Health Care – are you looking for a consistently Christian ethic?
Sunday, September 20, 2009 at 02:51 So patiently have I watched speeches being given in the well of Congress and YouTube, news clips from various “Town Hall Meetings”, and Presidential speeches from across the ocean, painfully aware that while we are debating some of the biggest moral issues of our national identity I am overseas. On the one hand, I long to be there to have some conversations with folks – friends, acquaintances and acquaintances of friends that I see posting emotional, coded and often very ill informed half thoughts on their pages. But, on the other hand, I am thankful that I am here, because for the last four years I have had residence in two countries that have supplied health care for my family – Denmark and the UK. Especially when my four month old was on the verge of a diagnosis of Cystic Fibrosis and received full, extensive, unqualified and very responsive testing and medical care. And now as I am starting my doctoral studies and could not otherwise afford health care for my family within one week of registering, we have all had medical and dental check ups – and we got to choose our doctors.
I know that is only anecdotal, but it is first person, and many of the anecdotal accounts arguing against public health care are not based on stories or facts, but fears and misconceptions. I share my story in order to do an end run around the stereotypical idea that when we talk about “those people” who don’t have health care we are talking about poor folks who are uneducated, or lazy folks who are trying to game the system and are just too proud to get a job at McDonald’s. No. We are talking about me. I am an ordained clergyman in the Lutheran Church who has been serving communities of faith in Pennsylvania and Denmark, traveled around the world to minister with communities in South Africa and Brazil, I am working on my PhD in Theological Ethics, and I am married to a woman who has a BS in Elementary Education and has educated children in the US and overseas, and we currently don’t have US health care. Because of my overseas status, the Church in which I have devoted my life much like many small businesses, will not give me short term coverage and when I come back to the US for Christmas with my two American children for the better part of a month I’m still not quite sure how I am going to cover their health insurance. I am a tax paying, voting, productive and contributing citizen who will not have access to affordable health care for his family next Christmas. You see, when we talk about Health Care, we are talking about those who are in fact homeless and jobless for whom this discussion should matter as much as my presence in their uninsured ranks, but we’re also talking about me and millions of fully functional contributing Americans like me and my family.
I have written before about my own experience of health care as a stranger in a foreign land, and it was met with mixed reviews that unfortunately fell along predictable lines. People either dismissed my views as “liberal” (which is not a theological category), or because I live overseas I either don’t understand or it doesn’t apply to the American context. Even though I write theologically, my thoughts were interpreted through people’s political lenses. There is nothing more frustrating that starting a conversation about faith only to have it derailed by pre-critical, entrenched cultural views that are incongruent with categories of faith and therefore stifle our ability to have faithful conversation about difficult ethical issues. Given that the current debate has reached a fevered pitch, I am going to try again. But this time, I want to approach the topic of health care not from a familiar place that can be quickly categorized by a political perspective, but starting to think faithfully from a neutral place that I think all of us can resonate with, and therefore demands your theological reflection …Freedom.
It’s a long post, but I’d love for you to come along for my thoughts, and leave your faithful reflections at the end. Here we go:
In my family’s devotions this morning, we were reading a passage from Mark – the one where the Pharisees ask Jesus about paying taxes using a coin that has an image of Caesar on it. The repercussions of course are that by participating in idolatrous taxation systems, he is breaking the Divine law, but by not participating in it, he is breaking the Civic law. Both are punishable…so, Jesus, what’ll it be? Not willing to let the Pharisees have all the fun, the Sadducees immediately follow up with a question about a woman who was married to seven brothers according to the Law of Moses. After the resurrection, to which one would she be married? Turns out, it was a trick question, because the Sadducees don’t even believe in the resurrection. So, their question was not even consistent with their beliefs. The conflict was created just to trap Jesus in an argument that, by virtue of its inconsistency, has no right answer.
As a person of faith, I wonder if you feel like this – caught in the middle of this conflict over Health Care in the US. I think you feel conflicted because in the public arena, there are two poles vying for your support, except just like the Pharisees and the Sadducees, the two choices presented are both inconsistent. And it’s the inconsistency that traps you to make a false choice. How can you choose which perspective is more aligned with what your faith tells you, when elements of each option conflict with different tenets of your faith? What would you give for a perspective that was actually consistent with your beliefs?
Well, these kinds of questions must have caused Jesus to ring his hands much for the same reason. He clearly saw the false choices that were simply designed to ensnare loyalties and tangle the mind. But he was able to see the consistently faithful way around these conflicts. And do you know what he did to sort out the tough issue? First he stepped to the side and did not answer the question because, having been presented with options that are inconsistent with God’s will, there is by definition no way to derive an answer that is consistent with God’s will. To find the faithful answer, he reframed the issue in a way that led to faithful consistency. That is what opened their eyes and left them amazed.
In much the same way as the Pharisees, most of the conflict over Health Care confuses issues of faith and politics, tangles Divine law and Civic law in a mish mash that ends up serving neither God nor the social order. And in trying to discuss our perspectives, most of us end up inconsistently contradicting one set of beliefs (caring for our neighbor) in order to support another set (ideas about government and economics), just as the Sadducees did. So to find a path that is consistent with faith, let’s kindly step to the side of the fearfully distracting political conflicts, and reframe the issue by considering a concept that I believe is consistently at the heart of the Health Care debate, but is never talked about as such – Freedom.
I want to refer to a couple of illustrations to get started. The first is a recent facebook tête-à-tête that my wife found herself in over the past few days. The origin of this unfortunate dialogue was a man who is married to a doctor, and is fortunately well off enough to stay at home with his toddler and write on facebook all day – he has health insurance. He wrote, “anything I can keep the government out of is for the better, especially when it comes to my money or (more importantly) my wife's livelihood”. A second person plugged into the conversation and complained about living in Florida and having a bunch of dual citizen Canadians snowbird and clog up Florida’s waiting rooms so that it takes her two weeks to get a mammogram. Ignoring the little fact that by definition these “dual citizen invaders” are actually Americans, she ended her diatribe by keeping her hard earned money and not wanting to wait in line at the DMV. (By the way, I’ve lived in two countries with national health systems, and between my son’s battery of critical blood tests, and our regular family check ups, the longest we’ve ever had to wait is a week, and we’ve gotten to choose our doctors every time.)
In addition to invoking God’s name in support of their opposition (which is very dubious for anyone who takes the second Commandment seriously), both of these people demonstrate their faith on their facebook page with such buttons as “Honor the Lord by giving him the first part of all your income”, and a post in which the second person proudly sends loads of money overseas to support a hospital that her brother works for in Cambodia to provide Cambodians with health care. Did you catch that inconsistency? She demonstrates her faith by willingly giving a portion of her money to provide health care in Cambodia and yet protests giving any money to fund of health care that might benefit her neighbor or the homeless poor in her own town.
After listening to my wife effectively weighing in to remind our Christian friends that the conversation might be clarified by thinking less about their own bottom line and more about providing access to health care for the uninsured, I surfed around news websites to see what was currently being featured. I found some recent photos of Town Hall Meetings in bars and backyards full of patriots dressed in stars and stripes protesting a public option for Health Care. Notice here that I’m not saying they were protesting health care reform, only that these are they who do not believe a government option is right. In one picture was a man holding a sign that read, “Say NO to Socialism”. In a second picture a woman was sitting on a chair, the back of which had a sign that read, “Keep your hands out of my piggy bank”.
Considering the sign in the first picture, let me first remind you that there is actually no such thing as “Socialism” and there is no such thing as “Capitalism”. They are both great theories, but neither of them actually works in their pure form. Many have tried and many have failed in fabulous flaming corruption – see the USSR on the left and Enron or Lehman Brothers on the right. The truth is, we live in a world of blended systems. In America, I think it is funny that many people protesting for fear of Obama’s “Socialist” agenda in the recent “Tea Parties” were at an age to draw Social Security and Medicare benefits, both of which are social programs. (Incidentally, many of these people were likely educated at Public Universities which are government run, provide world class education, and excel in free market competition with Private Universities. I chose between Wake Forest and UNC, and got more education for my parents’ money at the public university – as a case in point, the private/public combination can work. Also, both Denmark and the UK have National Health Systems and private options – doctors and hospitals where those who can afford it can pay to get private health care. Again, a blended system like the one that is being proposed by the President) Even more ironically, the folks who were protesting “Socialism” were being protected in their Constitutional right to protest by the Police, while Firemen and Medics were on hand to make sure everyone was safe and well during the protests. Social Security, Medicare, public schools, firemen, police, and military are all social programs. I am still not sure why we are comfortable entrusting our education and security to the collective society of our neighbors, but refuse to do the same with our medical care. The protest against public health care that stems from a nebulous fear of “socialized” government run programs is inconsistent with the realities of our daily American life that includes socialized programs or the European models that include private health care options.
As for the sign in the second picture, the woman in the picture reminds us that Americans tend to resist government’s hand in our “piggy bank”. That resistance is rooted in our Revolutionary beginnings, and confirmed by our more recent Cold War fears of communism. Both of these struggles for democracy reinforce the values sown by John Locke and Adam Smith, whose concept of democracy is inseparable from capitalism. Largely for that reason, we attach the notion of freedom to the notion that government should not interfere with our finances. This is the source of the recent outrage at the idea of the government using our tax money to bail out failing businesses to stimulate our free market economic system, and now we are opposing our tax money being spent on public health care – “keep your socialist hands out of my piggy bank.”
(By the way, when I first moved to Copenhagen after my second year in seminary, I was talking to an Ethiopian Orthodox friend of mine who used to live in Denmark. I said to him, “It will be interesting to see if I spend more money by paying taxes and receiving free health care or save money by not paying for private health care.” He looked at me blankly and said, “But Chad, that’s not the point. The point is, we pay taxes so that we can know all of our neighbors are cared for.” Those were powerful words for a young seminarian being trained to serve the Gospel in the Way of Jesus.)
Even though the fear of the folks in these “Tea Party” pictures makes them seem angry, I also want to say that I do not believe protestors are resisting public health care out of lack of compassion for their neighbors. Let me say that I know so many faithful, compassionate people who will generously help their neighbor at the drop of a hat because Jesus commanded us to do so, but are against a public health care option based on conservative political theory. Even though those on “The Left” would like to demonize those on “The Right” as uncompassionate, I know that is not the case. Both sides are full of compassionate people, but they are also both woefully inconsistent. So, with Jesus, let’s sidestep the conflict as it’s presented to us and find a way consistent with faith.
After patiently reading facebook diatribes, listening to Town Hall outbursts and being privy to various other public conversations I wonder if we can be so honest as to admit this simple reality – most people oppose national health care because they don’t want to entrust their hard earned money to the government. Can we be honest and say that? That is the heart of the opposition, right? It’s not about waiting in line for treatment, because that just isn’t the reality in the UK, Denmark or Canada. And it’s not about choosing your doctor because in our current HMO and PPO system you already have to choose from a list and call ahead to register before having your baby, as if you know 24 hours before that’s going to happen! And it’s not really about rationing health care and letting people die without testing, because doctors are actually more apt to run the test if they don’t have to consult for-profit insurance companies. And it’s not about a lack of compassion, because we tithe to the Church and willingly give more money to hospitals in Cambodia. No, at the heart of it all, it’s about being free to keep our money and do what we want with it. That’s why the Congressmen who oppose public health care passionately support tort reform – not because of the injustice but because malpractice suits cost money. Individuals at town halls admit that they don’t want the government to take their taxes to fund a public health system, not because they don’t care about my neighbor, but because they have good jobs, use their money to secure private health insurance and are free to do what they want to do with their money. Right?
I believe the conversation that should be about justice has been derailed by a conflict over how to interpret freedom. And here is the sidestep. The subtle shift from Health Care to Freedom has created the inconsistency that is conflicting the hearts of so many. So, what we really need to be talking about is Freedom. We seem to be afraid to do what’s right with regard to providing for our neighbor’s health, because we feel that our founding fathers framed a way of life that enshrined self evident truths about freedom. But I want to illustrate that as people of Faith, our exercise of Democratic Freedom is not actually as self evident as the Declaration of Independence might suggest, and this has major implications on the way people of faith approach the health care debate. And if we are going to have a faithfully consistent answer about health care, we need to prayerfully think about our Freedom.
For starters, if Democratic Freedom were a Biblical or theological concept, then we could manage to hold love of our neighbor in tension with financial freedom. However, Democratic Freedom is not a Biblical concept. In fact, as Christians, we are not actually democratically free. That probably sounds strange to many of you, I know. But here is where my thoughts reframe this issue in light of a consistently faithful ethic. If you are going to have a conversation where your ideas about economy are consistent with your faithful ideas about serving your neighbor, then we have to reframe this discussion not in terms of Democratic freedom, but in terms of Divine Freedom
Martin Luther famously wrote in his Treatise on Christian Liberty, “A Christian is perfectly free, subject to none. A Christian is a perfectly dutiful servant, subject to all.”
Got that? If not, please read it again. This is Christian liberty – before God, you are perfectly free, subject to no human, even government, but at the same time, before God, you are a perfect servant, subject to serve everyone of God’s creation. That is (roughly) the theological concept of Christian liberty. Now, here’s the Biblical rationale.
Paul writes on Freedom in Galatians. He says there that we are freed for freedom. Freed not to go back into slavery, but freed to freely serve God and neighbor. He goes on to say, “do not use your freedom as an opportunity for self indulgence, but through love become slaves to one another.” In other words, God in Christ Jesus did not free you to be bound up by allegiance to an economic theory (Capitalism or Socialism), but you are perfectly free to serve your neighbor. James did the same in his letter. (The savvy Lutherans among you will think it strange to have Luther and James in the same paragraph but, here it goes…) James talks about being subject to “the Law of Liberty” in the portion where he recognizes that it does not exercise your faith one bit to piously pray in confidence for your salvation and that of your neighbor if you send him away with no food (or vaccination against treatable diseases?). James is saying, because you are freed by Christ to live in the Law of Freedom, congratulations, you are free to employ your life in service to your neighbor by sharing resources and to do otherwise it to proclaim the Word, but not do it. The prophets rage about this kind of inconsistency. Amos, Hosea, Jeremiah, Isaiah – if you stand inside the gates and praise God but do not care for the physical needs of your neighbor outside the gates…well, you can read it for yourself. Again, as Paul, James and Luther all say, Christian freedom is about being free from securing your own freedom – Christ did that, now you are free to bind yourself to your neighbor. This is the Divine Law of Liberty, this is the Biblical concept of Freedom.
Now that I write that, it sounds familiar…just like something someone else talked about…who was that? Oh yes, I remember – Jesus. Jesus talked about the radical nature of being free. Free from the Law. Free from civic oppression. Free from cultural mores about disease, gender and class. But then he radically demanded that we are free to offer our selves in sacrificial love to our neighbor, not as we would have done to ourselves, but as Christ did for us. We are, in the end, left with the command that if our neighbor asks for our coat, we should give our shirt, too. That’s not pious, that is being bound by love to our neighbor – that is what it means to follow the Way. And Christian faith tells us, we are free to do that! We are free to offer our goods, lives, and resources to build up the life of our neighbor. This, by the way is also Luther’s explanation of the 4th and 10th Commandments – check your catechisms.
I want to stop here, and draw this conclusion before I go on – as Americans, when we talk about “Freedom”, we are not talking about the Biblical concept of Freedom. In fact, when our Civic/Political concept of Freedom causes us to insist that we the government has no right to our money through taxes even while great percentages of its citizens are languishing from treatable diseases, our civic profession of Political freedoms are actually contradicting our faithful confession of Biblical Freedom. At that point, we are using our freedom for self indulgence, instead of enslaving ourselves to love of neighbor. And in this 21st Century age of democracy, here is a modern example.
The Church in Latin/South America saw its share of bloody civil war in the latter half of the 1900s, much of which still flares today. And in that fire, Liberation Theology was forged. The Liberation Theologians drew on asserted that Capitalism had corrupted their governments, which were now led by the rich and powerful who were suppressing the poor (they had no health care or education either). Their warning was this – Jesus said we can’t have two Masters, so we if our government is serving Capital interests, it is not serving the people. Money becomes the subject and people become the commodity. (This is the situation with our current for-profit insurance situation) Freedom then becomes defined by economic freedom, and suddenly the whole society including people, is beholden to Capital. In our exercise of freedom, economic freedom becomes the pivot on which all other ethical decisions turn, and replaces our call to care for neighbor.
Now, obviously, the early Liberation theologians fell out of fashion with the Church for a while (especially the Popes), because their Marxist tendencies were “threatening” to the Church in other ways. Perhaps they have fallen from grace in your mind right now because their Marxist tendencies are “threatening” to democracy. Turns out you and the Pope have a good point. However, their critique is not of Capitalism or Democracy, but a faulty sense of Freedom. Their basic point is, like Luther, James, Paul and Jesus, if your zeal for economic freedom impoverishes your neighbor, you are no longer living out Biblical Freedom, and you have created an idol.
And as it turns out, the Pope agrees with that. Pope John Paul II wrote in The Crisis of Moral Truth that a Political definition of Freedom can quickly become an idol. Our exercise of freedom “can lay claim to moral autonomy which would actually amount to an absolute sovereignty.” Or, more simply put, your sense of democratic freedom can become an absolute, even eclipsing the revealed Truth of Christ. If your exercise of Civic and Political Freedom ever gives you the excuse to refrain from practicing the Love of Neighbor as Christ has sacrificially loved you, then your Freedom is an idol.
“Render to Ceasar the things that are Ceasar’s and to God the things that are God’s.”
When I consider this issue of US Health Care, I don’t get uptight with people who have good reasons for being against it. Fair enough. But I bristle when people don’t have consistent ethics. You know those who can stomach this paradox – “I am against abortion because of sanctity of life, but I support the death penalty as an acceptable form of justice.” Or, “The Government better stay out of my piggy Bank but they better come and fix the pothole in my road right now.” Or, “They really need to do something about these kids that are loitering on the corner, but we need to cut arts funding in the public schools to decrease the budget deficit.” These are inconsistent ethics. And from what I can tell, a good percentage of otherwise faithful people who oppose an option for public health care are dreadfully inconsistent. It is ethically inconsistent to proclaim to love your neighbor as Christ has loved you but not use your God given freedom to provide for their physical health while you faithfully tithe to the Church.
“But those who look into the perfect law, the law of liberty, and persevere, being not hearers who forget but doers who act--they will be blessed in their doing.”
I want to ask you to consider this question – is it possible that you can be Politically or Socially Conservative, free from “Big Brother” Government to pay for your own private health care, demand tort reform and yet - still share some of your hard earned capital for the government to serve the least of your neighbors? As a Christian I can’t see another way.
And in fact, this is the way that the majority of the western world operates. In my past two countries of residence, Denmark and Scotland, this is the case. Even the most nationalistic, socially conservative, capitalistic stalwarts of these countries would not dream of dismantling their public health care system. Why? Because they feel that it would go beyond political conservatism into social deprivation. They feel that it is society’s responsibility to collectively care for everyone and anyone who needs healing – and my son is proof to calm your fears of its functionality. Americans can cast judgment on secular Europe with some good reason, but Europeans are the one who feel that denying public health care is an affront to our innate human rights. And to turn the coin on liberalized rights based rationales, they also see health care as not only their right to receive, but their social obligation to provide for their neighbor. For them, providing care for a person’s health for the singular reason that they are human is a self evident truth. Does that not reflect the life giving, agape relationship God has revealed in Christ for our task of serving the least of these?
Someone once agreed with Jesus by saying that the measure of a society is not represented by the lives of the greatest, but how they treat the least. And it’s worth saying that American style freedom, the Democratic Republic, while the best form of government to date, it is still an experiment. Our economic freedom drew dangerously close to disaster in the past few decades because of folks using their freedom “for self indulgence”, culminating in last year’s global economic recession. And in its wake millions more Americans now don’t have jobs, have jobs that don’t provide health care, or lost their retirement benefits which could potentially create much more serious expenditures and social breakdowns. If we seriously consider the possibilities of that kind of injustice, then we have to seriously consider the possibility that societies and nations don’t have to perpetuate. Rome certainly thrived much longer than the US has before its tipping point. And so did Israel before that until, as the prophets remind us, security and economic freedom became the idol that replaced the Divine mandate to love our neighbor as ourselves.
Now, after reading all of this, I hope that you understand one thing. I am not suggesting any political solution. I am certainly not suggesting that a Christian has to think that the public option as it is proposed is God’s will. (Again, I can’t imagine another way, unless every one Christian family with private health care is willing to take on one family who doesn’t, or congregations and churches set up non-profit health care co-operatives and while that would be the ultimate test of sacrificial love, I just don’t see that happening without government funding.) I am saying that a consistent faithful ethic is the only solution that will leave you standing on solid ground. I am offering another way for you to think through the debate that is going on in your head, your heart and your facebook page. It doesn’t bother me if you disagree with the US beginning a public option for providing health care for its most vulnerable citizens if you have a well thought out, consistent ethical reason that squares with your faith. And if you do, I want to hear it. Again, as a Christian practice, you can’t be against “government socialized” programs on principle if you pay and receive Social Security, drive on roads, check out library books, send your kids to public school and are ready to call 911. We have to base our lives on something consistent if we are ever going iron out this debate in your mind or the public arena. To date, political parties are not nuanced or consistent enough to stand up to the rubrics of Christian ethics, so I pray that you start a different conversation about health care with your friends, family and your faith.
If you are fearful of government control, but haven’t actually lived under another system, please don’t listen to your fears, but ask someone who has. If you are fearful of loosing your freedoms, please don’t be preconditioned to think according to political definitions of freedom, but prayerfully and seriously consider whether or not your fear has created an idol out of your own economic freedoms that in practice supplants the Divine mandate to love your neighbor. And if you are conflicted by it, please consider the Way of Jesus before you appeal to the political which can never be absolutely sovereign.
“A Christian is perfectly free, subject to none. A Christian is a perfectly dutiful servant, subject to all.” “For you were called to freedom, brothers and sisters, only do not use your freedom as an opportunity for self indulgence, but through Love, become slaves to one another.” “So speak and act as those who are to be judged by the Law of Liberty.” “Love your neighbor as I have loved you.” “Render to Ceasar the things that are Ceasar and to God the things that are God’s.” “But those who look into the perfect law, the law of liberty, and persevere, being not hearers who forget but doers who act--they will be blessed in their doing.”
Reader Comments (6)
Several pieces I've read, like this one http://www.economist.com/world/unitedstates/displaystory.cfm?story_id=14363134
have started me thinking about health care in a different ethical direction entirely, and I wonder how these issues, from an informed Christian perspective, might inform the overall debate that currently rages about health care, which is how it should be provided and insured. Is there a way that a Christian ethic can speak amid the cacophony of popular voices to the concerns we all seem to have about death and dying, etc.? Everyone seems to agree that people should have health care, even the "least of these," but I wonder if the bigger debate that has slipped in undetected is...what exactly is reasonable, ethical health care?
Nice thoughts, I think there are a lot of people who would not agree with this, because we are so wrapped up in our lives and our needs, and what is best for me. We have a hard time here in the US of saying the government is doing anything that is good, because it does not give us what we need... It is not about the other - we are truly only focused on us. Which I believe is the comments you will not see, but are being said that this is truly about you, and your needs in this situation.
I pray for you and all of us as we struggle with this issue and what will come for all of us. Best of luck on the PHD work....
Grace,
Jerry
Philip...hey! I like the article. Yes, I think that we have to start naming these other issues - the etihcs of dying, freedom, economics - these are the faithful issues that go unspoken in the discussions. What do you think contributes to people's unwillingness to hear these nuances? Of course, sound bites and 24 hour news cycles, but I mean, in people's hearts...I do think these are the issues the church needs to be leading on in order to inform the debate in a new way...let's work some of them out and send them up the flag pole.
Let's keep this going...
Peace,
Chad