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On Choice, Coverage, and Contraception

On Choice, Coverage, and Contraception

I’ve been watching this story for a few days. For those who haven’t been keeping up with the news, the Obama administration is proposing rules that would require all employers to provide coverage for contraception in their health care plans. Catholics are in an uproar over this. The White House has responded (HT: Unsettled Christianity). The first line of the response indicates that “all employers” is not correct, by the way!

I have little sympathy for the Catholic view on contraception. I don’t mean this as generally anti-catholic. There are plenty of specific doctrines for which I have little sympathy. But at the same time, it is their conscience involved. I knew this type of issue would come up when health care reform law was passed. Despite its great length, most of the detail work was left to regulators to fill in. This is one of the dirty secrets of legislation–how frequently congress passes outlines of laws and not complete laws, and then agencies have to fill in the details.

For me, conscience should prevail on this issue. I realize this involves places where Catholic agencies are hiring people of other faiths, but that should be a factor in one’s choice of employer, just as other benefits and conditions are. It’s an imperfect world, but I tend to come down on the side of freedom of conscience.

On the other hand, if you read the White House statement, and if what they are saying is correct, much of the uproar over this issue is, in my view, overdone. The government is overstepping its bounds in my view, but less so than was believed. Nonetheless, I am opposed to this regulation.

Left Wing Closed Mindedness

Left Wing Closed Mindedness

I was asked recently in a comment for examples of shrillness from the left, and I didn’t respond at the time. The reason for that is simple. When I talk about right wing shrillness I hear from conservatives about how I’m ignoring the left. When I talk about left wing shrillness I hear from liberals about how I’m ignoring such behavior on the right. Simultaneously, each side will claim that their particular shrillness is justified, whereas the shrillness of the other side is not.

By “shrillness” I do not mean strongly expressed opinions. A commenter left a link to this rant by Josh Rosenau. Now Josh uses language that I would not use, but nonetheless he rants substantively about issues that matter to him. Is it easy to take if you’re on the other side on some issue? Not at all. But he gives you something to discuss.

Now in case someone missed it along the way, I have a certain appreciation for libertarians. I would describe myself in politics as independent, moderate in many things, but with a decided libertarian lean. So when Republicans want to reduce government interference in some area of economic life, I’m with them. When Democrats want to protect individual liberties, I’m with them. But when they each get into culture wars–and both groups spend more time in that territory now than ever before, or so it seems to me–then I am not with them.

So herewith a left wing example, brought by Radley Balko of Reason magazine. I’m going to link to his two posts. My only comment is that the article written by the CEO of Whole Foods to which he refers is a substantive capitalist contribution to the health care debate, the sort of thing that should be taken on point by point by those who disagree, but the reaction is something completely different. As a moderate, I strongly object to making something into a simple two-sided issue. I can oppose the current health care bill (once it can be identified!) without thinking that the status quo is acceptable.

Again, Balko uses some language that I would not, but he makes very good points, in my view.

On End of Life Counseling

On End of Life Counseling

Since I blogged two days ago about my opposition to certain phraseology used by Rev. Jim Wallis, I want to say something about the quote to which he is responding.

I find the “death boards” complaint about health care easily the least well-founded and most damaging of the issues. There is good reason to discuss health care and how we can provide it for the uninsured. I think there is good reason to debate the public option. In fact, there are many things that are questionable.

But a provision providing for payment for end of life counseling is a good idea, no matter who is footing the final bill. Setting aside the issue of who should pay, end of life counseling can be extremely important and can greatly improve quality of life.

I have sensed that many people have a great deal of difficulty facing these issues. I used to be one of them. I didn’t want to disuss it. I didn’t want to think about it. I think many fear to deal with these issues, but I can’t be sure what someone else is thinking. I was afraid.

Being married to a nurse who was a hospice nurse and then director of education for a local hospice organization for 12 years, and then living through the death of a child has changed my attitude.

The worst possible thing at end of life is to face the choices you must make without having planned ahead of time. In order to plan ahead of time, you need good information. I remember sitting in an oncologist’s office one day with our son forcing him to be explicit about the numbers and the value of various treatment programs. You have to know that the information is there and then get it.

I have now made a living will, and I encourage everyone, young or old, to do so. It will give you peace of mind to think about the issues and make your decision. I’m not trying to tell you what decision to make; I’m simply suggesting you think about the issues, make the decisions, and put your will in writing.

Might a doctor discuss things in a counseling session that I might not regard as moral? Certainly. Should that session be government censored? I strongly believe it should not be. It is interesting to me that there are people who very strongly oppose anything that might get between doctor and patient and their choice in general (though insurance companies do this all the time), yet they don’t want government insurance to provide for this kind of counseling, if there is a government insurance option.

My own decision is that in very few cases would I support heroic measures to extend my life. That doesn’t mean that I would not choose surgery or chemotherapy based on the best medical device. But if prolonging my life involves hooking me up to a machine permanently, I’m not interested.

It’s odd that some people seem to think that this is an attempt to choose the time of my death. I think the reverse, that technological efforts to keep a body that would otherwise have given up may well be the case of trying to force my continued life after God has chosen for me to go.

I hope to leave this world not kicking and screaming, but rather rejoicing.

Right to Protest – Not to Drown Out

Right to Protest – Not to Drown Out

Ed Brayton has some good comments on the protests at town hall meetings:

On the subject of these protests, I say the same thing I’ve said many times before when the shoe was on the other foot, when the protesters were left wing and the speakers were right wing: You have a right to protest but you do not have a right to disrupt an event, drown out a speaker or prevent an event from taking place.

At the same time, I think Democrats have been too eager to paint such protesters with too broad a brush. It is undoubtedly true that there is some astroturfing going on, with large interest groups with a stake busing people around and making it look like a totally grassroots effort. It’s also obvious that some of the protesters are just plain nuts or too stupid to take seriously.

But that doesn’t mean that everyone who shows up at a townhall meeting to express their concerns or disagreements with the healthcare reform efforts is an idiot, or that they’ve been bought off to go there or bussed in some big group. There are legitimate reasons to question many provisions in the various healthcare reform bills in Congress and legitimate debate to be had on what the best way might be to reform the system.

Just so! Ed is pretty much equal opportunity in sticking it to the right, left, and center when he thinks they deserve it.

I would add that fake townhall meetings where questioners throw softballs to politicians they pretty much agree with are not conducive to the debate either. But it doesn’t seem to me like we are getting the kind of debate that is needed. Thus I would say that whether I like it or not, if people are ruled out by the politicians, they are likely to take their protests to the level of drowning out.

For example, who is inserting the supply issue into the debate, as in the supply of primary care. More nurse practitioners and a greater supply of physicians would also change the cost of health care, but I don’t hear much about that. It appears to me that we are again holding a debate within the constrained walls of the existing special interests, left and right, and not really looking at all potential solutions.

Mixed Health Care Feelings

Mixed Health Care Feelings

That’s mixed feelings about health care and feelings about a mixed system of health care, in case you were wondering.

I’ve expressed my ambivalence about health care previously. While I hope for an ideal situation in which a certain level of health care is available to everyone regardless of ability to pay, I also want to protect the good things about American health care, including the level of choice and the leading edge developments.

Such a combination won’t occur completely in real life. Any compromise that increases government funding is going to cut into choice and in some cases quality of care. Maintaining our leading edge advantage (read “expensive” leading edge) cuts into the ability to give basic care to everyone, simply because it costs. If everyone is expected to pay, expect everyone to get in on the decision as to whether certain treatments are worth it or not.

Today on I read A tale of 2 sickbeds: Health care in U.K. vs. U.S., which expresses my ambivalence very well. The author was hospitalized for similar problems in the U.S. and the U.K. though about 10 years apart. There were aspects of each experience that were better than the other.

What is the possibility that real serious creativity could produce a system that gets the best of both? I suspect not. Everything I know about economics (which isn’t all that extensive) suggests it won’t work.

It’s too bad, because I think that this nation will not forever accept the idea that the Emergency Room is primary care for a substantial number of patients. That provides lousy care and forces other people to pay. It takes money out of some people’s pockets for others just as effectively, though not as fairly, as taxes would, but it doesn’t deliver health care all that effectively.

Redistribution: Wealth and Responsibility

Redistribution: Wealth and Responsibility

I blogged a couple of days ago about redistribution of wealth, and then I read this post at Pursuing Holiness that discusses responsibility.

Putting the two together it occurred to me that both are cases of redistribution–one of responsibility and the other of money.

In censorship, we take the responsibility for choosing away from the individual and we give it to someone else, thus reducing their choices. They don’t have the opportunity to do the wrong thing, or at least the thing we have defined as wrong, and they have one less choice.

We don’t have little green pieces of paper marked in “responsibilities,” but the change occurs just the same.

The two are very directly connected. Consider medical payments, for example. When more of my medical bills are paid for by someone else, I have less choices regarding my care, and even how I care for myself. I recall when I was in the Air Force, I had to work with the flight surgeons on my health. I couldn’t just say, “No, I’m not going to do that” when given orders by the doctor.

We don’t move that directly in the civilian world, but we do already see the signs in our handling of smoking. People who don’t smoke ask a very valid question. Why should we pay more for health care in order to support the bad habit of people who do? The answer? Reduce or eliminate their ability to make that bad choice.

If I were less concerned about individual freedom or responsibility, that one would go over well for me. I don’t smoke, and I never have. But wait a second! I’m overweight. No matter how much I may want to criticize smokers for risking their health, I have done the same thing in a different way. (I’m finally working diligently on this, by the way, nearly 20 years after I left the service and started to let myself slip, but that doesn’t change the basic point.)

When we talk about those over-the-top politicians who want to restrict what McDonalds should sell, we need to remember the basic arguments that are used to restrict smoking. They’re going to apply.

I’m not advocating a complete elimination of government payment. In fact, I’m pretty sure we’re going to end up with near universal health care in this country, and as a result we’re going to face interference with our lifestyles. I still think we need to look that way, hopefully with a multiple payer system rather than a single payer government program, and do so soon, since the longer we wait the more radical the solution is going to be. The basic reason is that, however much we pay lip service to individual responsibility, we ultimately don’t want to let people bleed to death for want of health care.

But we need to look very carefully at what we’re giving away and what we’re getting. Count the cost. Despite political promises, none of this stuff comes without a cost.

Church and Healthcare: Fear

Church and Healthcare: Fear

Let me remind everyone that I’m really thinking on my blog, rather than providing answers that I have really thought out in discussing health care issues and the church. I have lots of pieces, but I don’t feel that I have anything like an assembled puzzle. My comments will also necessarily derive from personal experience. And as always, I tend to ramble a bit!

One direction from which we can come at this issue is from the question of need. What is it that a person needs from their church community when facing either illness or death? Since Mark brought up especially end of life issues, I’m focusing on this, including life-threatening illnesses.

Several times when we’ve gone into the children’s wing of the hospital where our son received chemotherapy, my wife has commented that the real enemy is not cancer, but fear. I confess that the first time she said that, my reaction was a bit bewildered. Yes, I know that we have to fight fear, but we’re putting all of these chemicals into a child’s body for the purpose of killing the cancer, hopefully before they kill him. That’s surely fighting the cancer!

But she has a point. The real difficult thing about illness and eventually facing death is the number of decisions that have to be made. Now my wife and I obviously were not facing our own deaths, but rather the death of a child. At first I was less involved. I was the step-father, but then James had to face the death of a loved one during his own struggle–his father died of a heart attack. After this I got a new perspective, because I was the one to go with him to doctor’s consultations. I remember his response vividly. He had only known about his father’s death for perhaps 15 minutes when he walked up to me and said, “Well, I guess it’s all up to you now.” Thought it wasn’t “all up to me,” he had a point.

The thought of death does something to us, even as Christians, that I think makes us irrational. I say (and confess) “us” even though I believe our family managed to step back. The first thing is to realize that death isn’t your worst enemy. I say that not merely as a Christian who believes that there is more for us after this life. Leaving that aside, the process of medical care can be much more terrifying than the thought of dying.

To be honest, I don’t know how most people do it. I grew up in a medically oriented family. We discussed health issues around the dinner table. We talked about dying as a pretty ordinary topic. We talked about the choices in medicine constantly. My wife is an R. N. and has 12 years experience as a hospice educator. With all that background available, we would get into a doctor’s office for a consultation and become hopelessly confused.

I remember one consultation after the first recurrence of the cancer. The oncologist was outlining treatment options. I could look at James and see him tuning out. I told the doctor that I had the role of being the idiot and started asking him detailed questions, making him explain the treatment options, their impact both in terms of effectiveness and side effects. By being the complete idiot and making him go into ABC mode, I got the information. I’m wondering how many people would push that hard, or know when to push. He was a good doctor, with an excellent reputation, and we liked him. We ended up taking “none of the above” and going with a plan cooked up by a surgeon at another hospital.

Now our church family was a bit of a mixed bag throughout all of this. Because I’m going to point out some real failures of support, I want to note that I believe everyone sincerely wanted to be “the body of Christ” for us. Most of them also did reasonably well. But there were people who were not at all helpful. In most cases, I think this was because of fear, either their own, or their assumption that we would be running scared. (Please don’t imagine us as some kind of fearless heroes. We just tried to remain rational under pressure!)

Let me just list some things:

  1. You don’t have to be down all the time just because you or a family member is ill. A number of people took me aside because they felt they needed to let me know that Jody (my wife) was in denial, and didn’t understand the seriousness of the situation. She was much too cheerful. All things considered, I suspect the hospice educator was adequately informed. I was happy that there were times when she could be cheerful.
  2. Repeat that point for James. I don’t know how many times I was told he didn’t understand his condition and the fact that he could die. When he first went into treatment he wasn’t all that clear, but by the time it was all over he could educate most adults on cancer, death, and dying. Again, any time he could be cheerful was good. Before his father died, he and I had an agreement that we would just have fun, so I never brought up the illness when we were together unless absolutely necessary. Of course later that had to change. Church members (or any friends and relatives) need to be aware that you don’t need someone to be miserable with you. Often it’s nice just to have someone be normal and do normal things.
  3. It is impossible to follow every diet, special remedy, or treatment plan found on the internet. We were frequently presented with complete solutions discovered via the internet, ranging from eating lots of brussels sprouts to buying a several thousand dollar water filtration system. It was OK for people to suggest, but when they followed up to see if we were following their suggestions it was a bit much.
  4. Similarly, you can’t go to every faith healer, preacher, prayer team, special revival, or healing service that is offered. We had people who were desperate because they thought if we didn’t go to a particular place, James would not be healed, but if we did, healing was certain.
  5. People don’t necessarily hear what you teach and preach. Since both Jody and I teach and offer seminars, including on the topic of prayer, it was often expected that we should be able to pray for our son’s healing and that would be it. Apparently very few people had ever listened and realized that we had very explicitly said that there was no such guarantee or expectation. (Cue the folks who say that it was because we didn’t believe enough or in the correct faction that there was no healing.)

One Sunday near the time that James went home we all skipped church and met in the living room. Some of our family members had been hurt by things they had heard. I pointed out that the people who did the hurting were not intending to, but that they were very likely operating from fear. If you can find a reason why someone else is suffering, then you can feel that you won’t be targeted. On the other hand if they could be convinced that the right prayer would result in certain healing, they could feel confident that if that nasty diagnosis came in, they could handle it.

The idea of losing a child to cancer is so horrifying that we’d like to find a reason, and specifically a reason that doesn’t apply to you. Good luck! I wish anyone who does this the best in making yourself feel confident. But bad things do happen to generally good people, and whatever comes up as your lot, whether you look at is as God’s plan, or just the way things work in this world, you’re going to have to deal with it.

So what does a church do as a community about this fear? I found that there is one key, and that is staying together and sharing. James had friends who drew closer, and he had friends who couldn’t handle being with him in the fire of affliction. We have been so amazed and thankful for those friends who stuck with him. The majority of those were a few years older than he was, and that difference got more marked as time went on. He simply no longer talked about the things that the boys his own age were interested in. But there were a number of close friends his own age who walked the walk with him. There are others I know who have regretted it.

Simply staying friends, remaining part of the community, and allowing the portions of life that can go on normally to do so is extremely important. There’s such a thing as dying while you’re still alive. James made an early decision not to do that. His final summer he started out in marching band for his high school. He made a difficult decision to step out because he realized he wasn’t going to be strong enough to march that season and indeed would probably not live through it, but he continued to join them on the field, and help with those things he was physically capable of doing.

He made a conscious decision that death wasn’t going to stop him. The rest of us had to go along with that! And it was the right decision. The fear can destroy you long before the disease does, and make your remaining days a living death.

There is a value here in education, but that needs to be supplemented by active support. “Support” as I’ve said, isn’t a matter of having the right thing to say all the time. It’s a matter of simply continuing to be connected even when you don’t know what to say. I already knew all the words. The problem wasn’t to know what I ought to think. The problem was to get the encouragement and strength that comes from community. The ones who showed up and felt foolish, or so they tell me, didn’t hurt us in any way. Generally we had no idea they were as clueless as they claimed. We were just glad they were there. The folks who melted away–those hurt.

Most churches need to really reorient their thinking to truly be a community. The response to every problem is to have a program, and designate people. And of course we do need designated leaders and programs can help. But it’s not the designated people who showed up that helped. It was the close friends who remained and got closer.

Health Care: My Visit to the Emergency Room

Health Care: My Visit to the Emergency Room

I take this detour from discussing the church and medical care to talk a bit about why it is so difficult even to discuss medical care in this country, based on a recent personal experience.

I’m 50 years old, and a few weeks ago I made my first visit to the emergency room. (Just for interest, I have never been admitted to a hospital in my life for any reason.) I had pain in my upper abdomen, quite severe, and it just wouldn’t go away. I arrived there between 9:00 and 9:30 pm, and eventually left around 5:00 am. While there I underwent three scans, numerous lab tests, and a few discussions with the doctor.

I should note that it took some time to get any attention, but not really that bad as such things go. While I haven’t been to the emergency room for myself, I’ve been there with others, and I’m from a very medical family. It’s very useful to have things like an insurance card and a checkbook along on such a visit. Questions about money come up very quickly.

After all this testing, they still have no idea what was wrong with me. We’re eagerly awaiting transfer of the records to my family doctor so that he can follow up.

I got a call from my brother the cardiologist the next day, and he was very upset that they hadn’t done an EKG. He thinks that should be automatic when a 50 year old guy shows up with pain in his upper abdomen, and would like to inform the E. R. doctor that he was negligent, or something along those lines.

The bottom line is this: After the rather strong medication they gave me for pain wore off, the pain was gone and hasn’t returned. But nobody has any idea where it came from or where it went.

A couple of days ago I got the bill for all this. The initial bill for that incident was over $13,000. With the amount that is generally disallowed by the insurance company, the amount that will actually be paid to the hospital is over $10,000. My portion appears annoyingly large, but is actually blessedly small, all things considered. I have good health insurance.

Now as the son of a doctor and nurse, brother of another nurse and another doctor, and husband of a nurse, not to mention cousins and uncles and such who have pursued careers in the medical field, I have a fairly good idea what costs what. I knew the scans were expensive when I took a look at the machine they were putting me through. I also knew how annoying some of the older machines would have been, and how much better of a picture of my innards the radiologist would have to study. I had talked to my brother, and knew that he would suggest more, not less tests.

So supposing I’m an average citizen and I’ve been to the emergency room for pain that went away pretty much, I might suppose, on its own. Supposing I’m still waiting for my medical records, and haven’t been able to take care of the follow-up. What do you suppose my reaction would be to the bill? The hospital is receiving something like $1500 an hour to keep me on an uncomfortable hospital (stretcher? not-bed?), and for a couple of very short breaks, take me out to get tests.

If I’m this average person do I:

a) Say, “That’s the cost of good medical care and I’m glad to pay it?
b) Yell, “$10,000 for that?”
c) Call my lawyer
d) Vote for a politician who will provide single-payer health care
e) Get more and more frustrated with the health care system, but not know what to do

I don’t know which of those I’d do. Actually, I think a large portion of that is what we pay for some pretty good health care. Some items weren’t working perfectly in my case, but I know how much the machines cost, and I know the hospital in question isn’t rolling in money. My family and I have been very satisfied with them over all for many, many years.

The problem is that as soon as a politician starts talking about “controlling health care costs” two things happen. First, people assume that what is going to get cut out is unquestionably waste. Second, many people, especially politicians, assume they’re going to be able to cut out more than they realistically can.

There’s a constant refrain about unnecessary tests. Someone might well call my scans unnecessary. They didn’t find anything. Maybe I’m just a wimp and I can’t stand pain. As a matter of fact, I’m really not sure. I’ve never felt anything like that before in my life. The most pain I’ve undergone for any period of time was a sprain. But the difference between a necessary and unnecessary test in the eyes of the person who isn’t there is simply whether it found something. In my case, it didn’t. My guts look reasonably good when properly enhanced by computer. But the doctor didn’t know that.

On the other hand, it’s probably impossible to convince someone who hasn’t researched the various machines and their costs that the cost of that visit is at all reasonable. To be honest, I’m not certain myself whether all the tests were needed. My brother the cardiologist seems to think they were a good idea.

I guess I’m kind of beating around the bush, but it seems to me that we have a long way to go in understanding health care such as to get to the point of discussing it intelligently. I determined several months ago to study out all these health care plans, and I’ve found it pretty tough going. But the more I look the more I think that the plans are being sold optimistically. They are optimistic in terms of how much can be saved and they are optimistic in terms of the quality of health care that will result.

Perhaps the media should take up some of the time they spend trying to figure out just what Richardson said to the Clintons and when, and spend some time educating the public on the intricacies of health care. Perhaps the public should demand it. Of course, back in the real world, we’d be lucky if anyone watched it, much less demanded it!

Healthcare and the Church: But What is the Church?

Healthcare and the Church: But What is the Church?

[Since I have readers from a variety of viewpoints, let me note that the following is written from within the Christian tradition and to those in that tradition. It’s OK to read, of course, but it’s unlikely to be of great interest to non-Christians.]

Mark at Pseudo-Polymath has started a discussion on health care and the church and I have become involved. His latest post is here, which responds to some of my personal reflections as I begin posting. I have some further personal reflections, based on the five year battle with our son’s cancer. But those personal reflections are intended to lead to some thinking about the broader role of the church. My posts on this subject are in no way intended to be thoughts of an expert. I am far from an expert on this topic. But they are reflections from the consumer’s point of view on the health care system, and from the church perspective from one deeply involved in church activity.

I want to post just a few thoughts and questions here. My problem in thinking about this discussion has been that it is very easy to shift the discussion from the role of the government to the role of the church without changing the actual content. In other words, I can make this a debate over how much is the role of the government, and how much the role of the church. I can prepare a list of programs, and ask whether the church or the government (or some other private group) should carry them out.

That might result in a list of church programs: Education on death and dying, end of life care, support for individuals undergoing treatment and for their families, prayer, economic assistance (I know very well how demanding illness can be on one’s pocketbook even with good insurance), good lifestyle and health education and training, and so forth. I intentionally left out most of the spiritual things from that list (except prayer) because we often simply tack those on.

It seems to me that the church has become more of an adjunct to our secular lives, a club to which we belong, rather than our spiritual center. I’ve been reading Acts 2 as part of my lectionary readings lately, and it strikes me that the church that was breaking bread together and worshiping together constantly, sharing all their good, and so forth, was much more than an adjunct to the lives of those early disciples. I think they believed they were living at least a part of the kingdom of God. That fellowship was the central part of their lives.

Any health care related program of the church may be helpful, but it cannot be most helpful unless the church feels and acts like a body, the body of Christ in service to the world. Only in that case do we really have the ability to respond full to those within and without. In general, when a family in the church has a problem, it’s their problem with which we (the rest of the church members) may help them. It’s not our problem.

Should healing be an adjunct to our other activities, something we do as a program, or should it perhaps be an essential part of living as the body of Jesus Christ in the world? This is the question that’s been hitting me as I have been thinking about this. My father’s church, the Seventh-day Adventists, established health care facilities all over the world as a means of evangelism. Perhaps there is another step here, where the church in general establishes (or becomes) such facilities in order to be Jesus in the world. We’d then operate them in such a way as to look as much like Jesus in action as possible.

I don’t know precisely what this would look like, but I think it would look much different than what we have. The problem with resolving end of life care issues is not so much in knowledge, though knowledge is necessary, but in support.

Let me illustrate. The hardest moment in my son’s illness was not the day he died, but several months earlier. My wife was on a mission trip in eastern Europe. I had no means to contact her by e-mail. I was here alone with James. I had to call the doctor and get the results of a scan. Those results said that the cancer had returned in four places. Now theres knowledge, and then there’s the ability to apply the knowledge, to take the steps one has to take.

My knowledge was not adequate. I needed the support of my family and my church in order to work through the situation and take care of it. It seems to me that this is the most important consideration. No amount of training is going to help if we’re not there at the time of need. Being the church in some sense means that we are there at the right time.

Church and Health Care: Remembering My Parents

Church and Health Care: Remembering My Parents

Mark, at Pseudo-Polymath has written a post, The Christian Response to Healthcare and End of Life, which has what I consider the greatest quality for blog posts: It deserves to be discussed. My immediate problem is that there are simply too many things to discuss, and I’m a long winded person in any case.

So I’m going to divide things up a bit and write several posts. In doing this division, I will use a couple of my own beliefs, which I may discuss later if I remember. The first is that I believe that Christian motivation and Christian strategy or courses of action are different. For example, we are to be motivated by love for our neighbor, but we can disagree on just how we go about it. We can desire that nobody suffer for lack of health care, and yet take completely different paths. This doesn’t mean that all courses of action are equal; it’s just that they should be discussed in practical, empirical terms. The liberal who believes fervently that everyone must have health care, and therefore advocates a single-payer government system because he believes that’s the only way to make it work, is not less or more of a Christian than the conservative who believes that system will destroy health care in his community. There’s lots of room for debate there as to just how a Christian should act, but I would suggest regarding both as properly motivated by Christian principles.

The second division is between the things we accomplish through the government and the things we accomplish privately. As a Christian, I want my community to be safe. To what extent is this the work of my church, and to what extent is it the work of the police and courts? As a Christian where do I get involved? I think this type of question is important. For example, local churches provide various services to young people including tutoring, sports programs, and facilities for their activities. All of this helps make a safer community. I’m a firm believer in the Christian community as salt, or perhaps I might say more directly, the kingdom of God intruding on earth.

My previous post that Mark linked was very much in the secular community, and reflects me looking at solutions that involved action in the political arena. Mark makes an important point in mentioning that fact. I’m several steps beyond my basic motivations, and trying to resolve at least a part of the problem through public action. I don’t apologize for that, but it is by no means a complete picture.

It’s difficult for me to find the language for some of what I’m thinking, so I’m going to start by reflecting on my parents’ lives. Why? Because they embodied, in my view, the other side of the picture. There are things on which I disagree with them. My father has now gone to be with the Lord, but my mother is still very active at the age of 89. We now belong to different denominations. They are Seventh-day Adventists; I’m United Methodist.

I’m guessing some of my more secular friends would not be terribly happy to have my father treat them. Dad would offer to pray with every patient, whether it was a consultation in the office, surgery, or on hospital rounds. He didn’t force it. If someone refused, he didn’t use the sarcastic, “Well, I’ll pray for you,” but I know that he did pray for all those patients on his own anyhow.

For both my parents, providing health care was the way they lived out the gospel. They would not get along with many of the modern Christian hospitals where the only specifically Christian thing is the name of the sponsoring organization. There was no division. That was a difference between me and my dad. I speak “secular” when I feel it’s appropriate. His world was undivided.

When I was in my teens I asked him whether God healed his patients or his medical care did, considering he prayed for every one. He said, “God always does the healing. Sometimes he uses my medical skills.” At the same time, he was passionate about the best information, the best equipment, the best techniques, and absolute thoroughness and integrity in medical care. I only recall my father becoming truly angry a couple of times, and all were cases when it appeared that someone’s negligence had harmed a patient. That was something you just didn’t do in his world.

Though he was an MD, and was married to an RN, both professions in which one can make just a bit of money, my father lived and died with very little. One of the humorous incidents in our lives came while he was working in north Georgia, and my parents had applied to be a foster home. They were notified that they were approved, but then no children came. Since they had been told the county was desperate for foster homes, they wondered why. Suddenly, a year later, a new social worker arrives with child in tow, asking if we were prepared. Sure enough we were, but my mother wanted to know the reason for the delay. “Well,” said the social worker, “my predecessor didn’t think your husband was a real doctor. He doesn’t look like one or act like one.” We never did get the details, so we have to guess!

For my dad, being a Christian and a physician meant being available. Everyone who came to him received treatment. During the few years he was in private practice he wouldn’t even send bills to collection. He sent two reminders and then forgot about it. He asked his church where care was needed, and he went there, serving in Canada, the United States, Mexico, and Guyana (South America).

One of the more amazing things my parents would do, besides praying with patients was occasionally to sing for them, again during hospital rounds. This was especially likely in terminal cases, or cases of great hardship. Many patients remember Dr. and Mrs. Neufeld singing a duet for them at the bedside in the hospital.

What I’m asking myself as I write this is just how they would fit in the context of modern Christian medicine. I know that my father complained that there were very few places where he could practice the type of personal, caring medicine he believed in. I’m guessing that situation hasn’t gotten better. I also have to ask, when I consider things that I said such as “health care must be produced” (and it does), just what can and will motivate people to provide good health care. I know my parents weren’t motivated by money; they rarely had more than just what they needed.

I’m going to use this as a launching pad to get into discussing health care more broadly than I have, not just talking about what governmental programs might be proposed, but discussing what duties and opportunities the church has. And no, I will not forget end-of-life care either, which is close to my heart. But I’ve already written more than I intended in this initial post.

[I must add a brief commercial announcement, however, since I talked about my parents. My mother has written, and I published, a book on her experiences, Directed Paths, and my wife has co-authored a book on grief for Christians that rose out of our experience with our son who passed away at age 17. It is titled Grief: Finding the Candle of Light. OK, that’s all the commercial stuff!]