Mercy is at the Root of Health Care
- Terry Sweeney
- Sep 20, 2009
September 20, 2009
Mark 9:30-37
Body, Mind and Spirit Medicine
The Rev. W. Terry Sweeney
“The person who loves their dream of community will destroy community, even if their intentions are ever so earnest. But the person who loves those around them, will create community.” Dietrich Bonheoffer
In the Name of God: + Father, Son and Holy Spirit. Amen.
In the past few months our country has experienced an economic recession that was both predictable (the bubble had to burst) in part due to runaway consumer spending using credit, toxic home loans, bad regulatory policies that encouraged lending to unqualified people, and greedy bankers and investment counselors.
We’ve seen the horror stories of the Madoff ponzi scheme; bankrupt companies such as Lehman Brothers; the mismanagement of Fannie Mae and Freddie Mac, the housing crisis, the credit crisis, the jobs crisis, the automobile industry crisis, the crisis in the ongoing war in Afghanistan and Iraq, the crisis around closing gitmo and in the past weeks the health care crisis. . . . . Now I may have missed a crisis or two . . . nonetheless I do think we’re growing numb to the constant cry of Crisis.
Is everything coming unraveled - is the systematic dismantling of America really happening right before our eyes?
We see tea parties and town hall meetings going on across the country – concerned citizens who want their voices heard, especially the middle aged and seniors, are afraid and angry about the possibility of government run health care.
All sorts of name calling is going on – cries of racism and being un-American are being thrown around. . . . . it’s getting really ugly.
In the past few months a gigantic bailout package was passed that apparently is either not working or is going at a snails pace.
In an unprecedented announcement the Fed chairman announced the recession is over while the usual indicators such as two consecutive months of the increase in the GDP has not been realized – in fact unemployment is at 9.7%.
Something doesn’t add up here.
People are afraid the country is going to become bankrupt with deficits unequalled at any time of our history. . . . generations to come will be paying off the debt.
Obviously the fear of recession with inflation is palpable – the memory of the Carter years isn’t that distant.
And looming over us is the issue of health care reform which has literally been thrust upon us. . . . . it’s become the center piece of discussion in America.
It’s not the war in Afghanistan, or Iraq – it’s not the threat of Iran or Russia or China – it’s not immigration reform – it’s universal health care.
The fear is that we’re quickly being driven toward a European style socialist state and this fear, whether well founded or not, greatly influences the health care debate.
With the world in constant crisis and considering the huge changes we’ve experienced in the past few months some might ask, “Are we all actually just straightening out the deck chairs on the Titanic on a national scale?”
It is a surreal experience to consider how quickly the automotive industry, and the banks have fallen into the hands of government control and how quickly the national debt has risen with no end in sight.
People are in sticker shock – shell shock – unemployment continues to rise and housing foreclosures continue – and once again as I said Universal Health Care is being pushed as something we must take immediate action on – right now – and a growing number of people don’t believe it or buy the idea.
Stuck in the argument someplace are those who need health care – people with legitimate health issues – and the question becomes, “How do we approach this morally and I would add theologically?”
A place to begin is to affirm that Jesus Christ came to redeem the world (all of it) from sin and death. He gave His life for the sake of the world and even though sin still exists the redemptive power of Christ is greater.
The full effect of the cross on this world will only come once Christ returns – so the world has been redeemed, is being redeemed and will be fully redeemed at the Last Day.
The examples of present crisis - war, hunger, injustice, genocide, disease – are a result of fallen men and sin.
Going directly to health care – can we improve it? Sure.
Our goals would be to make it more efficient, affordable, and effective – we’d want to eliminate waste, and fraud – we’d want to pay fair prices for prescription drugs and insurance premiums . . . . . but for whom?
Our current system of health insurance comes out of the 1940’s industrial expansion that tied work to the employee benefit of company supplied health insurance.
Further Federal regulation allowed states to license only a handful of companies to sell health insurance and eliminated the possibility of shopping for insurance outside of ones state.
As our population has grown and technology increased both the demand for health care and the expansion of life saving drugs and treatments cause people to live longer and therefore creates the demand which pushes costs and expectation for better technology.
So we want it both ways: to live longer, live better, but keep the cost down to what ever we deem as affordable. Is that unreasonable? Is it possible?
So a growing majority of Americans would like to see some overhaul of the system – especially in premium costs and prescription drug costs . . . . but they don’t believe the system needs to be scrapped and replaced by a government run, public option.
Now, like you I have my own set of personal beliefs. . . . my beliefs on health care may be the same as yours or they may be different . . we may differ slightly or differ greatly.
I do however believe that we can find much common ground – important common ground in a basic principle that all Christians and non-Christians alike should be grounded in and that is MERCY.
Jesus was very clear that the call for merciful acts was within God’s desire for His people.
When Jesus called Matthew to follow him he was chided for eating with tax collectors and sinners. His response was to cite Isaiah 1.11 and Hosea 6.6 and Micah 6.6-8 where God spoke into the hearts of the prophets to reveal His deeper need for genuine honor and not just the ritual offering of blood.
Later as Jesus is moving about on the Sabbath his disciples were hungry and took some of the grain in a field. They were accused of breaking the ritual law. Jesus cited a similar incident in the life of David and went on to tell the teachers of the law that one greater than the temple was with them. Of course they didn’t get it.
Again Jesus cites the prophets and says mercy trumps sacrifice – the attitude of a Godly hearts is better than a mechanical display of piety.
Mercy applied means the spirit of the law is entrenched in the actions of grace toward both the deserving and undeserving.
Mercy is rooted in kindness, compassion and favor. . . . mercy is an action.
Mercy is when a judge uses discretionary power to send someone to prison instead of death row. . . . mercy often comes from a conscious choice.
Mercy like that of the Good Samaritan is not limited by stereotypes, or societal barriers.
The mercy I’m advocating has a universal application that is exercised on an individual basis by each of us.
In issues such as war and poverty and health care mercy is stretched and pulled and sometimes breaks . . . . . I’m not pretending this to be easy – you know some romantic gallant gesture where everyone feels good about themselves.
From a dollars and cents standpoint mercy is the crazy uncle no body really wants to address – the elephant in the room - because it complicates issues like who gets health care and who pays for it and how do they pay for it? Who pays for those who either won’t or can’t?
What limits do we place on health care provision when mercy stares us in the face?
Does mercy ever say “You cannot have this medicine” or “You cannot have this test or this operation or this service?”
I’m beginning to think that what short circuits mercy oddly enough is a the medical profession (emphasis on profession), the corporate enterprise of insurance companies and trial lawyers.
This is not the place to debate the public option, or tort reform, or abortion coverage with public dollars, or coverage for illegal aliens or fines for businesses or persons who remain uninsured.
That can be in another forum.
I believe “doctoring” has become professionalized and specialized. It has also become a corporate business enterprise influenced and boxed in by insurance and pharmaceutical companies and trial lawyers.
Doctors seem to be on a tread mill – like lawyers – to produce – to see patients in large numbers for a short time to bill enough to pay their bills and earn the standard of living they believe they have earned by years of education.
Someone once told airlines don’t make money unless their planes are in the air.
Well the way things work presently is that lawyers have to bill hours, and doctors have to be with patients.
My doctor once told me that he has to work till 2 p.m. to pay the office staff, rent, utilities, and equipment. Anyone he sees after 2 p.m. is income for him. He would not give the exact dollar amount but his malpractice insurance premium is significant.
One of the first things I’m asked at a doctor’s office, ER or hospital is what type of insurance I have or if they know me, if my insurance coverage has changed.
50 years ago, a doctor would employ a “nurse” who received patients in the office, and assisted the doctor. A larger practice may have had a receptionist and a nurse. Today the doctor I see is partnered with two other doctors and has at least 9 people ranging from medical assistants to office staff – they’re primary task is to answer the telephones, and perform various billing tasks.
With salary and benefits they alone would need $500,000 revenue to pay for.
My childhood doctor charged as high as $15 for an office visit, today its $246.
The doctor I saw from the time I was 10, who also saw most of my family, would take at least 15-20 minutes asking me about my family before he would tend to me. Today, I’m painfully aware that my doctor, even though caring and personable, is on a pretty tight schedule. In roughly 15 minutes he has to greet me, hear my complaint, and take some action including follow-up questions, examination, and prescribing some course of action.
My childhood doctor did his own lab work, could take out an appendix and deliver a baby. He treated cancer, and diseases of the elderly. He saw babies, and young children – he gave us our polio shots and penicillin when we had a bug. He was our doctor. In some cases he came to our house. When my father was dying from kidney failure he’d stop by to see him. When my father died our doctor attended his funeral.
Being a doctor at one time meant the doctor was a pivotal part of the community. He knew his patients and they knew him.
In the last year I’ve seen 3 specialists who coordinate my health care with my primary care doctor. . . . his main role seems to be to assess who I need to see. Sometimes he seems very much like the travel agent helping me get where I need to go next.
One stop doctoring has long since evaporated into the vast universe of specialized medicine.
It seems as though the insurance industry forces him to operate his practice around the rules he works under to accept their payments. If we consider that different insurance companies may prescribe different payment rules, it may force the doctors who take insurance such as BC/BS or Medicare, Medicaid, Medi-gap insurances, to operate their practices around principles that constrain or limit patient health care.
To get the fullest impact of how mercy is at the root of health care we have to turn to the scripture.
Let me give you an example of what I mean:
There are 16 chapters in the Gospel of Mark; there are 677 verses in the Gospel of Mark.
If we were to count the number of verses dedicated to the healing of the human person we’d find that 122 verses or 18% of Mark is devoted to healing. Almost 1 in 5 verses; or the equivalent of 3 of the 16 chapters.
The telling of healing stories is clearly critical to Mark’s presentation of the Gospel of Christ. They compliment Jesus’ power over the natural elements of weather, and the spirits of demons . . . . in other words ALL AUTHORITY has been given to Jesus.
Now it’s been said that Jesus did not heal just because people were sick – there were many that Jesus did not heal . . . . . scripture sometimes tells us that many were healed, implying that some were not. (Mark 1.32-34)
In fact Luke relays the story of Jesus’ rejection in Nazareth, his home town, and how He cited examples of Elijah and Elisha whom God sent elsewhere when they were rejected . . . .the result was Jesus did not perform any miracles in Nazareth and the people, in anger, tried to kill Him.
Jesus clearly is not a loose canon, miracle worker, who works off of a societal moral imperative . . . . .
As expected there is something much greater at work here: healing was to demonstrate what God’s kingdom actually looks like: that which is void of sin which results in disease.
The place healing holds for Christ is to give a sign of God’s purest intentions for mankind - to be well in body, mind and spirit - and therefore live fully in The KOG.
I’d suggest one of the keys to getting on the right track to better health care is to better understand and practice biblical mercy.
Mercy must be paramount in our families: the care for others must be seen as a moral obligation of the family for one another. Family members must do everything possible to care for one another and not be too quick to ship loved ones off the hospitals and long term care facilities.
When the family needs help the community around them joins in (love your neighbor as yourself). We are too self centered as a nation and must be more cognizant and willing to help our neighbors.
Health Care cannot be viewed as a percentage of the national economy or as a business enterprise.
The Church must regain its voice and active presence in this ministry – its hospitals and clinics must expand and be available to all people at reasonable costs.
Increase the number of doctors thereby decreasing the number of patients they take on.
Balance out the number of specialists versus family practice and develop a climate of service not just making a large income.
Set malpractice insurance at a reasonable rate – reform the tort laws – help doctors to practice medicine not defensive medicine.
Give patients the incentive to pay their doctors directly and only use insurance for major expenses.
Mercy comes in the form of helping people live healthy lives and when God calls them home to die well and in His arms.
Ending Charge:
We are a small church in a large community surrounded by some of the best doctors and hospitals in the world.
People from all over the world come to the Baltimore area seeking treatment at John’s Hopkins or Union Memorial or GBMC.
The area is packed with millions of people – the ideal picture of the community I had as a child is shattered by the rude awakening of the massive amount of people around us and the seemingly endless needs they have.
Yet I believe even under these circumstances we can begin to follow the pattern of Jesus in sending out the 72 and be like the Good Samaritan by showing mercy to even the most despised and lowliest of those in our midst.
We can argue and debate the public option and discuss our fears or support around it.
We can debate whether or not there is an effort to socialize our medical system – that’s a fair and important topic.
We can discuss tort reform and the place of paying for abortions with public funds – there are any number of important issues we can and should debate.
In the midst of the debate and back and forth there stands people in need.
The question, at least for me at this moment, is what principles do we insist on as a nation?
How can the church model principles that are congruent with the teaching of Jesus thereby demonstrating His power to heal and restore the broken, sick, and dying?
I’m suggesting that one of the non-negotiable principles is mercy . . . . . compassion that comes from the community to one another.
It’s in this spirit that I’m wondering if a few of you (just like we did for the beginning of the skate park) would be willing to prayerfully discuss how we can reach out in mercy to our community.
The homeless have a variety of needs. . . . . St Paul the Apostle once had a foot clinic.
Poor expectant mothers may need vitamins or baby formula.
A large percentage of homes within three miles of us are single parent homes – how can we reach out to them?
What about counseling or screening for diabetes or HIV?
What about people suffering from cancer? Disabled?
How can we partner in deeper ways with the Pregnancy Center West or the Catonsville Food bank?
What about a Free Clinic?
Look, the ideas are endless but again at the core is mercy . . . . . it’s not politics.
Who’s willing to dive in and take a run at this? Let me know.
Amen.
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