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Explaining Health Care Reform & “Christian” Reflections Thereof [REPOST]

Submitted by paulburkhart on Tuesday, 19 January 20106 Comments

Can the common man understand this health care debate? Is there a particularly Christian perspective on health care? Also, a curious and unexpected memorial to Ted Kennedy. Read on.

by Paul Burkhart

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[Editor's Note: This is a repost of an article posted in August. It was fairly popular at the time, and in light of the potential difficulties the current health care bill may be facing due to the fight for Senator Kennedy's Senate seat, I thought it might be helpful to post this up again. I'm also posting this to go along with a recent post I put up on my personal blog called "I sort of want this health care bill to die." It has to do with this Massachusetts's Senate race and health care reform. I hope these resources spur your thoughts on these issues facing our country.]

Below is a series of illustrations by Dan Roam and Dr. Tony Jones of Digital Roam explaining the current Health Care system and proposed reforms to that system. This is by far the best explanation I’ve seen. So much so, it is forcing me to break a bunch of my own rules concerning this site and perhaps even give some new freedoms for what I post up here. Take a few moments and look through this series of slides and familiarize yourself with these ideas. Analysis will follow below. A couple of things before you start: I have no idea why this guy calls these “napkins” nor do I know why he says there are only four. Don’t let that distract you too much. The quality is such that I am more than willing to forgive these minor lapses of clarity.

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View more documents from Dan Roam.

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Okay, everyone up to speed now? So are there any uniquely Christian thoughts on this? First, of immediate concern for those Christians whose consciences are so inclined to view abortion as a fundamentally political and legislative issue (no sarcasm in that statement, by the way; it’s a totally valid way that the Holy Spirit moves in many believers); in Obama’s most recent weekly address, as he “debunks” various ideas being spread about the reform, he says: “Some are also saying that coverage for abortions would be mandated under reform. Also false. When it comes to the current ban on using tax dollars for abortions, nothing will change under reform.” So apparently (at least from what the carefully phrased political talk) it would seem that these sets of reform do not concern abortion.

So with the one health issue it seems Christians have anything to say something about out of the way (yeah, there was some sarcasm in that one), what else does the Christian have to engage with in this debate? Well, before we get quite there, two foundational things that have plagued my thinking about this:

First, I believe it is the clear testimony of the New Testament as to what the ideal would be. If the government just scrapped all of its social policies and health care aspirations and came up to Christians and said, “okay, from the floor up we want you to form the health care system you think is right”, then (in a Biblically ideal world) these Christians would make a completely privatized system driven by the free market – no medicare, medicaid, welfare, or “public option”. Instead, the Church would take responsibility for the poor, the sick, the elderly and the like. Christians, through local churches, would give of their time, their money, and themselves to see to it that all those that lacked would be cared for. They would do this out the overflow of their hearts because they had been so changed by the Gospel of a God who came to us while we were sick and poor and gave of His time, His resources, and indeed, His very life, that we would be made well. This would be the health care of the Kingdom of God.

But, as Mr. Of-Hippo (a.k.a. “Augustine“) helped us understand, Christians are members of the City of God, but they dwell in the City of Man. And this brings me to the second plaguing thought of mine: where the Church fails in its duty and calling as the City of God, is it the right of the City of Man (the government) to step up and pick up the slack? I don’t know. Part of me says the Church needs to see how bad things can get with neither them nor the government helping before they’ll actually take action. Another part of me feels compassionless and insensitive at that thought. But, for whatever it’s worth, most people I respect seem to have the former sentiment rather than the latter.

But nevertheless, the Church has not been given this opportunity to make a system from scratch. We have an existing framework we must work from. And I think we can. When (not if) you went through the above slides, do you remember when they talked about the existing system, and the three plans that are on the table? The existing system was referred to as “Restrictive Private Insurance”. The three plans Congress is currently debating include the “Less Restrictive Private Insurance” plan where everything stays private, but insurance companies are forced to lighten their limitations on coverage; “Private/Public Plan” where there is a non-profit public option that competes with the private companies (non-profit? That’s not much of competition, if you ask me); and a third plan with Private Insurers existing alongside Private “Co-Ops” or “Exchanges”.

It’s this third plan I think most reflects the Biblical picture of health care that can be employed using the existing political structures. In it, people in particular groups (by neighborhood, city, state, region, etc.) pay into one giant pool, and whenever someone in that group gets sick, they are able to utilize the group’s collective pool of money. Whether or not you ever use it is not the point, you are freely sacrificing your resources for the benefit of the whole.

I really like this choice, and like I said, I think it represents the heart of a Christian way of functioning in this City of Man. Heck, it’s the way that local churches are supposed to function in the first place. That’s what the “offering” time is for. It is everyone freely pooling their money together to benefit others – both within the congregation and without – whether or not they ever actually need the help themselves.

In a curious final development. I was shocked and surprised when I looked back at the slides above to find out the names of the various plans on the table. I saw that this “Co-Op” option was not supported by Republicans, the ones usually assumed (incorrectly, I believe) to hold the most “Christian” views in politics. Rather, this was actually one of the plans supported by none other than the now-late Senator Ted Kennedy. I didn’t see that one coming.

So here’s to you, Ted. Though I have strongly and bitterly disagreed with you on most issues my entire life, bravo for shocking me and showing me the narrow-mindedness of my assumptions. I hope this particular plan is pushed through.

Remember: give me feedback and comment on the blog. I need to know where I’m off on this if I am. Where I’m not off, I hope this helps.

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6 Comments »

I sort of want this health care bill to die. « the long way home said:

[...] [You can read more of my recent thoughts on health care over at Reform & Revive Magazine in an article entitled "Explaining Health Care Reform and 'Christian' Reflections Thereof"] [...]

- 19 January 2010 at 7:22 pm

Leonard Riddle Jr said:

Don’t be so quick to assume that the abortion issue is settled. There is only one piece of legislation preventing federal monies from covering abortion and that can be overturned very easily. As a matter of fact, there have been subtle insinuations from Nancy Pelosi and others that suggest a move like that would be Act 2, should they be successful in passing the health care bill.

- 19 January 2010 at 10:27 pm

Leonard Riddle Jr said:

In response to the rest of the post, I sense that you either were like-minded with the napkin guys to begin with or they brought you into their line of thinking. Every thought is clearly presented in a non-confrontational way. That makes it an easy read. That said, there is one point I’m not sure is accurate. Slide 21 highlights the increasing annual profits of the insurance companies. The argument uses this data to essentially assure viewers that it’s OK to pursue the insurer side of the problem and come back after providers later. However, that data may be misleading. What I mean is, reading only the balances of their accounting books doesn’t tell you whether or not the growing incomes are keeping pace with the also growing outlays. Simplify it this way: year x/ income $2 – expense $1 = profit $1; year y/ income $5 – expense $3 = profit $2. The napkin argument is pointing out that the profits doubled but are ignoring how the profit margin shrank from 50% to 40%. These numbers extrapolated out to multiple years might be a frightening business model, especially to an industry being villified by an adminstration for politcal gain. I’m not on the side of insurers, let me make that clear. I just don’t want someone to be convinced by an argument that is concealing parts of the truth.

- 19 January 2010 at 11:00 pm

Tommy said:

I don’t follow the logic of this argument at all (although I am British and so have a different cultural history to healthcare that needs to be borne in mind.

Given the assumption that it is God’s plan for the church to look after those in need. Given that the church is not doing that how is the correct response to let it get worse until the church wakes up? Surely if God wants the church to look after those in need, he wants those in need to be looked after. If the church isn’t doing it how can a Christian say that the state should not? The Christian’s role has got to be to give the church a kick up the backside to start doing its job rather than campaign against healthcare reform that might see the needy looked after!

- 28 February 2010 at 11:40 am

Mike said:

There are some things not covered in this napkin explanation: (1) There is a 4th player that affects costs: lawyers who sue both providers and insurers (and sometimes even patients), (2) HR 767 (all-government, single-payer health plan) is off the table, but still in the works, as the current plan is meant as a transition to socialized medicine, (3) there are triggers that will force all but a select few to eventually give up their current plan and probably even their current provider, so the promise you can keep that is a classice bait-and-switch.

If you bring in free-market forces by putting the responsibility and decisions back into the hands of the patients, then pass tort reform so doctors don’t have to fear unreasonable lawsuits, then the prices will slowly start to fix itself. Imagine that!

- 12 May 2011 at 2:54 pm

paulburkhart (author) said:

“Mike”-

my main problem with the rhetoric of both sides of this is that it just wants to make everything far more simplistic than it actually is–including what you wrote.

(1) Really? This was so clearly addressed during the debate, I was so surprised to see you say this. Just a simple Google search for “health care tort reform” brought up article after article saying the same thing: lawsuits IN GENERAL only account for 1.5% of all health care costs, much less “frivolous” ones (maybe it’s just that Google “liberal bias”). Here are some examples that explain this well: http://goo.gl/Qpvn , http://goo.gl/Itzc7 , http://goo.gl/JsCvc

(2) This isn’t a “point”. This is fear-mongering. Most other first-world countries in the world have a single-payer system like that. It’s like saying “you can’t pass that bill, it will turn Congress into a Parliamentary system.” It’s not “argument” or “reason” to “counter” this. It’s throwing out some buzz words that sound “scary” to us Americans and saying “see? You don’t want THAT, do you?” Now, you may think that a single-payer system isn’t the best way to do health care in America–and that’s fine–that’s just a different “point” than simply saying “the scary and evil SOCIALISTS in Congress are conspiring to bring this about.” Your statement assumes that there is something inherently wrong about this system (which it’s not), that most people wouldn’t want it (which surveys continually showed that at the time this article was written, they did), and that American ingenuity couldn’t figure out a way to do it “Americanly”. That’s a lot of unproven assumptions that need to be addressed before you can simply say “they’re secretly doing this; be afraid!” Now, I personally, think those things have responses, and I don’t think a single-payer system is best in the long-run, but I just can’t stand the oversimplifying and fear and rhetoric-based things that keep being said about this.

(3) once again, this isn’t a “point”. Maybe what you said is true. Repeatedly, Democratic and Independent have said it isn’t true and you will be able to keep your insurance and Republicans are just twisting things; but maybe you’re right. But, even if so, you have to show that this would be bad. Perhaps many people aren’t satisfied with their coverage and costs, so slowly moving them off their already poor coverage may not be bad. Perhaps these “triggers” will be motivations for insurance providers to do what’s necessary to keep their clients. And even if the time comes when this happens, people will either be happy and content, or unhappy and freak out. And then, our legislators, terrified of not being re-elected, will rush some solution through Congress for us. So, either way, this is not some “doomsday scenario”

Once you get corporations and insurance companies get so big that they are wealthier than some nations in the world, “free-market forces” break down. Money doesn’t “trickle”, services/products don’t get better, things don’t get cheaper. The invisible hand is NOT the end-all-be-all of problem-solvers. Prices don’t “slowly start to fix” themselves when it comes to economies of scale of this size. Look at cable companies, utility companies, and phone companies. As more competition has entered the mix, prices HAVE NOT GONE DOWN. It’s NOT THAT SIMPLISTIC OF A SITUATION. People need to stop thinking in these black-and-white, either-or, good-and-evil, Republican-Democrat dichotomies that are KILLING us.

The Individual Mandate was first introduced by Republicans in the 90s. The bill that passed was very similar to the Republican bill offered to and rejected by Clinton. Most people are angry and see this bill more as a GIVEAWAY to the insurance companies–not the death of them. The CBO has said REPEATEDLY that it will LOWER the deficit. There are just as many opinions about this bill as there are people. This is complicated. I just wish people stayed away from talking points and overly-simplistic generalizations and actually gave some thoughtful, nuanced, and careful analysis to this. The above article represents what I feel is the closest to a REALISTICALLY achievable “biblical” picture of health care, NOT the most efficient or cost-reducing PER SE.

Do I think the that passed is ideal for health care? No, not at all. Do I have a comprehensive solution that ties up all the loose ends? No, not at all. Do I think there exists a single comprehensive solution that will tie up all the loose-ends for everybody? No, not at all. Do I think this bill will dramatically affect may day-to-day existence? Not really. Do I think the country will end or be radically altered in its substance or character if this bill stays in place.

Nope.

Not. At. All.

- 12 May 2011 at 3:53 pm