has not been free market driven without the influence of government interference for decades with medicare/medicaid, etc…. Dahlstroms comparison of public organizations such as fire/police and education to the healthcare system don’t add up in my mind. i think it is significant that the first two are locally run and sometimes volunteer. And education brings us back to history. Compulsory government education began in the early 1900′s in New York City when the federal government forced children out of their homes to attend the pilot program school at gunpoint via the national guard. Parents were against someone besides themselves training up their children but could do nothing to stop it short of being shot or thrown in jail. Before that education was much like the fire department in which local people pooled resources to bring in a teacher or a child was apprenticed to someone known by the family who had the skill/trade they were interested in. 100 plus years later, we have forgotten the past and think nothing is odd about our educational system or that these people have gradually taken power over more and more aspects of a citizen’s life. did i mention that literacy in the U.S. population went down 40% once government school took hold in a large nationwide scope? in the past much of the healthcare and educational organizations (think St. Lukes Hospital, Harvard University, the Salvation Army) were begun by the church and people both experienced the love of Christ and heard gospel within these venues. i suspect that one reason (other than power and money) our increasingly ‘religiously hostile’ government wishes to usurp control over these arenas is so that people can be less influenced by Christian teaching.

  • Barry Knight

    I agree that we should be careful as Christians with deferring our task of helping others to the government. However as far as seeking a political solution to assisting the poor with medical treatment, I believe that the Christian church has been active in political issues. The church is outspoken against abortion and homosexual marriage. Christians actively support propositions to limit marriage between a man ansd a woman and most Christians long for the day when Roe vs. Wade is overturned. Both good causes.

    Biblically, where does support against abortion come from (the word is not found in the bible). Typically it is reasonably inferred through Psalm 139. Homosexuality is addressed is both Testaments. However the verses against these two issues are much fewer than verses regarding assisting the poor. Let’s face it, the church is incapable of financing medical care for all those who do not have insurance. Curious how Christians will seek political solutions to abortion and homosexuality, but become upset with government interference over the issue of healthcare, not to mention raising taxes.

    As far as US medical care goes, change is mandated. The US spends 17% of GDP on healthcare and this healthcare does not rank high among industrialized nations. Other nations spend 7-11% of GDP.

    Richard, I applaud your courage in writing about this issue. A brave and perhaps foolish man. I also appreciate the civil comments from others on a difficult issue (I thought about copying a pasting Richard’s opening comments on a political message board to see what carnage would ensue).

    • Ken

      Barry,
      The flaw in your comparison between politically pursuing a change in law on abortion or gay marriage and providing universal health care is money. The costs and effectiveness of simply changing legislative law and perhaps public opinion in abortion and gay issues is a drop in the Pacific Ocean compared to health care. Nice try though. Ooops. Maybe that’s not civil ;)

      • Barry

        I was making no attempt to compare the issues monetarily, only to state that perhaps there also may a Christian ethical issue to provide healthcare to those who cannot afford it. That is not to say Obama’s plan must be supported or that univeral healthcare is even practical. After all the verses to support an anti-abortion stance are a drop in the bucket compared to the Pacific Ocean of verses that call to help the poor.

  • sp

    Richard Dahlstrom — you said this: “even though I live in a culture that doesn’t uphold the gospel, I’m called to work for the good of it anyway, and my convictions, drawn from God’s vision for Israel in the OT, lead me to believe that cultures work best when the inevitable gaps between wealth and poverty are mitigated”

    A couple questions arise for me, in your response:
    1) Are we to apply the model that YHWH used with His chosen people, as a correct/useful/applicable model that should be applied universally to all people?
    2) “in my convictions” is a relatively useless, if not perhaps dangerous, guide. Should “my convictions” become the matter for enforced policy?
    3) What really is, “common good”….and who am I, as one single human-being, to think that I can know what this is for all other 6 billion humans around me? (or, 300+ million in the US of A)
    4) “I’m called to work for the good of it”, you say….and I say, when this thing we call living the Christian Life becomes an “it”, we have moved from relationship to construct. From the heart, to an idea. From the steak, to our sizzle, if you will. The world doesn’t need Christians marching towards them because of “it” or ‘the gospel”, but Christ, and Christ alone…right?

    I think there is a danger to interpreting the construct of the Word, into simply and merely ideas that are useful for beating the drum of “our convictions”.

    • Richard Dahlstrom

      Thanks SP for you question and, thanks to all of you for a good discussion. My week’s quite full so I’ve been reading more than responding, but here are some brief thoughts regarding you question SP.
      1) The question about the extent to which either the church OR nations should appeal to God’s model with Israel is significant, and one of the most divisive issues in Christendom. The reason I believe that Jehovah’s vision for Israel needs to find application in how the church lives today is rooted in Romans 4, among other places, where we learn that WE are now the children of Abraham, the recipients of the covenant. Couple this with Christ’s message of the kingdom as present NOW and yet also still coming, and the reality that we’re Christ’s body, the visible expression of God, and there’s little chance that our faith can be reduced to something merely personal.
      Regards whether it applies to ALL people or not, I’d simply ask on what basis you, granted the privilege of having a voice in your nation’s system, vote? Unlike 1st century Jews, we are granted the privilege of participating in shaping our government and I’d argue all of us do that based on our own values. So yes… I want to live in a nation that honors marriage, treats the widow, orphan, and immigrant with respect, pays its bills, and cares for the poor. You can argue that one party does this better than another, or one candidate, but I hope we all agree that we’re voting because we want our nation to reflect our values.
      2) Most of us believe that the Bible has one accurate interpretation, not many. Still, even among those who believe that, we disagree regarding what that interpretation is. I could, if I were writing an article or book instead of a blog, share why I think my convictions are right. But by sharing “my convictions” rather than saying “the Bible says”, I’m trying to portray with honest humility that the way I read the Bible probably isn’t perfectly accurate, any more than the way you read it is.
      3) the common good is just that – a construct whereby, in this fallen world, oppression and injustice is mitigated so that more people are granted the opportunities of enjoying the common grace of God’s kindness. Yes, I do presume to believe that I have some ideas about what’s better. Not being sold into sexual slavery is better than being sold, so I want my government to address that. Granting equal access to public places rather than having racial policies serves the common good. Environmental laws that forbid the disposal of toxic wastes in rivers serves the common good, as do health regulations in restaurants. A justice system that doesn’t look favorably on bribery serves the common good. I use these examples because I’ve traveled in parts of the world that would be a libertarian’s dream: no environmental or public health laws, no laws to mitigate racism, or classism, or sexism; no commitment to justice. What do I see? Slums and insane wealth living side by side. The poor and marginalized being treated with disdain and offered, perhaps a better life in the future, whether that be heaven or reincarnation. Untimely deaths from food poisoning because dishes aren’t washed in hot water in restaurants. Illiteracy, even though people are ‘free’ to educate their own children. It’s not the utopia people envision. It’s barbarism. So yes… i do presume to know and advocate for some common good. At issue here is whether the American Health Care system has done well serving the common good.
      4. Yes, the Christian life is a person, but the person is a king, and his kingdom has subjects (that’s us) and an ethic (that’s all the examples and teachings of Jesus). Where it seems we ALL agree is that the church MUST work to embody this ethic in both our life together and service to the world. Where it seems we disagree is the extent to which we seek to extend that ethic into the larger community as governmental policy. So yes, CHRIST ALONE… who is our king, and calls us to represent his heart with our time, money, sexuality, treatment of neighbors… and o so much more, probably including our vote.

  • Naomi

    I would like it said of us what was said in remote Himalaya by a witch doctor “the Christians will heal you” as they pray in the name of their Lord Jesus.

  • sp

    I appreciate your response Richard Dahlstrom…in light of your very busy week. Thank you.
    1) Good points. As for answering your question, by what basis I vote: I vote on the basis that it is a right granted me, and one I don’t take for granted…so, I carry out my right as often as I can. This is a legal framework, but that is trivial to this conversation, as this conversation is ideological. It makes up the stuff on which, and by which, I do vote. The fact that I vote is a rounding-error. Annoying to some, and applauded by others, I would presume. But you knew all that, I presume…and I imagine I’m missing your true’er point in how I’m answering, here.
    2) I very much appreciate you pointing this out, Richard. That is one reason I feel I can trust where you’re coming from, and your voice. I too, act on “my convictions”, flawed as they may be.
    3) Using the…I’ll call them extreme for purposes of my response here…examples that you give, such as the sex trade, or the stuff that OSHA handles that could otherwise kill restauranteurs…I think even most hardcore libertarians may agree with you on at least most of your examples there. And yes, this is “common good”…so, I don’t mean to be so blunt in saying that no one could ever know what this “common good” may mean. HOWEVER, when it comes to areas that sit in more shades of grey, it’s not quite as clear, though you may seem to think so from your vantage, and I respect that. And for me, I’m not totally settled on this issue….BUT, I’m far less than sure that it is “common good” for the government to mandate a single-payer system on the backs of the middle — yes, middle — class, as well as those who employ them (which would then, employ LESS of them), because THIS is the common good. I love the idea of utopia as much as the next guy, but honestly, who will pay for this? One of your virtues you mentioned was a government who pays its bills…well…i agree! How about starting by CUTTING programs and expenditures, not expanding them anymore? Yes, that’s right…I’m not on the “hope and change” bandwagon because it was only ever a slick slogan, and only ever will be, run by a slick politician who is less slick nowdays. I’m just trying to differentiate between “common good” and pipe-dreams…and this, is a pipe-dream, here in this world anyways.
    4) Jesus may or may not have voted…I’m not sure. Personally, I wonder if he would have bothered. “Give to Ceasar what is Ceasars”, to me, seemed to imply a relative indifference to politico. I think he would have been looking for a 3rd party-ballot contendor. Someone who caucus’ed withe the “Apocalyptic” party. :-)

    Cheers


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