A major topic in the news this week has been healthcare, as the Republicans in Congress and President Trump seek to replace the Affordable Care Act (and I have been asked my thoughts). In the interest of full disclosure, I have never endorsed this plan; in fact, I do not know that I am at all qualified to endorse any healthcare law. I am told by those who do work in the field that the Affordable Care Act was doomed for failure and needs to be replaced. Also, I am told that the suggested replacement will seriously hurt: the elderly, the handicapped, the poor, and those with existing conditions, otherwise known as the vulnerable. As I said, I am not in the industry and do not know exactly how much these groups will be hurt and how much of these comments are political hype designed to strengthen opposition to the bill. However, I know there is some truth in this claim and that leads me to my point.
The lectionary readings for this week include 1 Peter 2:19-25, in which Peter calls on the Christians to act like Christ, seeking the welfare of others. He tells the believers that Christ sacrificed his rights and privileges to come to earth to work for our salvation. If this is the case we must also lay aside our rights, be willing to suffer something, and help our community. I believe this same attitude plays a role in debates such as health care. Are we each willing to take up some small burden to help those who have less? Are we willing to pick up the slack left from those not able to pull? The organization of which I am part currently provides health coverage for our retirees, a significant burden to our working body, but, something which helps those who have less and are unable to work for more. (sadly, I doubt this continues due to new laws). Peter presents two competing options for living: selfishness, or Christ centered sacrifice. Right now selfishness and greed dominate our culture, which makes a Christian voice sound out of step, but, we are called to live a life of giving. Going back to healthcare, a system which does not benefit the vulnerable leaves more of the burden of help with their friends and neighbors. We are a large enough and wealthy enough society that this shouldn’t happen. Within the Church we should support efforts to help these vulnerable out of our sacrificial mindset.
I would never advocate for a specific policy, I am hardly educated enough for that; however, I will advocate for an ethical base upon which the policy is constructed. We must look to those most vulnerable first, asking what people with diseases or disabilities on fixed incomes can afford. We must also consider other issues which have direct effects on customer costs, like Aetna CEO Mark Bertolini’s nearly $30 million compensation package, or the cost of malpractice insurance for doctors because of ambulance chasing lawyers. I ask does any of this sound like Peter’s advice to live with others in mind? Does any of this sound like Jesus’ ethical commands in Matthew 5:38-48?
I think part of the trouble right now is that these laws are personal, I mean that Mr. Obama and Mr. Trump have each tied themselves to the laws. Thus, often people are judged and judge others according to the simplistic assessment of which the person supports. We speak to each other in talking points rather than addressing real concerns. If I bring up that I am not in favor of President Trump’s AHCA, the response should be “why not?”; but, often the response is “do you think the ACA is the solution?” (the example works the other way round also). Instead I propose we begin with 1 Peter on ethical matters such as this.
Let us ask what is our goal in healthcare? Is our goal to provide healthcare to as many people as possible, is it to make healthcare inexpensive (sometimes these are at odds), or some other goal?
What will it cost each one of us and who is best able to bear this burden? Insurance is about understanding that costs spread over a community are lessened. Perhaps there should be a sliding scale in which the wealthy pay more for the same coverage, I do not know; but they can afford it far easier than the poor, disabled, and elderly.
Solving problems related to people taking advantage of misfortune to grow rich? We have seen in the last few years drug companies hiking up prices needlessly, and insurance companies slashing coverage, all while corporate executives get richer. Coupled with that attorneys and insurance companies cause damage through litigation. Raising the cost of malpractice insurance and thus overhead costs for medical services.
None of this is an easy fix, but, as Christians we should look to our example and be willing to suffer some stress (even financial stress) to help our brothers and sisters who have less and are crippled by healthcare costs. Again I am saying nothing about a specific policy we can all disagree somewhat there, my concern is the ethical system we are grounded in to make such decisions.