Rusty Benson
AFA Journal associate editor
November-December 2009 – Not so long ago health care seemed to be a simple proposition for both doctor and patient.
A Time magazine article published in January 1950 profiled two family doctors in rural western Nebraska. Dr. E. Howard Reeves and his partner, Dr. Robert A. McShane. In a week the two young physicians treated some 300 patients in their office, made 40 house calls, delivered four babies and performed several operations in their own 10-bed hospital.
For their normal 16-hour, 7-day-a-week practice, the doctors grossed around $20,000 yearly. According to the story, 20% of their services went to patients who could not afford to pay.
Noteworthy to contemporary readers, the feature story made no mention of insurance, threats of lawsuits, government regulations, Medicare, Medicaid or patients who were unhappy with fees ($50 to deliver a baby, $125 for an appendectomy).
Sixty years later, debate over reforming health care in America has laid bare a system only remotely resembling the one documented in the Time article. The functional simplicity of the country doctor’s practice has evolved into a health care system so colossal, so tangled and so abused that even the lawmakers creating future policy are dumbfounded.
Rep. Collin Peterson (D-MN) said, “The members [of Congress] don’t even understand what’s in [the current health care bills].” Senator Olympia Snowe (R-ME), a senior member of the Senate Finance Committee, agrees and has confessed publicly that she is perplexed by the length and complexity of the current bills before Congress.
Lawmakers, reportedly working behind closed doors, are now merging bills into a final proposal. These include: The Baucus Plan or America’s Healthy Future Act of 2009; The Senate Bill or The Affordable Healthy Choices Act; and The House bill or America’s Affordable Health Choices Act of 2009. Although cost estimates are difficult to nail down, each bill carries a price tag of around $1 trillion over the next 10 years, give or take a few billion.
So how can the average taxpayer understand a debate that overwhelms policymakers? That question is why AFA asked a selection of knowledgeable Christians – some directly involved in health care – to weigh in on the issue of health care reform and identify their top concerns.
Major surgery or take an aspirin?
First, we asked our panelists if the nation’s health care system needs a complete overhaul, a tweak or nothing at all. Most expressed opinions that major surgery is not necessary, but that something more than an aspirin is required.
“There are steep reforms that are needed at the base of things,” said James Landsberry of Samaritan Ministries, a Christian health care sharing ministry based in Peoria, Illinois. Near the top of Landsberry’s list is a system that divorces health care from employers.
Ken Connor, a trial attorney and chairman of the Washington, D.C.-based Center for a Just Society, says significant reforms are warranted, particularly in the area of health coverage for the nation’s working poor. However, his first concern is that proposals being pushed by the president and the Democratic Congress will amount to a paradigm shift in which the government will assume an even larger role in individual health care.
“Killing a roach with a cannon” is how Richard Land described the current proposals in Congress. Land is president of the Ethics and Religious Liberty Commission of the Southern Baptist Convention.
He says that the major problems in our health care system could be solved fairly easily without a complete restructuring. He also contends that there is a broad consensus in Washington to do just that. However, Land believes the president is determined to establish single-payer system – basically socialized medicine for America.
“I lived under socialized medicine for two years, 11 months and 4 days,” Land said, “and I can tell you that it is horrible.”
Who pays and how much … and who decides?
When Christians talk about health care as public policy, concerns for those who cannot afford the high cost of insurance naturally arise. Two of our Christian leaders, Landsberry and Robert Baldwin manage Christian ministries that for years have offered affordable, non-insurance solutions that work especially well for low-income and self-employed people.
Baldwin is president of Christian Care Ministries (CCM). Like Samaritan Ministries but unlike medical insurance, CCM members share their medical bills with one another through a program called Medi-Share. About 100,000 people in all 50 states participate in these sharing arrangements.
The two ministries have formed an alliance to work for the inclusion of exemptions for their members in proposed legislation that otherwise would require citizens to obtain health insurance or pay an annual penalty. At present, only the Baucus bill contains such an exemption.
Baldwin says that from his unique position of managing a non-insurance health care alternative, he sees the importance of fair competition and pricing transparency. He believes the Internet could play a key role in bringing equity to health care fees.
“Ten years ago when you purchased a car, you went into the dealership, looked at the sticker price and began to negotiate down,” said Baldwin. “Now you go on the Internet, find out what the dealer paid for the car and start negotiating up. Why can’t medical care be the same way?”
Land raises another issue that penalizes those who purchase their own health insurance. He explains that those who get their coverage through an employer don’t pay taxes on the premiums or the benefits of their coverage. However, people who purchase their own insurance don’t enjoy the same unlimited tax breaks.
Finding solutions that address the needs of the poor would also help fix what Dr. Joseph Leonard sees as a major ground-level problem in the current system.
“So many people who do not have the ability to afford basic health care for chronic diseases use emergency rooms as the provider of last resort on an episodic basis,” he said. “It’s en extremely expensive way to manage chronic diseases.” Leonard is a family physician in San Diego, California, and a member of the Christian Medical and Dental Associations.
Connor challenges both political parties when he talks about justice as a priority in health care reform. He contends that an honest examination of the way government operates must conclude that the rich and powerful – including large health care groups and pharmaceutical companies – are better represented than the poor before government. He lists two reasons that the poor are a disadvantage: First, the rich make campaign contributions as a cost of doing business. That’s why wealthy corporations and individuals often make political contributions to both parties in an election and sometimes to more than one candidate in the same party.
Second, the wealthy can afford a presence at the seat of power through lobbyists. The poor most often cannot, Connor says.
“I think it’s fair to say that Christians and a others who are interested in a just society ought to examine if government is giving preference to one group or another,” he said. “In my judgement, government should not prefer the rich over the poor, or the poor over the rich.” Connor argues that any health care reforms that do not meet that simple principle of justice should be challenged.
Government – the solution of the problem?
An issue that tops the lists of several panelists is the role of government in our society, particularly its growth and increasing power in the lives of Americans. Closely connected are worries about the impact of a federalized health care system on a federal deficit that is already unimaginably huge.
“We are avoiding the inevitable – our massive deficit, the enormous projections of federal spending and our propensity to continue to increase the role of the federal government,” said Jim Eckman, president and professor of Bible and history at Grace University in Omaha, Nebraska.
Quoting economist Robert Samuelson, Eckman said America is facing an “unprecedented collision between Americans’ desire for more government services and their almost equal unwillingness to be taxed.”
New figures from the Congressional Budget Office and reported by Samuelson make the point powerfully, Eckman said: “For the last 50 years, federal spending has averaged about 20% of GDP (gross domestic product), federal taxes about 18% of GDP and the budget deficit about 2% of GDP. The CBO estimates that by 2020 (assuming full employment) federal spending will be 26% of GDP, taxes 19% GDP and the deficit about 7% GDP.” The net result is that “balancing the budget in 2020 would require a tax increase of almost 50% from the last century’s average. … All of this is exacerbated by the aging population and the rapid increase in health spending.”
At the end of the day, Eckman says the key focus of lasting health care reform should be controlling spending, not expanding the services of government.
The ultimate issue
A draft document developed by Land’s organization, title Fifteen Principles for Successful Health Care Reform, names the sanctity of life as a priority one in the attempt at health care reform.
“Health care must honor all human life, from conception to natural death. Every stage of life, every type of disability must be treated with utmost reverence for every life,” according to the document.
Land says that on this issue, the legislation now under consideration missed the mark. “The pro-euthanasia fingerprints are all over this legislation,” he said.
And despite the president’s denial, Land is convinced that a universal health care plan would provide for abortion. “The president is not telling the truth when he says it does not provide for abortion,” Land said. “If the bills don’t provide for abotion, they why is it that Congressmen Waxman (D-CA) and Pelosi (D-CA) have fought like tigers to keep it from been excluded? It’s because they know from previous experience from Medicaid that unless you specifically excuse abortion as a covered service, the court will force the government to cover it.”
Prescription for reform
Each of our panelists voiced concerns for issues that deserve deeper consideration than space here allows. These include: tort, reform, preventative care and wellness, catastrophic insurance coverage, fraud and abuse in the system, entitlement programs, government inefficiency, insurance portability, maintaining a civil discourse in health care. For Christians the wide range of concerns underscores the need o come to the debate with Biblically consistent guiding principles.
The priorities of our Christian panelists tend to fall under three quitting precepts: 1) preserve the sanctity of life; 2) implement a patient-centered system rather than move from the current employee-centered system to a government centered system; and 3) promote equity and justice for both patients and the health care industry. 
Northern light by Fred Jackson, director of American Family News Network
Growing up in Canada, I don’t remember my parents ever expressing concerns about medical expenses. There was no need.
You see, medical care was like the police and fire departments. When you needed the services, they were there. And you never saw a bill.
But that was then.
Today, Canadian health care is still, for the most part, run by the government. However, the system has become a major financial burden. Not surprising, there have been cuts in the level of service provided.
The complaints I hear include waiting long periods of time to get basic diagnostic procedures, such as an MRI. Also, Canadians may wait months for non-life threatening operations such as cataract surgery.
In areas that have several hospitals, weekend emergency services are sometimes shut down in all but one hospital.
For the most part, all of these changes have occurred over a long period of time, so there have been no major citizen uprisings.
Another development in recent years has been the evolution of an upper tier of medical care. This higher level is available to those who can pay private sector doctors so they won't have to wait months for services. These are folks who used to come to the U.S. to get a procedure done rather than wait in line.
At first, there was some resistance to the idea from those who said it was unfair to have two levels of medical care, basically one for the rich and another for the rest of the population.
However, the reasoning that apparently won the argument was that if these wealthy people are going to spend the money anyway, why not keep the dollars in Canada?
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Health Care Debate Resources
• The Heritage Foundation www.heritage.org
• Christian Medical and Dental Associations www.cmda.org
• The Center for a Just Society www.centerforajustsociety.org
• Ethics and Religious Liberty Commission of the Southern Baptist Convention http://erlc.com
• Samaritan Ministries www.samaritanministries.org
• Christian Care Ministries www.tccm.org
• Issues in Perspective with Dr. Jim Eckman www.inssuesinperspective.com
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