Rev. Jackson H. Day
Health Care Justice Sabbath: 25th Sunday after Pentecost November 10, 2002
Trinity United Methodist Church
It's a pleasure to be with you this morning. I'm a clergy member of this Annual Conference, appointed to serve as Program Director for Healthcare and Mental Illness issues at our United Methodist General Board of Church and Society in Washington. Like other GBCS staff, my job is to interpret our United Methodist social principles and resolutions both to Congress and to the church. The core issue I face is 41.5 million uninsured Americans in the face of a consistent United Methodist belief that health care is a right. Other issues show how far reaching the problem has become. Millions of seniors have Medicare but no prescription drug coverage. Studies document that white people get better health care than people of color. Financial pressures attack the quality of care. At a meeting three weeks ago I heard that 400,000 Americans die each year as a result of medical errors, making health care itself the third leading cause of death after heart attacks and cancer. A steady stream of nurses turn to other occupations, complaining that nursing has become no longer a profession but an industry.This morning's reading from the book of Joshua contains a familiar passage: "Choose this day whom you will serve...but as for me and my household, we will serve the Lord." Though in the first moments of our relationship with God we may be focused on "what's in it for us" -- for our own salvation and our own eternal well being -- as we mature in discipleship and our relationship with God deepens, we focus more on what discipleship means -- what it means to serve our Lord. What does the Lord require of us? Micah (6:8) once answered that question - it is to love mercy, to do justice, and to walk humbly with thy God - but what does that mean for health care justice?
A year ago I was in Harrisburg leading a workshop on healthcare for Conference Church and Society leaders in the Northeastern Jurisdiction. My intent was to ground the workshop in Scripture. We started by focusing on the healing ministry of Jesus, and I had everyone in the room with me. Then I proposed that discipleship required that we ourselves take on the commitments of healing ministry. I still had everyone in the room with me. Then I proposed that we needed to support efforts to institute a government program of universal health care, and I lost half the people in the room! They couldn't deal with the "G" word.
For me that was a defining moment. Our Social Principles and Resolutions say a number of things about health care, but beneath them all is one common thread - health care for all. The United Methodist Church states clearly to the Congress and the world, "Health care is a right." It should be available universally, and the only entity that can make it available to all persons universally, and be fair in collecting the funds to provide health care to all is government. But can we deal with that "G" word?
For half the people in that room in Harrisburg, the bridge between my first point and the last had broken down. They were committed Christians, compassionate people of good will. But they couldn't get from Jesus to the "G" word!
They are not alone. Last week people in Oregon had a chance to adopt a single-payer state-wide health benefit program for all Oregonians. 79% said no.
Here in Maryland, our Baltimore-Washington Annual Conference leadership strongly supports the Maryland Citizens Health Initiative's Health Care for All campaign. In Maryland we have 43,000 children with no health care coverage, 510,000 adults who are uninsured, and 200,000 seniors without prescription drug coverage. In a 1999 poll by the Abel Foundation, 78% of all Marylanders felt all residents are entitled to comprehensive health coverage and 90% felt all workers are entitled to it. But our suspicion about Government programs and our reluctance to fund them will continue to slow efforts to solve our health care problems.
What help does our faith have for us in getting across to the "G" word? This morning I want to lay three planks across that gap and see if it will help any get from where we are to where we need to be if the United Methodist belief in health care as a right is to become a reality.
Plank 1: Bear One Another's Burdens
The first plank is about bearing others' burdens. Writing to the church at Galatia, St. Paul said, "Bear one another's burdens, and in this way you will fulfill the law of Christ. For if those who are nothing think they are something, they deceive themselves. All must test their own work; then that work, rather than their neighbor's work, will become a cause for pride. For all must carry their own loads." (Galatians 6:2-5, NRSV)
When I was young and trying to find contradictions in the Bible, I gleefully seized on this. Make up your mind, Paul, is it "bear one another's burdens," or "carry your own load?" After getting some life experience, I realize this is a paradox - we need to affirm both compassion and individual responsibility, and one of our challenges is to sort out how much of one and how much of another is needed.
Those who study rights talk about negative and positive rights. Freedom of speech is a negative right. Negative here doesn't mean bad, it simply means that you don't have to do anything to give me that right. If I stayed here and talked all afternoon, you might get tired and leave, but you could leave me free to keep talking and it wouldn't interfere with your lives. To give me freedom of speech, all you have to do is let me alone.
On the other hand, police and fire protection is a positive right. For each of us to have police and fire protection, all of us have to give something up - the cost of providing that protection. When it comes to paying taxes for police and fire protection, we are both carrying our own load and bearing one another's burdens. For me to have the security of knowing police and fire protection will be there when I need it, you have to give up some of your resources in the form of taxes. And you don't even spend time debating whether Jack Day, a nice guy but a complete stranger, deserves this sacrifice of your resources, because you know that for you to have the right to the police and fire protection you need, you have to provide for Jack Day as well.
If health care is a right, it is a positive right, because for all of us to have health care protection, each of us will need to give something up in the form of taxes. This is the essence of the arguments for and against. The United Methodist Church says it is a right. Our society says health care is a commodity, like fancy shoes or a kitchen appliance -- buy it if you can afford it, otherwise, do without.
In our hearts we know society is wrong. When someone is bleeding to death, we know we can't leave them there to die. Even people who have never heard the parable of the Good Samaritan know we have to give bleeding people the care they need. I'm convinced this knowledge comes from our inner awareness that each of us is created in the image of God, is a child of God, and is an expression of God to others. Many of the expensive contradictions in our health care system reflect our society's conflict between our materialistic, consumerist minds, and our God-inspired, faith-based hearts. When God made us, God made us to bear one another's burdens.
Plank II. Respect the Commons
The second plank is respect for the commons. In Medieval England the commons was the big field in the center of the village that was owned by everyone and all could graze their livestock upon it, cows, pigs, geese. So today we can talk about the commons as anything that all of us own together or which includes all of us together.
The first disciples were such strong believers in the Commons that they tried to extend the idea to all of life. In Acts 2:49-45, we read. "All who believed were together and had all things in common; they would sell their possessions and goods and distribute the proceeds to all, as any had need." Human nature being what it is, the disciples couldn't keep up having everything in common, but today anything we have in common is under attack.
When the Industrial age reached England, the commons became a target for the new wealthy class. The Lord of a village would enclose the commons, converting something that benefitted all into something which benefitted only the rich. Without a place to put their livestock, villagers lost their homes. They had to go to the new cities to find jobs and lived in misery and poverty because the commons had been taken from them.
An example of an attempt to enclose the commons in today's Maryland is the proposed conversion of Blue Cross Blue Shield Carefirst from a non-profit corporation with a duty to the public in Maryland into a for-profit corporation whose primary duty is to shareholders. We have become so used to such thefts that when the public became aware that the leaders of this non-profit were slated to personally receive millions of dollars from the California company that wants to buy Blue Cross Blue Shield, the public outcry was far less intense than it should have been.
Efforts of the greedy to make a profit by enclosing the commons are not restricted to the attempted sale of Carefirst. Another commons under threat is community rating in the health insurance industry.
From an insurance viewpoint, the bigger the pool, the greater the ability to spread the risks of ill health. In community rating, the premiums of healthy young people help cover the health care costs of those of us who are older and in poorer health. The system is fair if it's still around when today's young people are old and need these benefits.
But to make a profit, insurance companies pull healthy young people from the pool and offer them lower health care premiums. Inevitably, the premiums for the sick persons who are left in the pool go up. The profit making rule is that once you define a pool, you market to just the healthiest people who are eligible. HMOs marketing Medicare supplemental policies have told their salesmen, "don't sign up seniors in nursing homes, for heavens sake -- find seniors on golf-courses to sell to!"
Community rating is today's commons and it is the basis for health care for all. When the Government can pull all the people in a given state or region or even the entire country into one insurance pool, then marketing costs go away, the risk is shared, benefits are available to all, and in the realm of health care, the dream of the early Disciples who held things in common and distributed them as any had need will be realized.
Under the title of privatization, our American commons is under threat, just as the English commons was under threat hundreds of years ago. A rhyme from that era reminds us there is nothing new in punishing petty thievery while greedy corporate executives go free:
They hang the man and flog the woman
Treating health care as a right, providing it for all, and protecting it from those who serve only their own greed, will make health care part of our modern commons, whose benefits all of us can share, just like police and fire protection
Plank III. Acknowledge your kingship.
The third plank is to acknowledge your kingship. Excuse me? Your kingship?
The books of the Old Testament spend a lot of time describing the responsibility of kings. Isn't all that irrelevent in America where we have no kings? No. In fact, in a democracy, we are the rulers of the land. We are in fact the kings. Doesn't it stand then to reason, that messages of the Bible directed to those who rule the land -- are directed to us?
So what does the Bible say about the duties of kings?The very first duty of kings is to maintain a relationship with God. The writer of Proverbs 8:15 talks of God as the source of good rule and reports God saying, "by me princes rule, and rulers decree what is just". In Psalm 21:1 the King rejoices in God's strength. Psalm 33:16 emphasizes the same point: "a king is not saved by his great army; a warrior is not delivered by his great strength. The war horse is a vain hope for victory, and by its great might it cannot save." The writer of Proverbs again (21:1) emphasizes the importance of the relationship between God and the king: "The King's heart is a stream of water in the hand of the Lord." In a democracy, these words are addressed to us.
The king's relationship with God is for a purpose, and that purpose is effecting God's rule. In Proverbs 31 -- King Lemuel's oracle that his mother taught him -- kings are to speak out for those who cannot speak, for the rights of the destitute. They should speak out, judge righteously, and defend the rights of the poor and needy. The singer of Psalm 72:01 prays, "Give the king thy justice, O God... May [the king] judge your people with righteousnesss and your poor with justice." Proverbs 29:04 assures us that it is through justice that a king gives stability to the land, and 10 verses later assures us that the throne of a king who judges the poor with equity will be established forever.
When it comes to health care, these words apply to the uninsured, a majority of whom are working people whose jobs just don't pay enough to cover health care. People who try to do their best but just can't get ahead. People who have to go into bankruptcy when they have a serious illness. How can we defend the rights of the needy and leave them without coverage?
Acknowledging our kingship opens our eyes that words addressed by God to kings 3000 years ago are also addressed to us, today. Suddenly, when we realize that by virtue of our democracy all of these words are applied to us, these words of the Old Testament become personal and practical.Conclusion
Bear one another's burdens. Respect the Commons. Acknowledge your kingship. These are solid Biblical principles, and they support the United Methodist social principle of health care for all. These are solid planks which can bridge the gap between individual faith, community responsibility, and the role of Government. Apply these principles to today's world, and we will be practicing the words we pray in the Lord's prayer - Thy kingdom come, thy will be done, on earth, as it is in heaven.