A Christian view on Health Care

Christians desire health and wholeness, and call for our public institutions to encourage such.   Just as Jesus’ witnessed to the old, infirm and sick, church communities have been intimately involved with healing.  In our modern age, many denominations established hospitals and mutual aid societies.   But we have a problem: Americans spend the most on health care anywhere, but get the worst health care in the developed world.  This is because of the system of incentives that makes profit the center of the relationship between patient, doctor, and intermediate institutions, not health.

Some would object that it is Churches and not government, who should be working for such a change. Yet, if Christians truly were to embody the virtues of self-control and charity, they would drink moderately, refrain from smoking and keep a trim waistline.   Christian doctors would provide free health care and churches would create free clinics. Churches would also create mutual aid societies and cooperatives that would help mitigate the everyday illnesses and injuries that occur on a regular basis. This would be an appropriate religious response to our current health care crisis.  However, these are often challenging to manage and require immense resources to care for catastrophic events or long-term care.

Until churches make such contributions to their communities, public reform is the next best option.  A public option would decrease inefficiencies in the private health care market, encouraging companies to cut bureaucratic fat and coordinating administrative paperwork.

As institutions, churches would benefit from a reformed health care like other small businesses.  I’m fortunate:  most of my employees have health care under their spouses.   However, I could get the public option, my church would have more money to spend on mission.   My church can’t afford my getting married.  It means I can only marry someone with better health care than I have.

Health care would change the culture in a variety of ways.  One of which is subtle.  It would integrate society in a way we have not seen since the military was integrated.  It is one of the few places where both poor blacks and poor whites will benefit.   That many of the protestors are whites who feel disenfranchised exemplifies how universal health care will crush the ideology that connected socialism, civil rights and liberalism:  a resilient theology that has been losing credibility since both capitalism and civil rights won.

The Democrats should be aware that a policy that penalizes individuals, however, will end their current position as the party in power.  A universal health care system, however, will shift both parties to the left, ending the rightwing alliance of race populism, tax-cuts and nationalism.  A strong health care system would destroy the Republican party.  Blue Dog Democrats should realize that passing such a health care program will make their positions stronger, not weaker, with their constituents.

A universal system will bring down costs, liberate a sector of the economy trapped by insurance bureaucracies, give small businesses greater freedom in hiring employees, and further integrate our culture.  A mixed economy will catalyze the market.  People will need to be employed as caregivers rather than as insurance bureaucrats.  It will be easier to hire people full time.   It will restore that constitutional idea that the responsibility of the government is for the general welfare of all people.

I understand the resistance.  The Israelites resisted Moses.  Many wanted to return to Egypt.  They created false idols.  Remember – for some people, the idols probably worked.   Just as the current health care system works for some people.  But it doesn’t work for everyone.  There is a promised land.  It’s time for us to move toward it.

Party Priest

Fr. Malia’s been warned.

I’ve heard he is theologically quite conservative.  Most of his money comes from his own company.

Still, I think he can spend the money as he sees fit.

My own intuition is that he’s not connected to the diocese in any clear way.  Did he ever contribute to the diocese’s charitable projects?  Buy the bishop a bottle of bourbon for Christmas?  I have a sense that the only time the bishop heard of him was from the Daily News!

I am the Bread of Life

Yesterday I contined with the David story.

David’s been, as one parishioner noted, “a cad.”  His moral choices have been questionable and have undermined confidence in his leadership.  His son has decided to take matters into his own hands.  He’s a rebel.   He’s not the first son to rebel against his dad.

Not only that, Absalom had twenty thousand Israelites supporting him.  Now that the Israelites have vanquished their enemies, they are turning on their own.   This number is meant to convey total war.    Civil war.

Absalom has one adviser who is honest, reliable, and close to David.  Yet, he’s also the traitor to David.  The other is shrewd, self-promoting and slimy.   When the first is absent, the second moves in and gives Absalom bad advice.  Absalom becomes trapped.  The other, realizing that this will not end well, commits a sort of seppuku:  an honor suicide.

In spite of David’s orders, when Absalom is trapped, Joab kills Absalom.  The rebellion is crushed.  He’s completed what David commanded him, while also, perhaps rightfully, questioning David’s military judgment.  Can’t have any hint of future rebellion.  The slaughter must be total.  Think Scarface.

It’s not a simple story about a military action.  This is not how the military works, not the military we know.  It’s not how nation states work, except, perhaps, subconsciously.

It’s more like the Mafia.  David is the don; Joab is a boss or captain.   We’re in a world where pride, honor and face are important commodities.  They are worth dying and killing for.    If you want to understand this story – watch mafia fills.

When David finds out his son is killed, however, he asks himself if his position is worth it.  He is confronted with the consequences of his own narcissism and power.  Violence is impossible to control.

David asks why?

I imagine that several of you are asking “why” noting several tragedies that have become icons for our national condition:  the shooting of four young women; the homicide of eight people in the accident on the Taconic.   It’s easy to want to give God some advice here, but what we have to remember is that we know God through our freedom to make choices; and we have here two people who were enslaved to their rage; or to alcohol.  When Jesus says, “I am the bread of life” he is offering a metaphor, a symbol that is supposed to remind us that in him, we are free.  The alternative is a world where we are simply puppets in God’s grand plan.  But such a world would be dull and ugly.

Now there are constituent parts to this.  I will divide it into three parts – just for simplicity’s sake.  The first is gratitude – a remembering of the good things we’ve done and experienced.  The second is joy – experiencing the pleasures of this life now.  The third is hope that tomorrow is going to get better.  At different points in our lives we will find that the balance between gratitude, joy and hope will change.  But those are your emotional tools, constituent elements of what we call “love.”

But to access those tools, to open the toolbox, you’ll need a key.  And that key is the bread of life.  When Jesus  says “the bread of life” he invites us to stay connected, to be present for each other.  This means, in practice, the work of calling, gathering, even partying, working on the common task.

The murderer and the mother were both isolated.  The man couldn’t get a date; he probably spent most of his time on the computer.  He probably found social skills hard, and couldn’t get out of the despair and resentment that would kill him.   The mother was so isolated that nobody knew of her addiction and loneliness.  With such separation, it’s easy to make decisions that will get people killed.

Paradoxically, our current system of cooperation makes us both more interdependent, and isolated.

David, being at the top, is in an isolated position.  It’s part of the nature of being on top.  But he realized how deeply his connection to his son meant and wept when he lost what was most dear to him – not his status, but his son.    That is a hard lesson to learn.

I am the bread of life, Jesus says.  The community understood that only gathering together, or sharing each other s stories, of sharing gratitude, joy and hope, would they have any way of surviving into the future.  It would not be easy.  The end of time would not happen as soon as many had hoped.  But it was enough to know that their lives were worthy, and that they didn’t need to be isolated or forgotten.

We’re connected, Jesus says.  You have part of me in you.  You will always have my love.  Don’t ever feel I am so far away.    I am as close as your family, your friends, and even the strangers you live so near but barely know.  You are not alone.  I am the bread of life.

How to Talk about Health Care

How should we discuss health care?

One of my favorite theologians wrote:  “”Conversation is a game with some hard rules: say only what you mean; say it as accurately as you can; listen to and respect what the other says, however different or other; be willing to correct or defend your opinions if challenged by the conversation partner; be willing to argue if necessary, to confront if demanded, to endure necessary conflict, to change your mind if the evidence suggests it.”

I’ll expand.

First, get the story right.  Old people won’t be euthanized under a new health care plan.  There’s no risk we’ll suddenly become like Albania.    Be accurate.  Don’t be the guy who angrily said to his representative, “Don’t let government touch my Medicaid!”

Learn about how other countries handle health care.  Read about Kenneth Arrow’s famous essay on health care economics to learn why we are where we are.   Check out the Cato Institute and their arguments and compare to the Economic Policy Institute.

Second, discern the best argument from the side you disagree with.   Will there really be rationing of health care?  Will the quality change?  Will it overwhelm the system?  What if there is less inventiveness in technology or medicine? Is health care economics different than buying food?  What is “recissioning?”    Does more technology always mean better health?  How does fee for service compare to results based care?

Third, be aware about why you believe what you believe.  Have you had good health care?  Have you had to fight insurance companies?   Did you have poor or excellent experiences in countries where insurance was regulated or provided by the government?  What are YOUR criteria for assessing a good or a bad health care plan?

Fourth, give yourself some distance from slogans.  Although there are many uses of the media, it tends to manufacture conflict via sound bites.  The news cycle spent a week of pontificating on the word “stupidly” rather than on health care. The media will sometimes repeat wrong facts that go viral. Not everything on the internet is true.

Fifth, remember that change rarely happens neatly.  It took 40 years for the Israelites to find freedom; it took 100 years between the civil war and the Voting Rights Act.     There will always be some messiness.   There will be unexpected and unintended consequences.

Last, no plan will be perfect.  There will be trials along the way.   A comprehensive health care plan will surely change the economy and our society in some fashion, but it will not mean the end of what makes our faith or country worthy.

Thomas Frank on “Stupidly.”

And now comes Gates-gate, this latest burst of fake populism from the right. Waving the banner of the long-suffering working class, the tax-cutting friends of the top 2% have managed to dent the president’s credibility, to momentarily halt his forward movement on the health-care issue….

But when he sits down for that can of beer in the White House, it is another passage from his book that I hope Mr. Gates remembers. Speaking for liberal academics, he wrote in 1992 that “success has spoiled us; the right has robbed us of our dyspepsia; and the routinized production of righteous indignation is allowed to substitute for critical rigor.”

Today the cranking out of righteous indignation is a robust growth industry, and it threatens to do far worse than cloud our critical faculties. Help us to put the culture wars aside, Professor Gates. Too much is on the line these days.

The entire article.

Happiness Secrets

I’m a “happiness junkie.”

After reading an Atlantic article on George Vaillant, I found his suggestions for happiness, especially for men

  • A good marriage before age 50
  • Ingenuity to cope with difficult situations
  • Altruistic behavior
  • Stop smoking
  • Do not use alcohol to the point where your behavior shames you or your family
  • Stay physically active. Walk, run, mow your own grass, play tennis or golf
  • Keep your weight down
  • Pursue education as far as your native intelligence permits
  • After retirement, stay creative, do new things, learn how to play again
  • Lectionary for Proper 13

    2 Samuel 11:26-12:13a, John 6:24-35

    I’ll be preaching a bit on David, Bathsheba and Nathan tomorrow.

    David was a success in battle.  Now he is at leisure and has too much time on his hands.

    He has a wandering eye.  He sees Bathsheba.  She’s the wife of Uriah, who is a good guy, a bubba, a reliable chap, a good soldier.  You can rely on Uriah.  He might be a team leader or a commander himself.  He’s fought for his country well.   He was probably descended from an immigrant, the sort of immigrant who loves his new country and is very proud of it.  He’s a military man.

    So David commits adultery with his wife, and she gets pregnant.  And everyone will know that it will be David’s child.

    People in the court know.  They fetched her.  We don’t have her voice in the text, so we’re not sure if it was consensual, or if she submitted passively, or if she was seduced by his good looks and status, or if she was an opportunist.

    David does not want to be found out.  So he wants Uriah to lie with his wife so that David won’t take the blame.

    He hatches a plan, a clumsy one, to have Uriah killed.  The soldies will go to battle, and pull back.  But it is a transparent ploy; so to protect David, Joab sacrifices other soldiers so that it will remain a secret.  Most  likely, not only Uriah, but other soldiers died.

    In order to avoid being blamed, other people got hurt.

    David says, “oops.  Collateral damage.  We didn’t mean for that to happen.  We were at war.  And we had our enemies.  It is such a tragedy.”  It’s cynical, but he didn’t want to be discovered.

    I will probably discuss how easy it is to blame other people, rather than look at our own behavior.  It seems that lots of righteous people like to think of themselves as anointed.  Then they find ways, excuses, to justify their own actions.

    Jesus says, “for the bread of God is that which comes down from heaven and gives lif to the world.”  Jesus is referring to the transcendent future.  Apart from the immediate world to which we easily react, Jesus is talking about the long view:  eternity.  This is the food that endures for eternal life.

    Most of the time, “thrill wins over will,” but with knowledge of the transcendent, a belief in eternity, we can live better lives now.  The really good stuff is a belief in a healthy future that helps us shape what is truly valuable.  But it is a narrow path, and requires discipline and vigilance.

    The benefits of magnanimity; of honesty; or restraining our desire is not always immediate.  They are long term.  And the scriptures commend and warn us:  our enemies are not undocumented workers, soldiers, gay people, straight people.  The work we must usually do begins with our own hearts.