Thriving vs. Surviving: Thoughts on Health Care & the Common Good

Caveat: These musings have little to say about the specifics of the current health care bill (though a few are mentioned at the end). Rather, my thoughts are aimed at considering why universal health care might be a benefit to society. Moreover, my intent is to provoke empathy for those who live their daily lives without health care and hopefully generate an authentic concern for these 40 million men, women, and children. My hope is this: if we can at least all agree that health care for all is a good and much-needed proposal, then we have a common ground from which to begin. In essence, I want to establish the why before arguing about the how. Perhaps once the urgency of the problem is seen we might lay aside our selfish pragmatism and work together for the common good. (yes I know this is silly because only 8 people will read this, but that's OK. A songbird doesn't sing to be heard, it sings because it has a song)

Ok. Thoughts on Health Care & the Common Good

Many opponents to health care reform claim that everybody in the US who needs care can and does get it. For example, no child with a broken arm is getting turned away from a hospital just because s/he lacks health insurance. Doctors have to help these people who are in need and, thankfully, they do everyday! Ok, fair enough.

But I'm curious to know: what happens to that boy's mother/father or caretaker after his broken arm is mended? Is that the end of the story? How much debt do they owe to the hospital/doctor? And how will that debt - whether payable or not - affect their ability to thrive in society?

I recently received a bill from my doctor for $270. You know what I had done? She sprayed warm water into my ear canal to unblock wax build up. $270. Thank the Lord I have insurance and will only pay $30 of that.

How much would emergency care cost? A broken arm? Stitches? $1,000? $10,000? $20,000? (The average cost of a night in the hospital is between $3-5,000 The average childbirth: $7-10,000)

How does the cost of these common medical procedures have crippling effects on their recipients?

When a family is burdened with medical debt, their income is already pledged elsewhere. How does medical debt rob its sufferer of the ability to plan for or invest in the future? How does medical debt inhibit a person's ability to obtain credit and loans? How does medical debt rob its casualties of the ability to "pull themselves up by their bootstraps?"

And how does a Federal Minimum Wage of $7.25 allow anyone with significant debt to get out of it?

And here is the crux: medical care is not the patient's fault! Nobody is to blame for an accidental broken bone or contracting a flu virus. These things happen. Why should a family spiral into (or remain in) poverty because mom has asthma or a child needs an appendectomy?

"But Josh, health and wellness is a lifestyle. It is a preventive lifestyle. I don't have to go to the doctor but twice a year because I take care of myself. Many health problems are preventible. So many people who can't get health insurance don't take care of themselves in the first place. They eat McDonald's and drink Colt-45."

Agreed. And that is why people without health care do not thrive, they survive. People who lack health insurance do not take preventative measures like regular check-ups or catching health problems early. Why? Because it is too costly. If they can deal with it, they don't go to the doctor (I am much the same way, but when I finally can't put up with my ear-ache anymore, I don't have to think twice about whether or not I can afford a visit to the doctor, I go). The only time the uninsured get care is when their survival is jeopardized. Thus, these people are not thriving, they're merely surviving.

Why should a tax-paying citizen of the wealthiest nation in the world be afraid to go to the doctor for a sore throat? Are these citizens undeserving of "comfort" health care or preventative care? Should they only get care when their life is on the line?

What kind of mental and emotional condition will result from these fears? How much self-value will people have when they're told that they're not worthy of medical care?

It's no wonder that the "have-nots" are not patriotic. It's no wonder that unhealthy children do not perform well in school and rarely climb out of the lowest echelons of society.

Sure, nobody is saying those words outright, but what message is sent through the current system? Are the 40 million uninsured really not deserving of medical care? I thought the constitution answered that one: the preamble calls us to "promote the general welfare." And what about the Declaration of Independence? "...that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness."

Whatever happen to the Common Good? Wasn't Dr. King correct in saying, "Nobody is free until we are all free?" Don't we become better as a community, as a people, as a nation, as a world, not individually?

Yes, you can argue that nobody in America is getting turned away when their life is on the line, but is that the best we can do? Is that really good enough? Or are most of us just content because we're taken care of?

And what do these "survivors" look like? Surely they're not the better contributors to society. I know that when I have a headache I am irritable. When I have a sore throat I am lazy and bitchy. When I have a stomach bug I sometimes skip class or work. I am a much better (and more productive) person when I'm healthy.

And we might as well take note of the obvious correlation between health insurance and life-expectancy. Certainly those with good health insurance will live longer than those without; this is seen in the middle-upper class life-expectancy compared to lower class life-expetancy (furthermore, compare infant mortality rates and deaths from preventable causes! Talk about PRO-LIFE!)

Are these the quality of citizens we want to be producing as a society? (Remember, we are shaped by our social structure! There is a reciprocal relationship: as we shape society, it shapes us back) Think about it. Physically unhealthy people are like wounded soldiers. Unhealthy people are negatively affected by their health and they affect their surrounding environment as well. Physically unhealthy people are also emotionally, socially, and spiritually unhealthy. Let's not forget that God's redemption is material and physical as well! The Incarnation (Jn 1:14), as well as Paul's writings in 1 Cor. 15 and Romans 8 are strong affirmations of this.

We cannot just pretend that these "wounded soldiers" are not part of our community! They pump your gas and serve your food and fix your car and clean your bathroom and pick your produce! These are "the least of these." These people are not our social servants, they are our sisters and brothers.

Physical health is a basic human right. And most perspectives agree on this - whether for or against health care reform. But our current status quo leaves too many people to just get by, to not-die, to survive instead of thrive.

How great is the void in society when many of our members aren't able to contribute their potential? What might happen if more citizens were empowered through healthy lives and able to break the cycles of debt and poverty? What might the nation look like if 40 million people who currently have grim outlooks on life and contribute little to society, received a much-needed hand?

Health care to the poor is not a socialistic gift, it's an investment! We're talking about the greater good of society, not handouts to an ungrateful, undeserving class of leaches. Health care is an investment that has the potential to produce quality people. The evidence is already in: we see it everyday in middle-upper class America! Healthier people are more successful and more productive. The uninsured need someone to lend them some care. They need someone to invest in them and give them a real chance to pursue life, liberty, and happiness.

I'd like to take a moment to debunk a common misconception regarding the American Dream: Nobody ever gets anywhere in life on their own - nobody. At some point or another a person must receive some help. Whether it's time, money, trust, love, health care, or some other resource, nobody can get anywhere in life without the investment of another person. This concept is made clear in our own lives and is driven home both theologically and practically in the Bible.

We are a community. We need one another. That's the beauty of life. I give, you give. It's the power of "we."

So? I'm at a point of discontent. I would not be content playing on a soccer team if my forwards were limping. Yeah I might win some games, but I would know that we're not playing to our full potential. Neither can I be satisfied with my nation - one of the best places to live in the entire world - when my neighbors are hurting; when my neighbors are working hard but receiving little help in this essential area of basic health care. I don't think Dr. King was the most pragmatic person when he said, "No one is free until we're all free." But I think he was onto something about the reality of our world. Similarly, I don't think Jesus, - the Son of God, the Way, the Truth, and the Life - was very pragmatic when He said, "The Kingdom of God is at hand. Heal the sick, raise the dead, cleanse lepers, cast out demons. You received without paying, give without pay" (Mt. 10:7,8).

No I have not discussed details of the current bill, which is the actual matter at hand; so perhaps this is simply an abstract, idealistic rant. But I also strongly believe that if we can at least all agree that this is a pressing matter, we can enter into a process of communal problem-solving to help our brothers and sisters in need. Perhaps if we can all agree that the need for health care is vital and immediate, then perhaps we might stop shouting down every idea that is proposed (though certainly it is OK to disagree with parts of the bill!). If we can simply see together the long-term benefits of health care, then maybe we will stop resisting every suggestion regarding health care as if it is evil. Maybe if we lay the common ground that the need is substantial, then maybe we can start listening to one another instead of depending on a sound-byte, spin-cycle media.

These town hall meetings are a perfect example. Some go wonderfully. Others don't. The ones that do seem to have a desire for respectful dialogue and a common assent that health care is greatly needed. The ones that have turned into monstrosities seem to have involved people who do not desire dialogue and do not see the real need for health care in America. My hope is that we can at least see the need together. That is a starting point. Disagreement is expected and good. But can we please at least recognize that the need is real? And might we also see the hopeful potential of what could be with a nation of healthier citizens? This is my appeal. Where there is great need there is also great hope.


Regarding two specifics of the health care bill:

There are two main rumors that are causing a ruckus. The first is that the bill will mandate abortions. As if abortion alone isn't already terrible, the thought of the government mandating them is just sickening. I agree that this is awful - that's why I looked into it.

It turns out that the bill states nothing about "mandating" abortion. Everything in the bill about abortion is hypothetical. (No, that does not make it OK) But here is the deal: because the current law states that abortion is legal, the health care bill is obviously going to put in pieces of legislation that cover it.

Here is where all the rumors come from: "Unless the legislation explicitly excludes abortion procedures, pro-life lawmakers predict that abortions will soon become part of the required insurance package." (see http://www.worldmag.com/articles/15729)

What this is saying is that unless the package explicitly prohibits abortion (which won't happen because it is currently legal), then there will always be a chance that the insurance will provide care for an abortion. Thus, pro-life advocates can make the deductive inference that this bill mandates, produces, or encourages abortion.

But that's like saying that if you're not "against" something then you are "for" it. I'm not sure if it's that simple. Moreover, it would be hard to put an explicitly anti-abortion piece into the health care bill when the current law allows it. I'm not saying that it's OK, I'm just trying to debunk the rumor.

What else is good is that the current health care package is subject to the Hyde Amendment which currently prohibits Medicaid from funding abortions except in rare circumstances (see http://www.usnews.com/blogs/god-and-country/2009/08/04/does-house-healthcare-bill-fund-abortion-depends-on-whom-you-ask.html)

Another promising fact is that lower-income women do not get abortions as commonly as middle-class women (see David Claerbaut, "Urban Ministry in a New Millenium") The reason for this is that most lower-class women are minorities and these women value the status of being mothers. Culturally it is a sign of womanhood and maturity. It also gives women a sense of purpose and often fills the void for authentic love in their life. Children also provide a security since most of these low-income parents will need care when they are older. It is a misconception that lower-class, uneducated women get abortions.

This is great news since most of the 40 million Americans who need health care are in this category. How significant, then, is a piece of legislation that states that the government will cover an abortion when the recipients of the health care don't commonly get abortions in the first place? It's almost like saying "I'll buy you ice cream if you want it" to a lactose-interolerant person who rarely eats ice cream.

Furthermore, the good news is that health care might actually decrease abortions! Nations with universal health care have less abortions and higher birth rates (see http://www.abort73.com/index.php?/abortion_facts/us_abortion_statistics) How much more likely is a woman to give birth when she knows she won't have to foot the $7,000 bill?

None of this is to say that abortions are OK. Absolutely not. It's tragic and I stand firmly against it. All I'm saying is that the current rumors that somehow the government will have control over women to force abortions, fund abortions, or even encourage them, is downright untrue. The health care bill is merely remaining in accord with the current law that legalizes abortion as a civil right. Thus, it has included insurance that will cover it should a woman desire.

Listen to the language. Think. Critique it. Is it fact? Or is it hypothetical? In this case, most claims about the health care bill mandating abortion are merely hypothetical.


The second rumor is the infamous "death panel." I don't want to discuss this at length because it has largely been debunked already by most news sources.

I understand that there could be situations where a mentally unstable elderly person is persuaded by a doctor. That is certainly possible. But wait, doesn't that situation already exist? Don't elderly patients already heed their doctors advice about things - prescriptions, procedures, etc.? And don't insurance companies already deny coverage after coverage because their clients are "too costly?"

The thought of the government evaluating its citizens by standards of costs is scary. But I don't think we should get the heebie-geebies because it's the "the government." We seem to be OK with private insurance companies constantly evaluating us and telling us what care we can and cannot receive. Let's not jump ship just because some people are screaming the word "socialism." After all, Canada and other European nations haven't fallen into a socialistic state.

Please put trust in this fact: the government cannot and will not kill someone against their will. That is Orwellian conspiracy talk and it's not going to happen. It takes months - sometimes years - of deliberation to put a criminal to death! Surely no one is going to be put to death against their will, whether old or young.

A great irony must be pointed out here: the many people scared that the govt. will euthanize elderly are scared about the same thing that many uninsured elderly are afraid of - death due to their govt.'s lack of care. One is scared of the government's involvement, the other is scared of the government's lack of involvement! Both, however, are deserving of the best medical care possible because both are human beings made in the image of God.

So as far as the "death panels" go, yes, it's possible that an elderly person might be influenced by a meeting with a doctor about the realities of death. Should the government try to persuade the elderly to end their lives? No! And the aforementioned constitutional rights ought to support that! But on the other hand, how good that the government is willing to pay for the elderly to receive counseling and financial guidance for the actualities that come with death. Is this not a talk that is already happening in doctor's offices across America? I don't see what the big hullabaloo is about.

I am afraid that many who are opposed to this bill are simply using anything and everything to induce fear. That is wrong because it is destructive. It does not encourage respectful dialogue and it does not promote the greater good. Disagreement is fine and necessary to generate the best solutions. Deceitful scare tactics are a tragic interference with democracy and illustrate our inability to work together.

C'mon, America. You can do it. Respectful debate, not demonizing feuds. Ears to listen, not voices to dominate. Hope for improvement, not fear of change. Hearts for the needy, not the self-centered status quo. And a vision for the whole, not just the parts.