Monday, March 22, 2010

who is my neighbor? why health care is always being reformed

The first rule of thumb in ministerial etiquette is “do not mix religion and politics”. Of course, people do like it if your politics match their politics, but, of course, people disagree about politics. At the same time, I think the subject----health care in America—is too important for us as Christians to sit on the sidelines. Actually the church should be getting into health care. This flows from our recovery of the healing ministry of Christ, and the root meaning of our word salvation; as Joel Green of Fuller Theological Seminary notes, "scripture as a whole presupposes the intertwining of salvation and healing".

Government got into health care because the church got out of it; the church got out of health care because we "spiritualized" salvation, we “disembodied” the soul, we disconnected the mind, body and spirit, and this has had disastrous consequences for the poor, the sick and the creation itself. One of the implications of the incarnation (John 1. 14) is that God takes on our mortal flesh; the gift of salvation is, in the language of the Apostle Paul, a "new creation" (2 Corinthians 5. 17).

When the church got out of health care (leaving behind a rich tradition of hospitals and hospices formed by the Christian movement), the government took on our work. At this moment we began to lose the connection between our motivation---to continue the healing ministry of Jesus---and our actions---to be his hands in this world. In the name of efficiency and productivity, this work of government was later privatized, and came to be governed by the forces of the economic market. In time the motivation shifted from service to service plus profit, from the common good to the common good plus the creation of wealth. I am not talking about why a physician or a nurse treats a patient. I am talking about how that service is provided and how it is organized.

The way back into the matter, for a Christian, is to reflect on what God wants us to do in this situation. The salvation of God, in the ministry of Jesus, includes preaching, teaching and healing; he ministered to the spirit, the mind and the body. These were the three core activities of Jesus, and the three tasks he gave to his disciples.

So what does God want us to do? Jesus was asked this question, and he responded in a number of ways, usually by telling stories. God uses stories to get truths into our brains, the parable of the Good Samaritan (Luke 10. 35ff.) is among a small handful of the best known stories in the Bible.
In a culture that is saturated with religious communication, and at a time that our national conversation is obsessed with health care reform, it is amazing to me that I have heard no one talk about this story of Jesus.

The parable begins with the question of a lawyer, who, like many of us, was not really wanting to learn something new, but making a point. He wanted to know: “what is going to get me into heaven? What is required of me?”

Jesus says. You know the law, you tell me! He responds---Love God and love your neighbor as yourself.

This was also question that the prophets had reflected on, Micah, six centuries earlier, stating it with clarity: the Lord has shown you, and what does the Lord require of you---to do justice, to love mercy, to walk humbly with your God (Micah 6. 8). Jesus, who stands clearly in the prophetic tradition, would have remembered all of this, he knew the law and the prophets, do you remember Psalm 1, he had meditated on it day and night. Right answer, Jesus says.

But the lawyer could not let it go and so he pushed it, Luke tells us, to “justify himself”, And so he asks, “who is my neighbor?”

At this point, Jesus responds with what has become a well-known story. If you have been paying attention to our year long conversation about health care, we all have a story: physicians who have less time to treat patients, patients who cannot receive care, or who receive a poor standard of care, or senior adults who may be deemed to be beyond the stage of deserving care, or patients who will not exercise self-care, or corporations who limit care, for the sake of greater profit, government waste. If you watch one television network, you are likely to hear a certain story; if you watch another network, you will hear a different story. Each sees a different villain, a different danger, a different hero. Those who tell these stories are not talking to each other; they are talking past each other.

Well, I have chosen this story because what brings us together is not our politics or even our experience of health and disease, it is the One who told this story, and so, I believe, it has a claim on us.

In the parable a man is beaten, and is suffering. A word about suffering and illness: Some suffering and illness can be prevented, and is related to our lifestyle—what we eat, how sedentary we are, whether we get enough rest. Some suffering and illness is unrelated to our behaviors: a friend has a chronic disease, through no fault of her own. Some human suffering and illness is genetic. And some suffering and illness is related to our mortality. We are finite creatures, and some day, maybe sooner, maybe later, we will die. This is for many in our culture a taboo subject, and has been a tool to cause fear and confusion among many of late.

The New Testament teaches us that our bodies are temples of the Holy Spirit, and we are commanded to care for them. Where we abuse them, we and the society suffer the consequences, and this is leading to an epidemic is on the way, in our country, related to our self-care. At the same time, we all know many people who are ill through no discernable action, and we make matters worse by implying that they could have done something different and avoided the pain and suffering.

In the parable, there is a suffering person, and the question then becomes, “how do we respond?” Jesus gets to that first by noting how we do not respond, how we avoid a response. We pass by on the other side.

What does it mean, for us, in this moment, to pass by on the other side? One way to pass by on the other side is to say, “it is too expensive, it is too costly”. The paradox is that we already spend more money per capita for health than any other country; however, that help does not always get to the person on the other side----this is related to the specialties that we fund, and to other factors that are irrelevant to the 46 million who are uninsured, or in growing numbers, who are undersinsured.
Another way to pass by on the other side is to politicize the issue, to fire up the rhetoric and to accuse those who disagree with us of either lacking compassion or being a socialist. My sense is that our national debate has not really been about health care; it is about politics, and has been a way of passing by on the other side.

Another way to pass by on the other side is to be silent, to despair, to become cynical, but, of course, this is never an option for God’s people. In the parable the Good Samaritan picks up the suffering man, pours oil and wine into the wound, the medicine of the ancient world, binds up the wounds, takes him to an inn, and provides payment for his care, which is somewhat open-ended: whatever it takes, I will return and pay.

Back to the question, which Jesus changes: Not who is my neighbor, but which one is the neighbor? For me, this is a simple and yet complex story, and the question of Jesus leads to other questions, including ones of of compassion and justice? Mercy is about our command to give. Justice is about another person’s right to receive, and the deeper question is “does the person have a right to health care?”. The parable does not answer this question, focusing more on the Good Samaritan than the man who fell among robbers, more on the question “who is a neighbor” than “who is my neighbor”.

If Christians are to participate meaningfully in the conversation, we will rediscover what is uniquely at stake for us in all of this: the fullness of God's gift of salvation, which is extended to all people, even the beaten man on the side of the road. A response to the question, at the level of practice, is going to take people of all faiths and members of both political parties beyond rhetoric to reality. It is going to call forth, not the worst of us, but the best of us, namely justice and mercy, which is, the prophet says, what the Lord requires of us.

Another question: Where will the resources come from to help the neighbor? The answer: they come from us. Now how they get distributed is the complexity of it, and here Christians can, in good conscience, disagree. Do we trust the government to distribute health care? Do we trust an insurance company to distribute health care? Do we trust health professionals themselves to distribute health care? Whichever method of distribution we prefer, each and all of them must be weighed against the biblical concept of justice. As in the most effective responses in society to most needs, this will be a public-private partnership. The expanded role for the public sphere is a recognition that the private market response has not benefitted the common good.

A last question: Where do we locate ourselves in the story? What if you are the person who is suffering? The orientation for most of us is that, if it is someone else, we want care that is good but limited and efficient. If it is for someone we love----my daughter or sister, your father or grandmother, no expense is too lavish. When it becomes personal, it is different.

And this is where the parable leads us, because, for God, it is personal. The neighbor extends farther than we had first thought. Some have a limited definition of neighbor, others have a more expansive definition. Is an aging person the neighbor? Is the unborn the neighbor? Is the immigrant the neighbor? Is the poor person my neighbor? The scriptural answer to each of these questions is yes.

I have wondered lately: can Christians approach this issue of health care in America differently, and I think it is possible. We can offer gratitude to those who have heard the gospel and have moved toward those who suffer, and here I think of health practictioners who are deeply devoted followers of Jesus.

We can repent of the political divisions that have allowed us to pass by on the other side of human suffering.

We can turn toward our brothers and sisters in Christian conversation, in patient listening and measured speaking. And the outcome, with the help of God, may be the channeling of resources toward those who are suffering, and the creation of a world that is more just and merciful.

This will truly be health care reform, and if we can do this, the parable says, we will live.


Blogger Desaree said...

This was an GREAT piece of work!!!

11:32 AM  
Blogger DED said...

I appreciate your post on who is our neighbor and the need for health care reform. I do have a question about how we can work as a Church to help make that process happen - specifically as it relates to the just passed bill.
In a speech before the United States House of Representatives on March 21, 2010, referring to the Health Care Reform Bill which was passed then Speaker of the House Nancy Pelosi announced that The United Methodist Church “endorsed this legislation.” Since the bill was not finished until well after March 15, 2010, and since most people, including most Representatives, have still not read the bill, how did The United Methodist Church endorse it, and when did The United Methodist Church endorse it?
This is not a question of supporting or not supporting health care reform. I certainly am in favor of health care reform. It is a question of process and openness and respect for each other. Since the bill was not finished until 72 hours before the vote, how did any agency, board, committee, council, Council of Bishops, or conference of The United Methodist Church manage to read the bill, discuss it, and vote whether or not to endorse it? I was under the obviously misguided notion that only the General Conference could speak for The United Methodist Church.
As an individual I have talked with Speaker Pelosi and Majority Leader Hoyer to express my support for health care reform, but there was no way I could read that bill and then have time to contact them about endorsing that bill. If we have such a process in place, will we be able to start using it for other issues, such as immigration reform?
Please let me know how the process now works.

Thank you, Dennis E. Dosch

8:46 PM  
Blogger Lane said...

I posted the following in response to the website's feature article from today, "Pelosi hails church agency on health reform", and I think it applies to this Blog entry as well:

'Jesus taught us to care for one another but as in the rest of His teachings He emphasized the choices an individual must make in his or her life, not that it is the "government's responsibility" to do anything. It is up to each of us to decide whether we will follow Christ's example and give our time and money to help the less fortunate. In contrast, forcing someone to "help" other people, whether done by government or any other means is not what Jesus taught. It removes the element of free will and the ability to choose the right thing to do, rather than being told what to do.'

If you use the argument that because Jesus wants each of us to care for one another, then the government should get involved, then how is that any different philosophically from the widespread practice in the Middle Ages of mass baptisms when a Christian ruler conquered a nation? It wasn't these so-called "baptisms" that made the people Christians. Only if they made the individual choice to accept Jesus's teachings did they truly become a Christian.

10:05 PM  
Blogger medina_education_blogger said...

I am really curious about how and when Christ's specific directive to each one of us (as individuals) to feed the hungry and cloth the poor was "translated" into we need to "pay" others to do our "giving" for us through taxes.

Does paying our taxes relieve us from the obligation to fulfill the specific directive given to each one of us by Christ? Absolutely not! What Jesus called us to do, has nothing at all to do with what our government, or any government chooses to do, or not do, with the tax money that we pay it. I really wish people would stop connecting the two as being the same thing.

Does it really help the poor when about 30% of the tax money supposedly targeted to the help the needy actually does what it is intended to do? Does it really help the poor if federal funding to charitable organizations is only given if the organization that refrain from witnessing the salvation of Jesus Christ? Did Jesus tell us to save the body and ignore the soul, of course not!

Just because our Churches have failed in their mission to care for the needy, doesn't mean we are given a license to abandon, or worse yet, change the terms of Jesus' directive for each one of us to care for our neighbor!

11:55 AM  
Blogger Jana said...

Sir, why are "Christians" looking past the fact that millions more of unborn babies will die through this wonderful "good samaritan" healthcare reform and WE all have to pay for it? This issue alone if you are a Christian should be the reason to be against this bill. It is not, nor was it ever intended to be the job of the government to take care of us, but rather Jesus said to all of us "heal the sick, cleanse the leper, cast out demons, freely you've received, now freely give". We are the solution, not the government. Shame on the Methodist church and all those who claim Christ as their savior to stand with this evil, and YES it IS evil. Consequently, I DO believe we need healthcare reform, but this is not it.

8:40 AM  
Blogger Tom said...

Jana, I'm shocked and dissappointed that nowhere in any of the churches "positions" do they include the Bible verses that offer a contradictory perspective.

Verses like;

1 Thessalonians 4

"Make it your ambition to lead a quiet life, to mind your own business and to work with your hands, just as we told you, so that your daily life may win the respect of outsiders and so that you will not be dependent on anybody."

2 Thessalonians 3

"In the name of the Lord Jesus Christ, we command you, brothers, to keep away from every brother who is idle and does not live according to the teaching[a] you received from us. For you yourselves know how you ought to follow our example. We were not idle when we were with you, nor did we eat anyone's food without paying for it. On the contrary, we worked night and day, laboring and toiling so that we would not be a burden to any of you. We did this, not because we do not have the right to such help, but in order to make ourselves a model for you to follow. For even when we were with you, we gave you this rule: "If a man will not work, he shall not eat."

We hear that some among you are idle. They are not busy; they are busybodies. Such people we command and urge in the Lord Jesus Christ to settle down and earn the bread they eat. And as for you, brothers, never tire of doing what is right."

1 Timothy 5

"Give proper recognition to those widows who are really in need. But if a widow has children or grandchildren, these should learn first of all to put their religion into practice by caring for their own family and so repaying their parents and grandparents, for this is pleasing to God. The widow who is really in need and left all alone puts her hope in God and continues night and day to pray and to ask God for help. But the widow who lives for pleasure is dead even while she lives. Give the people these instructions, too, so that no one may be open to blame. If anyone does not provide for his relatives, and especially for his immediate family, he has denied the faith and is worse than an unbeliever."

11:48 AM  
Blogger Jana said...

Tom, unfortunately most churches haven't taken a position but sit back and watch as our freedom is stripped from us in the name of "separation of church and state" and being "politically correct". A comforting thought though, God is still God and is not surprised or upset but always has a back up plan and will not let our prayers return void!

11:58 AM  
Blogger Ken Carter said...

thanks for these posts, and i appreciate our freedom of speech, and in the body of Christ there are different voices. the good samaritan has a privileged place in the debate on health care because it is 1) a teaching of JESUS about a health care intervention and 2) it stretches us to expand the answer to the question "who is my neighbor?" it is this JESUS who will judge us, and I am under the judgment as well! peace, sisters and brothers

7:10 PM  
Blogger Tom said...

Hi Ken,

Thanks for providing the forum for discussion. Surely we all do have an appointment before the Lord. As an Adult Sunday School teacher, I am also keenly aware that as religious leaders and teachers, we will be judged even more harshly than others.

James 3

"Not many of you should presume to be teachers, my brothers, because you know that we who teach will be judged more strictly."

8:41 AM  
Blogger Tom said...

Hi Ken,

In reading the Bible and praying about it, I came to an idea and would like to hear your thoughts on it.

Is our Church's (3rd largest denomination in the US) material wealth; people, places and things, more important than practicing the "Good Samaritan" lesson you used?

8:42 AM  
Blogger Lindsey said...

Great points. Thank you for poignantly stating a Christian view of the health care issue. Very well said! :)

3:13 AM  
Blogger Travis said...

Thanks for being willing to broach the subject! We need more of this type of conversation.

My stance, simply put, is that Jesus used physical healing to spread the message of a spiritual healing. Supporting government run health care will detach completely the spiritual element from the physical- Christ from the healing.

Furthermore, the parable of the Good Samaritan breaks down significantly by comparison. Christ told the story to urge individuals to make a decision to help others. Using that same story in any way to support a bill that builds its foundation by first eliminating one's right to choose is very bad logic. The logic is as follows: Jesus wants us to decide to help others with their physical needs. Therefore, Jesus wants us to help pass a bill that forces others, in an unequal way, to help meet people's physical needs, despite his or her desire to do so.

The Good Samaritan story would read as follows and consequently would have to change its "name": 2 men pass by, a third is forced to stop and help. The "I-have-no-choice-in-the-matter" Samaritan doesn't have quite the ring to it as the common title.

What makes the man "good" is his decision to help, not his decision to force others to help. If people want to support a bill that truly aligns with the story's teachings then that bill would have to be written where only those who want to participate actually do. BTW all proponents of the health care bill have that right now... they just choose, for the most part, not to exercise it.

Health care reform is needed, but not one where free choice (and therefore freedom) is eliminated.

11:51 AM  

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