Are We There Yet?

Featured, The Remedy — By on October 26, 2009 at 12:02 pm

medicine-and-health-triageI recently drove from Los Angeles to Portland with my friend and her two small children.  We sang silly songs, ate snacks and read a stack of children’s books.  It was a fun adventure, until we were about 300 miles from home, and her son informed me that it was “taking too long.”

“Are we there yet?” became the predominant question of the last few hours of the trip.  “Are we there yet? Are we almost home?”

This past week, when the Senate Finance Committee passed the fifth and final health care reform bill, I had the same sentiment.   “Are we there yet? Are we almost home?” I just want this issue resolved so I can focus on other things.  But even now, it seems we as a country are not much closer to reaching a consensus than we were when these debates first started.  It’s still an ugly scene.

For months I’ve been reading newspapers, listening to radio commentaries, watching and re-watching clips of T.V. interviews, and I still can’t untangle the knot that is our health care debate. And this is the thing: it’s not just the issue of health care that’s messy; the debate itself is a disaster.

It’s hard for me to trace how President Obama’s platform, which promised innovation and change, went from a bang to a whimper in less than a year. Where did the concept of death panels come from? How did a health care discussion that began with Senators McCain and Obama sparring at lecterns during presidential debates dissolve into angry mobs packing live ammo to town hall meetings?

And even if I could wade through all the refuse that the debate has created over the past few months and find my way to the facts, I have the feeling I may not be any closer to a solution, because both sides of the debate share the same data, but manage to make completely different conclusions from these seemingly objective numbers and facts.

And now that the five proposals have reached the floors of the Senate and the House, it seems that we now have longer than ever to go before reaching a national consensus on health care reform.  We are not anywhere near “there” yet.

But as my motivation dwindles, it seems the stakes are becoming higher and higher.  The American Journal of Public Health published a  Harvard study in September of 2009 that showed that uninsured Americans are dying at faster rates than those with insurance.   In fact, an uninsured, middle-aged American is 40 percent more likely to die than his insured counterpart.  Forty percent. 1

I think it’s easy for Christians to get frustrated with the broken society we live in, then step back and shrug, “Well, render unto Caesar what is Caesar’s…” And with these words we pay our taxes and then disappear as we become citizens in abstentia, no longer engaged in our nation’s ongoing debates.

You may feel as I do, that you’d rather disengage than untangle this knotted mess.  But if you stay involved for no other reason, let it be this: people are dying.

In medicine, there’s a triage system that involves four colors: green, yellow, red and black. First responders who show up at disaster sites have a booklet with tags of these four colors, and the first step they take is to decide who needs what how fast. Green means a patient has a minor injury, or no injury at all. Yellow means if he doesn’t get medical care in the next few hours, he could potentially have a life-threatening injury. Red is reserved for a patient who is dying and needs intervention stat. Black means the patient has already died.

I think as Christian citizens, it’s appropriate for us to triage which issues we’ll invest ourselves in. Who designed First Lady Obama’s dress? What medium is an NEA-funded artist using? Probably green tags.

The black tags are what we call “history,” events that have already come and gone. Will we declare independence from England? Will we have female Supreme Court justices? These issues are black tags (a.k.a. “toe tags”), because there’s nothing we can do to change them.

Most issues seem to fall in the yellow category.  Budget items, interest rates, campaign finance reform, education – these things could potentially have a dramatic impact on society in the long run, but they can probably wait at least another day.

And then there’s the red zone.  I think this is reserved for extremely severe circumstances, when people are literally, physically dying, or where there is a great moral travesty that the church must address.  Where yellow meets red may be a difficult line to define.  When did Nazism stop being about socialism and start being genocide?  When did slavery stop being South vs. North and start being about wealthy men oppressing fellow humans?

At some point, the debate ceases to be about Right vs. Left and becomes a battle of Right vs. Wrong.  And in these vital issues, the church is not only negligent, but an accomplice to injustice, if it remains silent.  Once an issue becomes “red,” it isn’t solely political anymore; it is now a moral issue.  The political system may become one avenue of intervention, but it is not, at its heart, a political problem.

You may argue that the health care crisis does not equal the Holocaust or slavery in numbers or intent, and you would be right.  Those were sins of commission, carried out by malevolent men who willfully oppressed, tortured and killed fellow human beings.  The health care crisis is more a sin of omission – I don’t think it’s a conspiracy by anyone to purposefully harm the uninsured.  But regardless of intent, tens of thousands of Americans are dying, have died, and will die because they didn’t have health insurance. And it is in our power to affect change on their behalf.

Maybe as Christians our first priority should not be reaching a national consensus on reform, but a community consensus on when and where the health care crisis becomes not a political, but a moral, issue for us.  As the questions and debates roll on, here’s what I want to know: are we there yet?

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  • Josiah says:

    Compelling call to reform.

    Question (with no agenda behind it, I swear): Why has this administration found health care to be something so immediately necessary to fix when past administrations have given it so little attention? Was there a breaking point of some sort which called for reform to happen promptly? (I apologize if this is a silly/dumb question)

    • Jordan Green says:

      Health care has primarily been a big agenda for Democrats, and it was not an issue for the Bush administration. It was one of the Clintons’ pet projects, but I think the Lewinsky scandal derailed any attempt they may have made.

    • James says:

      Jordan, if my memory serves me correctly, the Lewinski thing didn’t have an effect. It was before that. Hillary jumped in the first week that Bill took office and started putting together a govt healthcare plan which many people opposed, and the opposition was very loud. It never made it because of the opposition, very similar to the opposition it faces now.

      There are some differences, of course. For one thing, in 1992, many people objected to a First Lady, an unelected non-official, crafting legislation. This wasn’t what First Ladies did before Hillary. They played Hostess, and adopted some pet charity or cause like literacy. So that certainly played into the objection.

    • I was talking with a loved one, a relative, the other day about just this point. He is a Republican and a strong opponent of just about anything Obama does or has in his mind to do. This relative was frustrated that Obama has made this an urgent priority and that many of the forty amendments offered by congressional Republicans to the health care bills have been nonstarters. I am sympathetic. I think a bi-partisan solution to the health care crisis would be preferable. But, I said to my relative, isn’t there an extent to which Republicans in Washington have had their chance? I mean, they didn’t do anything under Reagan or Bush I. Clinton was in the White House in the nineties, but Republicans had the majority in Congress from 1994-2006 and the White House to boot for six of those twelve years. Where were their solutions?

      My point is, even if this hasn’t been a political priority for previous administrations and congresses, it has been an actual priority for, like, three decades. There are any number of elements of Obama’s plan that I don’t like – I fear and resent “big government” as much as (though no more than) “big corporations” – but something needs to be done. And now.

    • Jordan Green says:

      The other difference would be that national polls indicate the majority of people are in favor of health care, where it wasn’t a major issue 16 years ago.

      But yeah, you might be right about that…I was 12 years old, so I was more concerned with ninjas, candy, and Little League.

  • Nathan Bubna says:

    It’s an echo chamber. This is not a new situation. There is a serious lack of both historical and global perspective in the whole debate. And frankly, there is a 100% chance of death for both the insured and the uninsured. Your quote of that 40% number is wack. Even once corrected to something meaningful, it is still a useless statistic policy-wise, for those who lack insurance often have bigger problems and providing insurance is not always the answer.

    The real, new and pressing situation here is not insurance. It’s cost. Healthcare costs are spiraling out of control in this country due to a wide-variety of factors. Here’s a few:

    - We’re half-socialized already due to Medicare/Medicaid. This prevents both adaptive free-market pricing and single-payer controlled pricing. Half and half is worse than fully either.
    - Even in the so-called “free market” half, we have grossly restricted the size of the market by making it illegal to buy insurance from out-of-state companies (restricting supply choices) and tax-encouraging group benefits provided by employers (reducing the number of demand choices and unfairly handicapping the self-employed and un-employed individuals). Neither of these laws actually make sense in a free market and would be irrelevant in socialized health care. Why do we have them?
    - We are law-happy. Many states pass numerous laws requiring all policies to cover a wide range of things which the purchasers often do not need. New Jersey is a particularly insane example.
    - We have an entitlement society whose lawyer/politicians refuse to enact tort reform. Malpractice insurance eats massive amounts of medical dollars, both directly and through over-intervention and unnecessary testing done out of fear of lawsuits.
    - We’ve redefined ‘insurance’. Your car insurance doesn’t cover routine maintenance. Neither should your health insurance. This wouldn’t be so bad (prevention is good!) if it weren’t for the fact that it hides the real costs of most procedures. Decisions come down primarily to “is it covered?” This is fatal for any ostensibly free market system, as it causes gross overspending.
    - We have a pill society. Despite the previous, the bulk of the US medical establishment is still focused on the technological cure (i.e. expensive one), because these are more profitable. This is NOT an accusation against individual doctors, but rather against the system of drug companies, advertisers and the specialization of the medical workforce. Tech and special knowledge pay better than family practice and lifestyle correction. Where the money goes, so goes the energy of the system. Thus the system is itself biased toward expense. Many studies have proven this, and the culture of the consumers is also to blame. There is more demand for the quick fix, which thus commands more money and energy and thus accrues more attention.

    These are core problems. These are terribly difficult problems to solve. Many of these problems are the result of legislation to correct earlier problems. The legislation being crafted now may fix some of these, but will probably worsen some or even cause new ones. We must work hard and do our best to help people, but we are not there yet and i guarantee we will not get there until Jesus comes back.

    In the meantime, remember that the death of the body can be tragic when it seems premature, but we all have our time to go. It is more important how we live than when we die. I know you all know that, but it’s the kind of thing i believe should always be said in such discussions. It is just that important, however trite it may seem.

    • James says:

      Nathan, great, great post. Very thoughtful. I wish everyone would get that opposition to a bad solution to the problem does not equate not caring for those who need healthcare.

  • Nathan M says:

    Nathan Bubna,
    I agree with your statement that we as Christians are to remember that this world is not all that there is (and nice name, by the way!)However, I have a different opinion on a couple of issues and would like to contribute to the dialogue. Some of the discussions on this and other websites often get heated, so I want to state at the outset that I appreciate you as a brother in Christ and hope that this discussion will edify both of us, as well as others who might view or contribute to the discussion.
    First,I was wondering if you could explain why you think the statistic is “wacked.” The research was done by a prestigious university and published in a reputable journal. It also quoted the lead writer of the article, Dr. Andrew Wilper, as saying, ““The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors, and baseline health.” While I agree with you that providing health insurance will not necessarily solve all of a person’s problems, it is a major issue in many people’s lives.
    Second, it seems in your response that you view the free market as being the answer to the problem, as you state two of the problems with health insurance being that it is “half-socialized” and that the free market has too many restrictions on it. However, I think that putting all of one’s faith in the free market is just as mistaken as putting one’s faith in the government program. As Christians our hearts, mind and will are to be captive to the Word of God. In Scripture it is abundantly clear that the followers of God are called to care for the weak and the poor and promote justice (Lev. 19:15, Deut. 15:7, Is. 58:66, Jer. 22:6, Matt. 5:42, James 1:27). The fundamental question with health care is not whether it allies with capitalism or socialism – the fundamental issue is whether it allies with the Word and heart of God.
    So where does this leave us? First, I believe that Christians are to have an active pessism when it comes to involvement with the government. While I do think that we need to engage with issues that relate to social justice, I think we need to remember that the US is not a theocracy and that there is a limit to the amount of change that can happen through legislation. Secondly, and most importantly, I believe that Christians need to stop watching and criticizing from the sideline and start living out our faith. Christians need to be opening up clinics for those who don’t have insurance, helping pay for health insurance for our brothers and sisters who can’t afford it, etc. My family was privileged to see this kind of thinking in action. We have friends who are part of the Amish community, and one of the families in their church had a baby who needed heart surgery. Because they don’t believe in owning cars, my mom drove them to the hospital. When they got there the man pulled out a large wad from his pocket and paid cash for the surgery! The community had joined together to raise money because the Amish believe that it is their responsibility to take care of one another. This was a powerful testimony to my family (and those at the hospital) about the opportunity to use a situation such as this to be a powerful testimony for Christ. May He give us strength as we seek to live out our faith!

    • Nathan Bubna says:

      No, i said your quote of the statistic is wacked. 40% higher likelihood of death is a meaningless statement, because everyone (100%) dies. You must add some context, as any statistic minus full and proper context equals falsehood. Give a timeframe “die within ___” or “die due to ___” or something, otherwise, it’s wack. Sorry to say. :(

      And no, i do not favor capitalism or socialism. You read that into my post. What i am opposed to is the attempt to combine both on the federal level, which leads to both being ineffective price controls. I espoused no solution in my first post, just complaints. Personally, i would favor county-run or city-run universal, tax-funded healthcare, with federal or state funding optional and no restrictions on coexistant private competition of either the charitable or capitalistic varieties. But the powers that be seem to prefer clumsy, lobbyist-written state/federal half-measures to giving up power to the lower echelons of govt. And i usually feel like the only one out there who sees scale of systems as the primary issue when considering implementations. Everyone else thinks “small vs big” govt, while all i can see is in terms of broad vs local. So i’m not optimistic about the chances for my favored solutions.

      Oh, and you’re right about taxes being equally consistent with Scripture. “My money” is God’s, if the authorities He puts over me tax me or if i give it away, either way it’s His to have. I don’t see a problem either way.

    • James says:

      There’s nothing wrong with favoring capitalism over socialism, Nathan.

    • Nathan Bubna says:

      Why do think i would think that? I do favor capitalism, for many aspects of the economy. I don’t however, favor capitalism in at least the areas of *local run* police, fire and healthcare (though all such services should have options to contract out non-personnel services to private, capitalist endeavors). I believe such services are better run by municipal and county governments and funded by taxes from many levels of government. Of course, healthcare is not currently run that way. I just wish it were.

    • Nathan Bubna says:

      Nevermind. I just scanned my previous reply (“i do not favor…”). By that i meant that i don’t really have any ideological bias to either capitalism or socialism. I consider both useful economic/governmental tools for different applications. Rooting for one of these ideologies to dominate in all levels of government and all sectors of the economy seems extremely foolish to me. Equally foolish is trying to run them in a “half and half” type scenario (like Medicare for the old subsidized by taxes on the capitalism left to the young). Using both tools in that way on the same industry and at the same level of government like that is a recipe for failure. The only way to use both together sensibly on one level/sector is to lay a socialist foundation that does not divide the population, and allow the rich to divide themselves by adding capitalistic support on top. A good example is policing. The government provides a baseline, but those with wealth are free to hire additional private security.

      I do, however, have a strong ideological bias against centralized government. Local control is more democratic, more adaptive to local circumstances, more agile, less of a magnet for corruption (well, slightly), easier for people to escape when corrupt, and is more resilient against threats of all kinds. The federal government is the opposite of all those things. But don’t get me ranting… :)

  • James says:

    Nathan M, your example of people willingly giving of their resources is more evidence, to me, that forced giving (via tax money) is neither advisable nor consistent with Scripture.

  • Nathan M says:

    Thanks for your reply, but I must disagree with your statement. I have heard the argument that when the government stops taxing so high then Christians will have money to give to help others. However, I don’t believe that this is consistent with Scripture. Jesus said that we are “to render to Caesar’s what is Caesar’s” (Matthew 22:21). Also, Paul states that Christians are to obey the civil authorities (Rom. 13:1). Therefore “forced giving” is consistent with Scripture. While I believe that the tax burden needs to reasonable, and there can be discussion about what the best level is, Paul urges the churches to give and makes no reference to taxation (I Cor. 16:1-2, II Cor. 8:1-15). Therefore I believe that the Church needs to care for each other and for the poor regardless of the current tax rate.

  • Nathan M says:

    Not to drag this on, but I would like to explain what I meant. First of all, Nathan, I did not write the article, so I do not have to defend how the quote is used. I was merely wondering what your objection to the statistic was. I do think the meaning was fairly clear, especially if you follow the link to the report, but that’s a matter of opinion.
    James, sorry if my reasoning was confusing. You said the example of the Amish is a reason against “forced giving (via taxes)and inconsistent with Scripture.” My response was that Scripture does teach us to pay taxes and obey the governing authority over us unless it goes against God’s Word. Therefore, your statement that taxes are unbiblical is incorrect. Secondly, I believe the Amish are an example of Christians living out their faith within society. While they are exempt from paying Social Security tax because one can be exempt from this on religious grounds, they do pay all other taxes. When Jesus, Paul and James talk about giving the focus is on the need for followers of Christ to give sacrifically. No mention is made of taxes, so I believe that Christians need to stop using taxes as an excuse for not fulfilling the Golden Rule.

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