‘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?

Questions for Conservatives About Healthcare Reform

On Sunday evening as I was relaxing after dinner, my gallbladder violently rebelled against the meal (scrambled eggs and sautéed zucchini). This would not be worth writing about, except that, for the first time in my adult life, I don’t have health insurance. When, late last year, Blue Cross and Blue Shield of New Jersey informed me that my $600+ per month individual plan rate would increase to $753 (just for me), I knew I was done. My husband is retired with a work-related medical disability, you see, and we were fast approaching financial insolvency as we awaited the resolution of his decade-old workers’ compensation case. (That’s a story worth telling about the kinds of people who can outlast insurance companies in court, but one for another day.)

As I was doubled over in pain and retching in my bathroom, I begged God for relief so that I wouldn’t have to go to the emergency room and possibly have a surgery that would plunge my family into thousands of dollars worth of debt. I thought about the millions of people who have lived this reality for years and felt ashamed of myself for having been so indifferent to their plight for so long. God answered my prayer eventually, but I woke up Monday morning dry heaving from the taste of bile rising in my throat.

I made an appointment with my primary care physician, hoping he would give me the green light to delay the surgery that had been recommended last year until August, when I’ll be eligible for NJ Protect, a federally subsidized health insurance plan for New Jersey residents who have pre-existing conditions, but who haven’t had health insurance for at least six consecutive months. The doctor did give me the green light to wait, along with dietary and homeopathic recommendations and a prescription in case I have another attack. For this, I paid $100.

Do Economic Conservatives Believe Small Business Owners Will Be a Drain on the Economy?

Before he came into the room, however, I told his nurse that I would need him to fill out a form for NJ Protect affirming that I have a pre-existing condition. She began grilling me about my situation. “Can’t you get a job?” she asked. “I have a job. I’m an independent journalist,” I said. She wanted to know how I get paid. God only knows why I submitted to this inquest, but I told her I have contracts for steady work, but given the state of journalism (especially since fall 2008 when I moved from California back to New Jersey and began job hunting), it doesn’t matter how hard or much I work, I will never be able to afford $753-a-month for health insurance. I didn’t bother telling her about my supplementary work in catering or substitute teaching, and I didn’t tell her that I’d just been tapped for a coveted vocational school teaching job that I had to decline because of the kind of senseless bureaucratic regulations that many, including me, fear “Obamacare” will usher in.

Her rudeness got me thinking though. What is it, I wonder, about my free-market loving friends that makes them willing to suggest, even by default, that entrepreneurs and small business owners like me will be a drain on our national resources or that we have some sort of moral obligation to take corporate jobs in order to be deserving of affordable health care? I’m not speaking of her, of course, but of the plethora of conservative pundits who rail incessantly against the Patient Protection and Affordable Care Act in the name of freedom. I don’t get it. Are they saying I shouldn’t be free to choose the kind of work that best suits me, my God-given temperament, and the needs of my family? Or that if I do, tough luck when I get sick? If it weren’t for the exorbitant cost of health care, I’d be earning enough income right now to meet my family’s modest financial needs. We can even manage the subsidized plan at $369-a-month now that my husband’s case has settled, but that’s a function of the ACA, so they’d like to deny me that.

Do Family Values Conservatives Think Mothers Reentering the Work Force Are Undeserving of Health Care?

On Tuesday, someone asked me what I thought of the Supreme Court ruling on the ACA. I took a deep breath and said I was glad it wasn’t struck down, because I need affordable health insurance sooner rather than later and the ACA is the engine that will give it to me.

I probably would have opposed it a decade ago when my husband was earning a six-figure income in home improvement sales and we were owners of an apartment building in addition to our own home. But then my husband’s back gave out and he spent several years trying to do other kinds of work before he was forced to retire at age 47. He now lives in crippling pain every day and takes care of the house. His medical expenses will be covered for the rest of his life through Medicare, a supplementary plan that we pay for, and workers’ comp. He’s eligible, in part, for these benefits because he worked outside the home and was injured at work, while I mostly stayed home and raised children for 20 years.

So, what I’d also like to know is why the family values crowd thinks it’s okay to abandon women like me, who bought into their message and eschewed careers, but then had to re-enter the workforce because of death, divorce, or disability without the benefit of a strong work history? Is this really how they want to repay us?  You know, the uninsured mothers who serve as teachers’ aides in their children’s classrooms, or bring them their salad at The Cheesecake Factory, or wipe their aging parents’ bottoms so they don’t have to?

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And, what about my fellow pro-lifers? All they seem concerned about when it comes to the ACA is the contraception mandate. Don’t they care about women like me who dropped out of college to have our babies instead of aborting them because we heard and believed their message, but then are forever playing catch up career-wise? Don’t they owe us some level of fidelity for living out what they merely preach? Or did we only matter to them when our stories affirmed their cost-free convictions?

These are serious questions, not accusations. A freedom-loving, family values, pro-life writer is asking them.

Now, I understand that one reason an individual health insurance plan is so expensive in New Jersey is because insurers here are not permitted to discriminate against people with pre-existing conditions and insuring everybody drives up costs. But, I thank God New Jersey is ahead of the curve in this regard. In California, I could not purchase insurance for my son after he was routinely kicked off our family plan as a young adult and then diagnosed with a debilitating, uninsurable condition.

He eventually got well with the help of a generous doctor who treated him on the cheap and a county health service that he still uses because so few specialists take his lousy $190-a-month individual plan. You see, he works for a non-profit organization as a warehouse supervisor, but like many employers, his employer hires most of its workforce for just under the number of hours at which employer-delivered health insurance is mandatory. I know what “government” care looks like and it isn’t pretty, but it’s something and I thank God for it.

I frequently hear insured people say that if the ACA survives, it will mean they won’t have access to timely medical care. This tells me they not only believe they have a right to health care, but that they have a right to the prompt delivery thereof. And yet, they don’t seem to think people like me and my son have any right to it at all. Well, I disagree with them. I need heathcare reform and I think I deserve it, not from “the government,” but from the society that my family and I have contributed to and served for most of our lives. I’m not saying Obamacare is the answer. I’m only saying that we need to solve this problem and the uncaring rhetoric of my conservative friends is speaking so loudly that I’m finding it difficult to hear anything else they’re saying about healthcare reform.

*Please note: an editorial change has been made to this article.

Supreme Court to Judge Affordable Care Act

Happy Second Birthday; Some Hope There Won’t Be a Third

Friday was the second birthday of the Patient Protection and Affordable Care Act, but the bill may not see a third if the Supreme Court strikes it down after hearing arguments on the act’s legality this week. At least, that’s what Doug Carlson of the Southern Baptist Ethics & Religious Liberty Commission hopes will happen.

“The Department of Health and Human Services (HHS) issued a rule requiring that, under state health care exchanges, every enrollee in these insurance plans must pay a $1 surcharge directly into an account for abortions,” Carlson said. This comes after a January HHS directive that would require most religious employers to provide free contraception and other controversial reproductive health services in their insurance plans caused a political and religious fury.

Yale Legal Scholar Says Act Will Survive Supreme Court Scrutiny

But it would be “remarkable” if the Supreme Court struck down the act’s individual mandate to purchase health insurance and “revolutionary” if it struck down the act’s “extension of Medicaid to increase coverage for the poor,” Jack M. Balkin, Knight Professor of Constitutional Law and the First Amendment at Yale Law School, said at The Atlantic. Overturning the medicaid expansion would “throw into doubt the way that modern federal government works with states and it would jeopardize many popular social programs,” Balkin said.

Projected Employer Insurance Dump Could Reduce Deficit

The Affordable Care Act will cause a lot of employers to “dump people on government-run exchanges to get them off their neck,” Philip Klein, senior editorial writer for The Washington Examiner, said in an interview with CBN News. But a new Congressional Budget Office report “argues that dramatic increases in employer dumping could reduce, not expand, the deficit,” Forbes “Apothecary” blogger Avik Roy said in a post at The Atlantic. In another post, Roy said the idea that the U.S. health-care system is predominantly a free-market one is a myth. “In reality, per-capita state-sponsored health expenditures in the United States are the third-highest in the world, only below Norway and Luxembourg. And this is before our new health law kicks in.”

President’s Standing With Catholics in Jeopardy

Nonetheless, the campaign of religious conservatives against the act “is taking some toll on the president’s standing with Catholics,” The Washington Post reported. The article cited a new survey from the Pew Forum on Religion and Public Life that found “the percentage of white Catholics who said the Obama administration is unfriendly toward religion has nearly doubled since 2009, from 17 percent to 31 percent” and, among all Catholics, the percentage rose from 15 percent to 25 percent.

Republicans Have Troubles of Their Own

Republicans have problems with their own alternative to the president’s plan, however. On Thursday, House Republicans “voted to eliminate language in their healthcare reform bill that said the U.S. healthcare industry affects interstate commerce, which Republicans feared could undermine their argument that the Democrats’ 2010 healthcare law abused the Commerce Clause of the Constitution,” The Hill reported.

Prayer Rallies Left and Right

On Friday, pro-life groups held rallies in cities around the country to protest the “unjust violation of our religious liberty by the Obama Administration’s contraception, sterilization and abortion-inducing drugs mandate” and, on Sunday, they surrounded the Supreme Court building to pray “that justice may be done in these proceedings” and that “the religious freedom and freedom of conscience will be respected, that there will be no taxpayer subsidizing of abortion, and that the US Constitution will be honored.”

Today religious supporters of the act who want to “help people of faith move beyond cable news interpretations of health care reform” will follow suit by encircling the Supreme Court for prayer during oral arguments. According to The New York Times, their plan originated in the White House earlier this month.

As someone who joined the ranks of the uninsured this year for the first time in my adult life, I’ll be watching debate about the Affordable Care Act closely. I don’t know what the best solution is to the problem of unaffordable health insurance, but like an increasing number of Americans, I need one.

What do you think?

Do you want to see the Patient Protection and Affordable Care Act enacted or overturned?