MASS REPEAL: Calls for the dismantling of President Obama’s signature healthcare legislation have gone into overdrive since the Supreme Court ruled the law as constitutional last month. (Jonathan Ernst/Newscom)
The federal government has not taken over health care. The federal government has taken over access to health care. There is a difference.
When I was a student at Morehouse College in the early 1970s, activists launched a campaign to address the shortage of African American doctors in the state of Georgia. They produced bumper stickers that asked “Only 100 Black doctors in Georgia?” with a map of the state’s 139 counties in the background. With many of those 100 doctors concentrated in urban areas such as Atlanta, people voiced clear concern over access to health care for thousands of African Americans in rural, poor and remote areas. Morehouse College President Hugh Gloster responded to this concern by founding the Morehouse School of Medicine, which joined Howard University Medical School, Meharry Medical College and the Charles Drew School of Medicine (similarly founded to address access issues in the Los Angeles area) as the nation’s only predominantly Black medical schools.
Were the government to have taken over health care, the government would be proffering medical diagnoses, prescribing medicine, and performing surgery. This is not the case. What the Supreme Court’s ruling upheld on June 28 was not government-controlled health care, but a federal system that expands access to health care for millions of Americans, mostly poor and many people of color. In a country where national strength finds measure on barometers of military might and economic prosperity, Scripture connects a nation’s well being to its care for the poor. In the fifth chapter of the biblical book bearing his name, Jeremiah challenges his nation, saying:
5:26 For among my people are found wicked men: they lay wait, as he that setteth snares; they set a trap, they catch men.
5:27 As a cage is full of birds, so are their houses full of deceit: therefore they are become great, and waxen rich.
5:28 They are waxen fat, they shine: yea, they overpass the deeds of the wicked: they judge not the cause, the cause of the fatherless, yet they prosper; and the right of the needy do they not judge.
5:29 Shall I not visit for these things? saith the Lord: shall not my soul be avenged on such a nation as this?
And among the judgments God speaks through Ezekiel, health care stands prominently:
34:4 The diseased have ye not strengthened, neither have ye healed that which was sick, neither have ye bound up that which was broken, neither have ye brought again that which was driven away, neither have ye sought that which was lost; but with force and with cruelty have ye ruled them.
Interestingly, the arguments against the healthcare reform upheld by the Supreme Court do focus on the problem of systemic access, and the price to be paid for it — whether the price is monetary in the form of the penalty for failure to carry health insurance or individual liberty in the form of governmental coercion. Yet in both cases, the plight of the poor and needy, the sick and infirm, goes unaddressed. How to make health care accessible for those on the margins of society receives little attention from those who would dismantle “Obamacare.” Promises to repeal the legislation without offering a clear alternative for how we as a nation make health care available and accessible to all persons reduces “the least of these” to political pawns, whose lives represent fodder for a political machine designed to appeal to the self-interests of America’s middle class.
UPHOLDING THE LAW: Supporters of President Obama’s healthcare reform rallied outside the Supreme Court chambers prior to the Court’s historic ruling on June 28. (Jonathan Ernst/Newscom)
Such a move must be resisted by President Obama and supporters of the legislation. The president campaigned for much of 2008 by appealing to that same middle class. He has lost some of their support with his championing of this version of reform, but that is precisely because our electoral system makes it difficult to appeal to a moral high ground as a strategy for garnering support (unless the issues revolve around sexuality and/or abortion). Some who have been disappointed by the president but still support him for reelection need to become more vocal in raising this issue above individual self interest to the moral high ground, much as Jim Wallis and Sojourners put forth the notion that poverty is a moral issue in the 2004 presidential campaign.
The question of access to health care ought matter significantly to people of faith. But it is easy to see how a church whose own theology promises personal prosperity apart from systemic issues of justice can miss the mark of its high calling to care for the poor. Indeed, it is as if a central claim of many messages draws directly from the Rev. Frederick J. Eikerenkoetter, better known as Reverend Ike: “The best thing you can do for the poor is not be one of them.”
Our ministry to the sick must move beyond prayer and visitation, and our work amongst the poor requires more than acts of charity. Justice questions continue to loom large in a nation with rampant inequality in quality of life, minimized access to maximal care, and economic stumbling blocks that tie the quality of health to possession of wealth. The spiritual gift of healing is not restricted to those in a specific economic category. If God’s divine, miraculous intervention to bring healing cannot be tied to social status, why should not a national healthcare philosophy be similarly non-discriminatory?
The Supreme Court ruling on the constitutionality of the Affordable Care Act provides the opportunity for the various agencies: government, hospitals, physicians, pharmaceutical companies, insurance companies, and employers to move with plans for implementation. It is good news for many who currently have little if any access to health care.
While many decry the “intrusion of big government,” an unanswered question for Christians who have opposed healthcare reform is “how has the church mobilized on behalf of the sick and the poor?” In other words, could it be that the intrusion of “big government” in part reflects a gaping hole in our mission to care for the least of these through ministries of mercy, prayer for healing, and advocacy for the oppressed? Are we so busy with “destiny and prosperity” that our attentions have been taken from our responsibilities to fulfill Jesus mission in Luke 4 and Matthew 25?
RELIGIOUS LIBERTY UNDER FIRE?: Supporters of religious freedom and against President Obama's HHS mandates on faith institutions rallied in front of the HHS building on March 23. New protest rallies led by Catholic and conservative groups are taking place around the nation. (Photo: Olivier Douliery/Newscom)
Last Friday at noon, hundreds of demonstrators gathered on Capitol Hill and at rallies across the nation to protest President Barack Obama’s health-care law and, specifically, the law’s mandate requiring employers to provide insurance coverage for contraceptives.
Conservative politicians and activists led the charge, with leaders such as Minnesota congresswoman Michele Bachmann declaring, “This is about, at its heart and soul, religious liberty. … We will fight this and we will win.” Bachmann’s battle cry represents a growing movement of religious conservatives who contend that the president’s plan violates their freedom and beliefs.
Growing up, I had the opportunity to attend a Catholic school until my senior year. As a result, I know first-hand the strong commitment to pro-life causes that many Catholics hold. For instance, as a choir member, it was an annual tradition for us to sing at the youth mass that occurred before the Right to Life March, a protest against Roe v. Wade. Abortion, euthanasia, and the death penalty were topics that came up regularly in religion class. So it came as no surprise when I heard that 34 Catholic organizations have filed 12 federal lawsuits challenging the U.S. Department of Health and Human Services’ birth control mandate under the Affordable Care Act (also known as “Obamacare”).
Under the mandate, employers are required to provide access to contraceptive services as part of their health plans at no cost. However, as President Obama stated during a February 10 press conference, “[W]e’ve been mindful that there’s another principle at stake here — and that’s the principle of religious liberty, an inalienable right that is enshrined in our Constitution. As a citizen and a Christian, I cherish that right.” Knowing that many religious institutions oppose the use of contraceptives, originally all churches were exempted from the requirement. Now, that exemption is extended to any religious organization that has an objection to providing contraceptives; in those cases, the insurance company is responsible, not the organization.
To many people, including Christians, this sounds reasonable. So, why are Catholic organizations complaining?
The problem, they argue, is in the definition of “religious organizations.” In a lawsuit filed by Catholic organizations in Washington, D.C., the plaintiffs state that the mandate requires religious organizations to satisfy four criteria.
• First, the organization’s purpose must involve teaching and sharing religious values.
• Second, employees must subscribe to the same faith.
• Third, the organization must primarily serve those that subscribe to the same faith.
• Finally, the organization must be a non-profit.
“Thus, in order to safeguard their religious freedoms,” the lawsuit continues, “religious employers must plead with the Government for a determination that they are sufficiently ‘religious.’ ” Failure to adhere to the mandate could lead to penalties and fines. Since many Catholic organizations, such as hospitals, charities, and schools, employ and extend services to people of different faiths (and many people who claim no faith at all), it would be difficult to prove they are exempt from the mandate based on religion.
“If a group isn’t perceived as ‘religious,’ then they will be forced to provide drugs that violate their doctrine,” says Chieko Noguchi, the Director of Communications for the Archdiocese of Washington, one of the plaintiffs. “If the government can order us to violate our conscience, then what comes next?”
But don’t think that this is just a Catholic issue. According to the mandate’s opponents, it affects all Americans who profess to believe in God.
“One of the central missions of any church is supporting the less fortunate in our communities,” writes Lutheran pastor Joe Watkins in a June 3 editorial for the Philadelphia Inquirer. “With this mandate’s redefinition of a religious institution, many charitable operations will effectively be driven out of business. Under the new law if you are a Lutheran charity and you provide help to or hire non-Lutherans, you cease to be a religious institution. The same goes for Catholics, other Protestant denominations, and all other faith-based organizations.” He also argues that this will not only impact all religious groups, but also those who are either influenced or helped by these groups, since more time would be dedicated to religious background checks for potential employees and clients.
“It is distressing that our government would opt for a coercive and unfair regulation that requires us to make such an impossible choice,” Watkins wrote. “As a church, we have always opposed the use of drugs and procedures that are abortion-inducing. … Under this new governmental regulation, though, just by simply following our beliefs, we will face penalties under law.”
Watkins isn’t alone in his critique of the mandate. Back in February, some 2,500 Catholic, evangelical, Protestant, Jewish, and other religious leaders signed a letter asking the President to “reverse this decision and protest the conscience rights of those who have biblically based opposition to funding or providing contraceptives and abortifacients.” Also, the Catholic Church is planning to invite evangelicals for their upcoming event “Fortnight for Freedom,” which will take place the two weeks between June 21 and July 4 in order to bring attention to religious freedom issues.
In his speech announcing changes to the mandate, President Obama reflected on his first job in Chicago working with Catholic parishes in poor neighborhood. “I saw that local churches often did more good for a community than a government program ever could, so I know how important the work that faith-based organizations do and how much impact they can have in their communities.”
I am living proof of the positive effects of the faith-based organizations that President Obama described. I’m a proud, non-Catholic alumna of a Catholic school who understands why Catholics and their supporters are upset and concerned by the Affordable Care Act’s implications for religious freedom. By defining what a religious organization is, the HHS mandate could potentially hinder Christians from living out their faith with integrity. We, as Christians, are called to serve others no matter what. As a self-professed believer, President Obama should’ve recognized this.
What do you think?
Are Catholics and their conservative allies overreacting to the mandate or do they have a point?
As the U.S. Supreme Court wrestles with the constitutionality of President Obama’s Affordable Care Act, and especially the “individual mandate” provision requiring every capable American citizen to buy health insurance, many people continue to frame the debate as one of individual rights versus socialized medicine. They view a law requiring all citizens to buy insurance as a violation of fundamental American freedoms. I’d suggest the opposite: requiring all Americans to own health insurance is actually a demonstration of American patriotism and solidarity.
Allow me to explain.
Guess how many states today have laws that REQUIRE citizens TO BUY insurance? FIFTY. That’s right, folks. Every single one of them. Red states as well as Blue states require citizens to buy insurance. To be more specific, every single state requires citizens who drive motor vehicles to buy liability insurance to cover any damage they might inflict.
Now of course this law doesn’t apply to everyone. There are two primary classes of people who do not have to buy automobile liability insurance. Those who don’t drive. And those who can prove financial responsibility to cover any damage they might cause up to a certain limit.
The rationale behind these laws requiring citizens to buy liability insurance is simple. There is a significant risk that anyone who drives a motor vehicle may, over the course of their lifetime, cause an accident which causes damage to the property or bodies of others. There is a strong societal interest in making sure that those so injured can be compensated for their losses. You cannot buy insurance to cover an injury after you cause it. You have to have the insurance ahead of time. The insurance covers the damages caused by negligent drivers. Of course, this cost is paid for by all of the non-negligent drivers who pay their premiums every month without causing any damage. Hence, the requirement that ALL drivers, negligent as well as careful, carry liability insurance.
Those of us who live on planet Earth are also at significant risk of needing medical treatment at some point in our lives. We may contract a disease, be injured as the result of an accident, or develop some other illness or chronic condition — sometimes as the result of our own choices, sometimes not. There is a strong societal interest in making sure that those who need medical treatment can afford treatment for those illnesses. There is also a strong societal interest in making sure that those who provide medical treatment are compensated for having done so.
Health insurance, like any other form of insurance, only works if there is a shared assumption of the risk. Insurance companies rely on actuarial tables to assess the risk and base their rates accordingly (after factoring in a healthy profit, of course). Healthy people have to pay into the program so that sick people are covered. Previously, insurance companies could refuse coverage or charge significantly higher rates for people with pre-existing medical conditions. The current legislation seeks to prevent that by spreading the risk around to all citizens.
Now some may argue that health insurance is different than auto insurance because only people who drive motor vehicles have to purchase insurance. Granted that is true, mandatory health insurance should only be required of citizens who might be expected to contract, carry, pass on, or suffer from a medical condition, or sustain an injury requiring medical treatment. Of course, since I’ve yet to meet another human being who doesn’t fit that profile, I think it’s safe to say it applies to everyone. All of us are vulnerable to physical injury and ailments. Only corpses are not at risk of needing health care.
For those who still think the individual mandate is a violation of one’s individual freedom, another option would be an opt-out provision. To be effective, this kind of provision would need to come with the understanding that those who opt out are not entitled to receive any medical-care treatment that they haven’t paid for prior to the administration of the treatment. Kind of like buying broccoli at the grocery store — you can’t take it home and eat it until you’ve paid for it. If you opt out and don’t have the money when a health issue hits, you’ll get no EMT care, no ambulance ride, no appendectomy, no CPR, no emergency room care, no cancer treatment, no life-saving procedures.
Nada. Zip. Nothing.
If you think this is a cruel approach to health care — leaving people to suffer or die who can’t afford treatment — I agree with you. But what justification for entitlement to treatment can people give who, given the chance to share the risk with the rest of us, REFUSE to do so?
Mandatory health insurance is PATRIOTIC. It exemplifies the highest ideals of the American public — a willingness to stand up with our fellow citizens against threats against any of us. That means patriotic citizens who are willing to fight and die in the military against threats to the rights and freedoms from our enemies. And it means patriotic citizens being willing to pay for our fair share to spread the risk around, standing together against threats to our health. We don’t want our fellow citizens to be denied health insurance by insurance companies because they have pre-existing medical conditions, or to be charged so much they can’t afford it. We don’t want our fellow citizens losing their homes because of catastrophic illness. We don’t want our fellow citizens buried in debt which they can never repay because of some medical misfortune. We’ve got each other’s backs. That’s how we roll.
May God bless America, and may every American citizen be willing to shoulder his or her fair share of the risk to provide medical care for all, even if it means the government requiring us to buy it.
POINT/COUNTERPOINT: Protesters from either side of the political divide have descended on Washington this year to make their cases for the preservation or elimination of federal programs.
I have to ask myself: am I part of the American majority who wants to scale back government expenses — as long as none of my personal benefits are touched?
I confess: I turned 63 last week, and I don’t want Social Security or Medicare reduced or — heaven help us — privatized.
I have personal reasons.
My husband and I have been saving heavily for 20 years, have paid off the mortgage on our modest house, have nursing-home insurance policies, and have no debts whatsoever. Nevertheless, our retirement accounts have been significantly diminished by the recession of 2008-11, and the future of stocks and bonds does not look good. Without Social Security to supplement our savings, we’d have a rough retirement.
Both of us take good care of our health. We’ve never smoked, and we exercise daily. We eat no red meat, few desserts, and lots of whole grains, vegetables, and fruit. My weight has always been right where it’s supposed to be, and his isn’t far off. Nevertheless, I’m scheduled to have open heart surgery next week, and I will need to have costly check-ups and possibly medications for the rest of my life. Without Medicare, I’d probably have a very short retirement.
So yes, I’d much prefer that we strengthen Social Security, Medicare, and our entire health-care system and stop paying for 46.5 percent of global military spending, for example.
But my reasons are not entirely personal. Although my husband and I are the kind of people Republicans love (and Jesus worried about), we will be in trouble if the senior safety nets come down, right along with people who have had to face unemployment, divorce, foreclosure, addictions, natural disasters, accidents, disabilities, and catastrophic illness; right along with people who don’t know how to manage money, who abuse their health, and who long ago stopped thinking about tomorrow (see my personal blog for an earlier post, “The United States of Florida“).
Really, folks, this isn’t a question of deserving. As Jesus pointed out, God “makes his sun rise on the evil and on the good, and sends rain on the righteous and on the unrighteous” (Matthew 5:45). God may or may not be the sender, but I’ve noticed that crap falls on both the good and the bad as well. We all benefit from God’s grace, and we’re all just one step away from catastrophe.
Government programs can’t give us comfortable lifestyles if we have no job and no savings. They may not be able to give us good health if our bodies are faulty or abused. They can’t keep us from getting old and dying. What they can do is help us — all of us who need help — have food, shelter, and necessary medical care.
By the way, I’m not saying that Social Security and Medicare are our most important social programs. Nothing is more important than educating our young, and comparative test scores show that the U.S. is in trouble here (22nd place in math!). Still, many of our suburban schools are excellent. We say we believe in equality of opportunity: what are we doing to assure that all of our children, no matter where they live or how much their parents pay in property tax, have access to good schools?
Back to my main point. If all of this means additional funding — a payroll tax on all earned income, for example, and not just the first $106,800 — so be it. If it means ending President Obama’s extremely unwise payroll tax holiday, so be it. If it means I have to pay more taxes, so be it.
Our government is not only of the people and by the people, it is also for the people. May Lincoln’s vision of a nation dedicated to the common good not perish from the earth.
Our culture’s current brand of political strife is nothing compared to the division and hostility that prevailed in the first century. Yet, despite opposition, the Great Physician boldly demonstrated what it means to welcome and care for “the least of these.”
Last month the United State House of Representatives voted to pass health-care reform, thus affording millions of medically uninsured Americans the opportunity to secure basic health-care as a civil right. This historic legislative act is an attempt for America to become a more civil society (with regard to “the sick and poor among us”) — similar to most other first world (and some third world nations) like Canada and parts of Western Europe. During my four-year stint in England to work on my doctorate at the University of Manchester, my family and I were under the National Health Care system (NHS) whereby every citizen and resident was assigned a general practitioner in the area. Quite a paradigm shift from what we’d known in the United States.
Despite the significance of such a major legislative passage in our nation, a partisan dispute continues. The reform measures were largely supported by Democrats, the uninsured, and sympathetic others. But Republicans and some among the privileged class argue that the legislation will bankrupt America in various ways. They also resent the fact that their tax dollars will be used to help pay for the coverage of less-privileged individuals in our society.
Contention over this legislative act has sparked volatile tension and a curious rash of narcissism: seemingly ordinary citizens (protesters) have reacted with a sense of barbarism, hurling racial slurs and other derogatory epithets at members of Congress. Reports of Congressman Emanuel Cleaver of Missouri being spat upon by angry protesters are now well known. Likewise, Congressmen John Lewis of Georgia and James Clyburn of South Carolina were heckled and called “nigger” as they passed protesters outside the House chambers.
It’s enough to make one recall the violent emotion and political chaos that set the scene for Jesus’ arrest and subsequent trial before Pilate:
Now the chief priests and the elders persuaded the crowds to ask for Barabbas and to have Jesus killed. The governor again said to them, “Which of the two do you want me to release for you?” And they said, “Barabbas.” Pilate said to them, “Then what should I do with Jesus who is called the Messiah?” All of them said, “Let him be crucified!” Then he asked, “Why, what evil has he done?” But they shouted all the more, “Let him be crucified!” So when Pilate saw that he could do nothing, but rather that a riot was beginning, he took some water and washed his hands before the crowd, saying, “I am innocent of this man’s blood; see to it yourselves.” Then the people as a whole answered, “His blood be on us and on our children!” So he released Barabbas for them; and after flogging Jesus, he handed him over to be crucified. Then the soldiers of the governor took Jesus into the governor’s headquarters, and they gathered the whole cohort around him. They stripped him and put a scarlet robe on him, and after twisting some thorns into a crown, they put it on his head. They put a reed in his right hand and knelt before him and mocked him, saying, “Hail, King of the Jews!” They spat on him, and took the reed and struck him on the head. (Matthew 27:20-30, NRSV)
Similar to modern America, the late Second Temple Judaic period (the period in which Jesus lived and ministered) was as diverse, volatile, and politically charged as our world today. Under Roman rule, heterogeneity with regard to philosophical thought and religious sentiments set the backdrop of first century Palestine. In Palestine, the Israelites maintained a sense of religious Judaic tradition. As an imperial province, new ideas were viewed with suspicion, especially if they challenged traditional thought and the status quo.
Although Judaism by no means was a unified monolith, certain fundamentals were foundational (the function of the Temple, observance of the Mosaic Law or Torah, embracing monotheism, and the expectation of a prophesied Messiah). As a result of tradition and the law, many in the society, especially the sick, were prohibited full inclusion in social-civil-religious life; this led to legal disenfranchisement and marginalization.
As recorded in the New Testament Gospels, Jesus both lived and functioned in this type society. Throughout the Gospels, he went about engaging and healing many who were sick. Jewish purification laws first outlined in the Pentateuch set social-civil-religious policy against persons considered impure: the leper, those with bodily discharge, the lame, and even the Gentiles. The acts of Jesus were contrary to the current policy. In Mark 5, Jesus interacted with a demon possessed man (who dwelled among corpses), was touched by a woman considered impure with bodily discharge, and touched the corpse of a young boy. In all three cases, Jesus enacted legislative health care (healing that went contrary to current policy), thus restoring these individuals back to full participation in the society.
As a result of his universal health-care plan, as well as his controversial declaration that he was the incarnate Son of God, Jesus was persecuted, spat upon, and mocked. James 5:14-16 sums up the kind of health-care plan that Jesus enacted:
Are any among you sick? They should call for the elders of the church and have them pray over them, anointing them with oil in the name of the Lord. The prayer of faith will save the sick, and the Lord will raise them up; and anyone who has committed sins will be forgiven. Therefore confess your sins to one another, and pray for one another, so that you may be healed. The prayer of the righteous is powerful and effective (NRSV).
Our newly passed health-care legislation is a good start and will likely help many who are in need. Nevertheless, it’s still an imperfect plan, the patchwork result of much political squabbling and strife. But the health-care plan of Jesus is something altogether different. It is comprehensive, unfailing, and truly universal.