Black community has new option for health care: The church

Black community has new option for health care: The church

In this May 9, 2021, photo, Rev. Joseph Jackson Jr. talks to his congregation at Friendship Missionary Baptist Church in Milwaukee during a service. He is president of the board of directors for Milwaukee Inner City Congregations Allied for Hope, which along with Pastors United, Souls to the Polls and the local health clinic Health Connections, is working to get vaccination clinics into churches to help vaccinate the Black community. He’s also been urging his congregation during Sunday services to get vaccinated. (AP Photo/Carrie Antlfinger)

MILWAUKEE (AP) — Every Sunday at Friendship Missionary Baptist Church, the Rev. Joseph Jackson Jr. praises the Lord before his congregation. But since last fall he’s been praising something else his Black community needs: the COVID-19 vaccine.

“We want to continue to encourage our people to get out, get your shots. I got both of mine,” Jackson said to applause at the church in Milwaukee on a recent Sunday.

Members of Black communities across the U.S. have disproportionately fallen sick or died from the virus, so some church leaders are using their influence and trusted reputations to fight back by preaching from the pulpit, phoning people to encourage vaccinations, and hosting testing clinics and vaccination events in church buildings.

Some want to extend their efforts beyond the fight against COVID-19 and give their flocks a place to seek health care for other ailments at a place they trust — the church.

In this May 9, 2021, photo, Rev. Joseph Jackson Jr. talks to his congregation at Friendship Missionary Baptist Church in Milwaukee during a service. He is president of the board of directors for Milwaukee Inner City Congregations Allied for Hope, which along with Pastors United, Souls to the Polls and the local health clinic Health Connections is working to get vaccination clinics into churches to help vaccinate the Black community. He’s also been urging his congregation during Sunday services to get vaccinated. (AP Photo/Carrie Antlfinger)

“We can’t go back to normal because we died in our normal,” Debra Fraser-Howze, the founder of Choose Healthy Life, told The Associated Press. “We have health disparities that were so serious that one pandemic virtually wiped us out more than anybody else. We can’t allow for that to happen again.”

Choose Healthy Life, a national initiative involving Black clergy, United Way of New York City and others, has been awarded a $9.9 million U.S. Department of Health and Human Services grant to expand vaccinations and and make permanent the “health navigators” who are already doing coronavirus testing and vaccinations in churches.

The navigators will eventually bring in experts for vaccinations, such as the flu, and to screen for ailments that are common in Black communities, including heart disease, hypertension, diabetes, AIDS and asthma. The effort aims to reduce discomfort within Black communities about seeking health care, either due to concerns about racism or a historical distrust of science and government.

The initiative has so far been responsible for over 30,000 vaccinations in the first three months in 50 churches in New York; Newark, New Jersey; Detroit; Washington, D.C.; and Atlanta.

The federal funding will expand the group’s effort to 100 churches, including in rural areas, in 13 states and the District of Columbia, and will help establish an infrastructure for the health navigators to start screenings. Quest Diagnostics and its foundation has already provided funding and testing help.

Choose Healthy Life expects to be involved for at least five years, after which organizers hope control and funding will be handled locally, possibly by health departments or in alignment with federally supported health centers, Fraser-Howze said.

The initiative is also planning to host seminars in churches on common health issues. Some churches already have health clinics and they hope that encourages other churches to follow suit, said Fraser-Howze, who led the National Black Leadership Commission on AIDS for 21 years.

FILE – In this file photo taken June 6, 2021, first lady Jill Biden, center left, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, Choose Healthy Life public health navigator Linda Thompson and Choose Healthy Life Founder Debra Fraser-Howze, far right, speak to a person as they visit a vaccine clinic at the Abyssinian Baptist Church in the Harlem neighborhood of New York. The church is part of Choose Healthy Life, a national initiative involving Black clergy, United Way of New York City and others, that has just been awarded a $9.9 million U.S. Department of Health and Human Services grant to expand vaccinations and provide screening and other health services in churches. (AP Photo/Craig Ruttle, File)

“The Black church is going to have to be that link between faith and science,” she said.

In Milwaukee, nearly 43% of all coronavirus-related deaths have been in the Black community, according to the Milwaukee Health Department. Census data indicates Blacks make up about 39% of the city’s population. An initiative involving Pastors United, Milwaukee Inner City Congregations Allied for Hope and Souls to the Polls has provided vaccinations in at least 80 churches there already.

Milwaukee is one of the most segregated cities in the country, according to the studies by the Brookings Institution. Ericka Sinclair, CEO of Health Connections, Inc., which administers vaccinations, says that’s why putting vaccination centers in churches and other trusted locations is so important.

“Access to services is not the same for everyone. It’s just not. And it is just another reason why when we talk about health equity, we have … to do a course correction,” she said.

She’s also working to get more community health workers funded through insurance companies, including Medicaid.

The church vaccination effort involved Milwaukee Inner City Congregations Allied for Hope, which is faith organization working on social issues. Executive Director and Lead Organizer Lisa Jones says the effect of COVID-19 on the Black community has reinforced the need to address race-related disparities in health care. The group has hired another organizer to address disparities in hospital services in the inner city and housing, and lead contamination.

At a recent vaccination clinic in Milwaukee at St. Matthew, a Christian Methodist Episcopal church, Melanie Paige overcame her fears to get vaccinated. Paige, who has lupus and rheumatoid arthritis, said the church clinic helped motivate her, along with encouragement from her son.

“I was more comfortable because I belong to the church and I know I’ve been here all my life. So that made it easier.”

___

Associated Press religion coverage receives support from the Lilly Endowment through The Conversation U.S. The AP is solely responsible for this content.

Her Biopsy Report was Benign, But the Bill is a Spot of Contention.

Her Biopsy Report was Benign, But the Bill is a Spot of Contention.

While living in Detroit earlier this year, Brianna Snitchler wanted a cyst removed from her abdomen. But her doctor wanted the growth checked for cancer first. (Callie Richmond for KHN)

 

Brianna Snitchler was just figuring out the art of adulting when she scheduled a biopsy at Henry Ford Hospital in Detroit.

Snitchler was on top of her finances: Her student loan balance was down and her credit score was up.

“I had been working for the past three years trying to improve my credit and, you know, just become a functioning adult human being,” Snitchler, 27, said.

For the first time in her adult life, she had health insurance through her job and a primary care doctor she liked. Together they were working on Snitchler’s concerns about her mental and physical health.

One concern was a cyst on her abdomen. The growth was about the size of a quarter, and it didn’t hurt or particularly worry Snitchler. But it did make her self-conscious whenever she went for a swim.

“People would always call it out and be alarmed by it,” she recalled.

Before having the cyst removed, Snitchler’s doctor wanted to check the growth for cancer. After a first round of screening tests, Snitchler had an ultrasound-guided needle biopsy at Henry Ford Health System’s main hospital.

The procedure was “uneventful,” with no complications reported, according to results faxed to her primary care doctor after the procedure. The growth was indeed benign, and Snitchler thought her next step would be getting the cyst removed.

Then the bill came.

The Patient: Brianna Snitchler, 27, a user-experience designer living in Detroit at the time. As a contractor for Ford Motor Co., she had a UnitedHealthcare insurance plan.

Total Bill: $3,357.52, including a $2,170 facility fee listed as “operating room services.” The balance included a biopsy, ultrasound, physician charges and lab tests.

Service Provider: Henry Ford Health System in Detroit.

Medical Procedure: Ultrasound-guided needle biopsy of a cyst.

What Gives: When Snitchler scheduled the biopsy, no one told her that Henry Ford Health System would also charge her a $2,170 facility fee.



Snitchler said the bill turned out to be far more than what she budgeted for. Her insurance plan from UnitedHealthcare had a high-deductible of $3,250, plus she would owe coinsurance. All told, her bills for the care she received related to the biopsy left her on the hook for $3,357.52, with her insurance paying $974.

“She shrugged it off,” Snitchler’s partner, Emi Aguilar, recalled. “But I could see that she was upset in her eyes.”

Snitchler panicked when she realized the bill threatened the couple’s financial security. Snitchler had already spent down her savings for a recent cross-country move to Austin, Texas.

In an email, Henry Ford spokesman David Olejarz said the “procedure was performed in the Interventional Radiology procedure room, where the imaging allows the biopsy to be much more precise.”

“We perform procedures in the most appropriate venue to ensure the highest standards of patient quality and safety,” Olejarz wrote.

The initial bill from Henry Ford referred to “operating room services.” The hospital later sent an itemized bill that referred to the charge for a treatment room in the radiology department. Both descriptions boil down to a facility fee, a common charge that has become controversial as hospitals search for additional streams of income, and as more patients complain they’ve been blindsided by these fees.

Hospital officials argue that medical centers need the boosted income to provide the expensive care sick patients require, 24 hours a day, 365 days a year.

But the way hospitals calculate facility fees is “a black box,” said Ted Doolittle, with the Office of the Healthcare Advocate for Connecticut, a state that has put a spotlight on the issue.

“It’s somewhat akin to a cover charge” at a club, said Doolittle, who previously served as deputy director of the federal Center for Program Integrity at the Centers for Medicare & Medicaid Services.

Hospitals in Connecticut billed more than $1 billion in facility fees in 2015 and 2016, according to state records. In 2015, Connecticut lawmakers approved a bill that forces all hospitals and medical providers to disclose facility fees upfront. Now patients in Connecticut “should never be charged a facility fee without being shown in burning scarlet letters that they are going to get charged this fee,” Doolittle said.

In Michigan, there’s no law requiring hospitals and other providers of health care services to inform patients of facility fees ahead of time.

Brianna Snitchler’s procedure took place on campus at Henry Ford’s main hospital site. When she got her bill, with its mention of “operating room services,” she was baffled. Snitchler said the room had “crazy medical equipment,” but she was still in her street clothes as a nurse numbed her cyst and she was sent home in a matter of minutes.

With Snitchler’s permission, Kaiser Health News shared her itemized bill, biopsy results and explanation of benefits with Dr. Mark Weiss, a radiologist who leads MediCrew, a company in Flint, Mich., that helps patients navigate the health system.

Weiss said it probably wasn’t medically necessary for Snitchler to go to the hospital to receive good care. “Not all surgical procedures have to be done at a surgical center,” he said, noting that biopsies often can be done in an office-based treatment center.

Resolution: Hoping for a reasonable explanation — or even the discovery of a mistake — Snitchler called her insurance company and the hospital.

A representative at Henry Ford told her on the phone that the hospital isn’t “legally required” to inform patients of fees ahead of time.

In an email, Henry Ford spokesman Olejarz apologized for that response: “We’ll use it as a teachable moment for our staff. We are committed to being transparent with our patients about what we charge.”

He pointed to an initiative launched in 2018 that helps patients anticipate out-of-pocket expenses. The program targets the most common elective radiology and gastroenterology tests that often have high price tags for patients.

Asked if Snitchler’s ultrasound-guided needle biopsy will be included in the price transparency initiative, Olejarz replied, “Can’t say at this point.”

In addition to the pilot program to inform patients of fees, Olejarz said, the hospital also plans to roll out an online cost-estimator tool.

For now, Snitchler has decided not to get the cyst removed, and she plans to try to negotiate on her bill. She has not yet paid any portion of it.

“You should always negotiate; you should always try,” Doolittle said. “Doesn’t mean it’s going to work, but it can work. People should not be shy about it.”

“We are happy to work out a flexible payment plan that best meets her needs,” Olejarz wrote when Kaiser Health News first inquired about Snitchler’s bill.

The Takeaway: When your doctor recommends an outpatient test or procedure like a biopsy, be aware that the hospital may be the most expensive place you can have it done. Ask your physician for recommendations of where else you might have the procedure, and then call each facility to try to get an estimate of the costs you’d face.

Also, be wary of places that may look like independent doctor’s offices but are owned by a hospital. These practices also can tack hefty facility fees onto your bill.

If you get a bill that seems inflated, call your hospital and insurer and try to negotiate it down.

Bill of the Month is a crowdsourced investigation by Kaiser Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!

Her Biopsy Report was Benign, But the Bill is a Spot of Contention.

Her Biopsy Report was Benign, But the Bill is a Spot of Contention.

 While living in Detroit earlier this year, Brianna Snitchler wanted a cyst removed from her abdomen. But her doctor wanted the growth checked for cancer first. (Callie Richmond for KHN)

 

Brianna Snitchler was just figuring out the art of adulting when she scheduled a biopsy at Henry Ford Hospital in Detroit.

Snitchler was on top of her finances: Her student loan balance was down and her credit score was up.

“I had been working for the past three years trying to improve my credit and, you know, just become a functioning adult human being,” Snitchler, 27, said.

For the first time in her adult life, she had health insurance through her job and a primary care doctor she liked. Together they were working on Snitchler’s concerns about her mental and physical health.

One concern was a cyst on her abdomen. The growth was about the size of a quarter, and it didn’t hurt or particularly worry Snitchler. But it did make her self-conscious whenever she went for a swim.

“People would always call it out and be alarmed by it,” she recalled.

Before having the cyst removed, Snitchler’s doctor wanted to check the growth for cancer. After a first round of screening tests, Snitchler had an ultrasound-guided needle biopsy at Henry Ford Health System’s main hospital.

The procedure was “uneventful,” with no complications reported, according to results faxed to her primary care doctor after the procedure. The growth was indeed benign, and Snitchler thought her next step would be getting the cyst removed.

Then the bill came.

The Patient: Brianna Snitchler, 27, a user-experience designer living in Detroit at the time. As a contractor for Ford Motor Co., she had a UnitedHealthcare insurance plan.

Total Bill: $3,357.52, including a $2,170 facility fee listed as “operating room services.” The balance included a biopsy, ultrasound, physician charges and lab tests.

Service Provider: Henry Ford Health System in Detroit.

Medical Procedure: Ultrasound-guided needle biopsy of a cyst.

What Gives: When Snitchler scheduled the biopsy, no one told her that Henry Ford Health System would also charge her a $2,170 facility fee.



Snitchler said the bill turned out to be far more than what she budgeted for. Her insurance plan from UnitedHealthcare had a high-deductible of $3,250, plus she would owe coinsurance. All told, her bills for the care she received related to the biopsy left her on the hook for $3,357.52, with her insurance paying $974.

“She shrugged it off,” Snitchler’s partner, Emi Aguilar, recalled. “But I could see that she was upset in her eyes.”

Snitchler panicked when she realized the bill threatened the couple’s financial security. Snitchler had already spent down her savings for a recent cross-country move to Austin, Texas.

In an email, Henry Ford spokesman David Olejarz said the “procedure was performed in the Interventional Radiology procedure room, where the imaging allows the biopsy to be much more precise.”

“We perform procedures in the most appropriate venue to ensure the highest standards of patient quality and safety,” Olejarz wrote.

The initial bill from Henry Ford referred to “operating room services.” The hospital later sent an itemized bill that referred to the charge for a treatment room in the radiology department. Both descriptions boil down to a facility fee, a common charge that has become controversial as hospitals search for additional streams of income, and as more patients complain they’ve been blindsided by these fees.

Hospital officials argue that medical centers need the boosted income to provide the expensive care sick patients require, 24 hours a day, 365 days a year.

But the way hospitals calculate facility fees is “a black box,” said Ted Doolittle, with the Office of the Healthcare Advocate for Connecticut, a state that has put a spotlight on the issue.

“It’s somewhat akin to a cover charge” at a club, said Doolittle, who previously served as deputy director of the federal Center for Program Integrity at the Centers for Medicare & Medicaid Services.

Hospitals in Connecticut billed more than $1 billion in facility fees in 2015 and 2016, according to state records. In 2015, Connecticut lawmakers approved a bill that forces all hospitals and medical providers to disclose facility fees upfront. Now patients in Connecticut “should never be charged a facility fee without being shown in burning scarlet letters that they are going to get charged this fee,” Doolittle said.

In Michigan, there’s no law requiring hospitals and other providers of health care services to inform patients of facility fees ahead of time.

Brianna Snitchler’s procedure took place on campus at Henry Ford’s main hospital site. When she got her bill, with its mention of “operating room services,” she was baffled. Snitchler said the room had “crazy medical equipment,” but she was still in her street clothes as a nurse numbed her cyst and she was sent home in a matter of minutes.

With Snitchler’s permission, Kaiser Health News shared her itemized bill, biopsy results and explanation of benefits with Dr. Mark Weiss, a radiologist who leads MediCrew, a company in Flint, Mich., that helps patients navigate the health system.

Weiss said it probably wasn’t medically necessary for Snitchler to go to the hospital to receive good care. “Not all surgical procedures have to be done at a surgical center,” he said, noting that biopsies often can be done in an office-based treatment center.

Resolution: Hoping for a reasonable explanation — or even the discovery of a mistake — Snitchler called her insurance company and the hospital.

A representative at Henry Ford told her on the phone that the hospital isn’t “legally required” to inform patients of fees ahead of time.

In an email, Henry Ford spokesman Olejarz apologized for that response: “We’ll use it as a teachable moment for our staff. We are committed to being transparent with our patients about what we charge.”

He pointed to an initiative launched in 2018 that helps patients anticipate out-of-pocket expenses. The program targets the most common elective radiology and gastroenterology tests that often have high price tags for patients.

Asked if Snitchler’s ultrasound-guided needle biopsy will be included in the price transparency initiative, Olejarz replied, “Can’t say at this point.”

In addition to the pilot program to inform patients of fees, Olejarz said, the hospital also plans to roll out an online cost-estimator tool.

For now, Snitchler has decided not to get the cyst removed, and she plans to try to negotiate on her bill. She has not yet paid any portion of it.

“You should always negotiate; you should always try,” Doolittle said. “Doesn’t mean it’s going to work, but it can work. People should not be shy about it.”

“We are happy to work out a flexible payment plan that best meets her needs,” Olejarz wrote when Kaiser Health News first inquired about Snitchler’s bill.

The Takeaway: When your doctor recommends an outpatient test or procedure like a biopsy, be aware that the hospital may be the most expensive place you can have it done. Ask your physician for recommendations of where else you might have the procedure, and then call each facility to try to get an estimate of the costs you’d face.

Also, be wary of places that may look like independent doctor’s offices but are owned by a hospital. These practices also can tack hefty facility fees onto your bill.

If you get a bill that seems inflated, call your hospital and insurer and try to negotiate it down.

Bill of the Month is a crowdsourced investigation by Kaiser Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!

Is Black Church Culture Unhealthy?

Is Black Church Culture Unhealthy?

“Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God? You are not your own…. Therefore honor God with your body.” 1 Cor. 6:19-20

It is well known that blacks live sicker and die younger than any other racial group. Look no farther than the church with the pastor battling hypertension and diabetes or the congregation with several obese members sitting in the pews. It would seem that the black church in America would be the leading ally supporting the nation’s first black president in the debate over access to affordable healthcare. It would seem that the black church would lead the way toward healthier eating and living.

Could it be that black church culture is leading us astray?

I thought about this during a recent conference in Baltimore on black global health. The International Conference on Health in the African Diaspora, hosted by the Johns Hopkins Center for Health Disparities Solutions, brought together healthcare professionals and researchers, from across the Western Hemisphere to discuss common health problems among the descendants of African slaves. Black Arts Movement icon Sonia Sanchez set the tone as the keynote speaker July 4, inspiring the crowd with a special poem for the occasion. The award-winning author participated throughout the weeklong conference.

Listening to a sister from Brazil and a brother from Peru discuss high rates of obesity, diabetes, infant deaths and the spread of HIV/AIDS among blacks in their countries sounded like the health crisis of black New York, Chicago, or the Mississippi Delta. Modern racism and the legacy of slavery haunt all of us. Participants also shared solutions and pledged to work together. In fact, according to Dr. Thomas LaVeist, a book and curriculum addressing these health themes are being created for the public and for high school and college educators. Thomas, who happens to be my brother, directs the Hopkins center and is the mastermind behind the conference, which is scheduled to take place every two years.

Solutions are basically what government and institutions can do to end racism and ensure all people have access to quality affordable healthcare and what blacks can do themselves to care for their “temples of the Holy Spirit.”

The black church should be more outspoken in support of increased access to quality affordable care. Our cousins from Canada and Central and South America, who for the most part receive varying degrees well-executed and poorly-executed universal healthcare, are puzzled as to why we richer Americans are debating what the rest of the industrialized world has long settled — that healthcare access is a God-given human right, not a privilege to be determined by profit-seeking private insurance companies.

After the conference, Thomas told me that the Catholic Church (obviously many Catholics are also black) has been the most vocal Christians on healthcare, mainly around the debate on whether Catholic organizations should be mandated to support abortions for employees (some evangelical Protestant organizations have recently joined that fight, too). Thomas suggested the traditional black church denominations could find their unified voice by calling for all Americans to be insured (Obama’s Affordable Care Act would still leave 20 million people uninsured). However, regardless of what the government does, black churches should lead by example with healthier eating and living, he said.

BAD FOR THE SOUL? Black churches are routinely feeding their people unhealthy soul food staples such as fried chicken and macaroni and cheese. Is that biblical?

“Black church culture is out of alignment with some biblical teachings, particularly when it comes to how we eat,” my brother said. “Church culture has got us drinking Kool-Aid, eating white bread, fried chicken, large servings of macaroni and cheese and collard greens drenched with salty hog maws (foods that are high in sugar, salt, calories, and carbohydrates that trigger health problems). We’re eating this in the church basement at dinner and at church conventions! Meanwhile, the Bible teaches against gluttony.”

Don’t judge or condemn those who are obese, but encourage and show everyone how to eat healthy, Thomas added. He cited Pastor Michael Minor of Oak Hill Baptist Church in the Mississippi Delta as pushing the healthy eating message that all black churches should adopt. The Delta is one of America’s poorest areas and leads the nation in obesity, diabetes, and heart disease rates. In 2011, Pastor Minor, known as “the Southern pastor who banned fried chicken in his church,” banished all unhealthy foods and insisted soul food meals be prepared in healthier ways; many of his members are losing weight and improving their overall health. Other churches across the country such as, First Baptist Church of Glenarden in Upper Marlboro, Maryland, are on similar missions.

Ask yourself, when it comes to health, what is the black church best known for?

What might the state of black health in America (and the African diaspora) be if your answer was healthy eating and living?

‘Obamacare’ Is About Access, Not Excess

‘Obamacare’ Is About Access, Not Excess

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?