Community sense

Health Care and Community

Mark R. Wenger

I was stunned—and then infuriated. The voice on the other end of the line represented a large national health insurance company which shall remain anonymous, although I’ve not forgotten its name. "We do not believe that admission to the hospital is medically indicated. We will not authorize admission or cover the costs."

I was a pastor in the home of a church member. It was evening; there was desperation in the air. The church member had seen a doctor earlier that day, a board-certified psychiatrist, who strongly recommended immediate admission to a mental health facility. I talked by phone with the doctor; I talked again by phone with the health insurance representative. No budge.

I could hardly believe my ears. An accountant 1000 miles away knew more than a physician who had just seen the patient.

The only option was to drive forty-five minutes to a hospital emergency room without assurance of being admitted, something the distressed person was unwilling to do. I left the home of this friend very worried. As it turned out, the next day the person’s employer petitioned (and perhaps threatened) the insurance company and the admission was authorized.

It’s August 2009 as I write. The summer sun isn’t the hottest item at the moment; health care reform is. Town hall meetings have disintegrated into shouting matches. Special interest groups on all sides of the debate have brought out the big guns, blazing away. This conflict has the feel of a civil war with fear and righteous indignation spilling from the media.

The fight is nothing new. In the words of an Associated Press article,

President Barack Obama’s campaign for a health care overhaul is an intense installment in a long-running story, dating to Theodore Roosevelt in 1912. It did not go well nearly a century ago. Roosevelt made national health insurance an issue in his last, losing campaign for the White House, and successive efforts to get it enacted have lost, too.”

I hope the effort finally succeeds this time. And I also hope the reform includes the so-called "public option" authorizing the government to provide health insurance. If I had my way, I’d like to see the United States adopt a single-payer system like Canada or Great Britain’s National Health System.

I’m not usually a fan of movie-maker Michael Moore, neither his message nor his "gotcha" style of journalism. But his 2007 movie "Sicko" turned me into an unlikely fan. When he traveled with a group of patients denied coverage in the U.S. and took them to Cuba for free medical treatment, I cheered them on.

I don’t typically promote a stronger role for government. I prefer smaller networks of community in neighborhoods, families, congregations, clubs, work places, and sports teams. That’s where face-to-face relationships over time foster the vital human connections that give life color and meaning.

But this time the issue and the need are different. I believe the government—state and national—must act to bring some sanity to the competing and bullying private interests that, for too long, have played mean-spirited hardball at the expense of average citizens.

I am not a health care expert; I don’t pretend to understand all the complexities. I’ve been covered by private health insurance most of my fifty-four years—as a missionary kid, as a student, and as a bivocational pastor. I’ve had it pretty good.

During my years of pastoring, however, I often walked alongside persons facing health and financial uncertainty and have helped to coordinate numerous collaborative support and caring efforts. Healing and health care are, in fact, at the taproot of the Christian tradition and community. That’s the heart of the issue for me.

Morton Kelsey, in his book Healing and Christianity (Harper & Row, 1973), contends that Jesus Christ "showed more interest in physical and mental health than any other religious figure in history." During his lifetime Jesus was known primarily as a healer and deliverer from hostile spirits. Healing was part of the DNA of the Christ’s mission.

Jesus operated with an unusual access policy; he was particularly responsive to those on the fringe of social networks. Of the 41 healing and deliverance stories recorded in the traditional Gospels, one-third of them involved women and one-third touched people that no one wanted around, including several foreigners.

In a culture where disease was usually attributed to sin or even God’s judgment, Jesus showed compassion and love for the sick and haunted. He didn’t blame the victims.

This story has been carried forward by millions of Jesus’ followers. Amanda Porterfield, a professor at Florida State University, makes a remarkable claim in the book Healing in the History of Christianity: "Healing has persisted over time and across cultural spaces as a defining element of Christianity and a major contributor to Christianity’s endurance, expansion and success" (Oxford University Press, 2005, p. 19).

In light of this trajectory, something is shameful and immoral about the current health-care system in the United States. The rich can toy with breast implants and tummy tucks while the poor can’t afford to get a rotting tooth filled. If you lose your job, there goes the health coverage too. Doctors play defensive medicine, ordering pricey, superfluous tests just to keep from being sued. Patients can’t buy insurance because of a pre-existing condition. Health claims get denied because the insurance company has to watch its profit margin. And just to keep track of the tangled billing system requires a dual degree in accounting and law.

Speaking of "Swashbucklers of the Day," Garrison Keillor likens the current scheme to "the railroads of the early nineteenth century, when each line decided its own gauge and each stationmaster decided what time it is" (New York Times, Aug. 12, 2009). It reminds me of the tangle of a thousand fishing poles, fishing lines, and sharp hooks. How are you supposed to catch any fish and feed hungry people without getting hurt?

Americans have understood the communal benefit of public schools, public water systems, road construction, mail delivery and public safety. Where does the resistance to public health care come from? I’m persuaded that it is rooted in the weed patch of fear, selfishness, and greed.

Right now the weeds are growing like kudzu, an alien vine that threatens to choke the tree of freedom and moral values rooted in the Jesus movement and Christian tradition. I know there are countless medical professionals and institutions sacrificially dedicated to alleviating human suffering and sickness. The problem is that their admirable efforts are hampered by the mess of a hopeless system.

A caring, effective community fashions networks that equitably provide the basics for the common good: food and water, shelter, care and education of children, public safety, respect for the aged. The time has come for the United States to recognize this shared obligation and practical benefit for all in health care.

This conclusion, however, does not rest ultimately on a cost-benefit analysis. Rather, it grows from the taproot of Jesus’ healing ministry and the enduring Christian tradition of caring for the sick. This moral base is the primary reason I support national health-care reform. A hundred years after Teddy Roosevelt first proposed national health insurance, I hope it finally comes to pass.

—Mark R. Wenger, Lancaster, Pennsylvania, is Director of Pastoral Studies for Eastern Mennonite Seminary at Lancaster.