Though health care legislation appears to be stalled for now with Scott Brown’s (R-Massachusetts) recent election to the Senate, I want to address the health care debate that is occurring in our country.  My interest is to help us understand the biblical principles touching the subject so that we might think Christianly about it rather than just react to the political rhetoric or our own fears.  Today I will only bring us up to speed on what has occurred in the political debate thus far.[1]  Later, with the help of Dr. Robert Campbell of Christ Community Health Services and Dr. David Jones, Professor of Systematic Theology and Ethics at Covenant Theological Seminary I will try to lead us in a community discussion.  My hope is that with these experts and your input we could assemble some keen Christian insights into this and related topics like human rights, merciful care, justice, stewardship, etc.

One of the many challenges President Obama promised to tackle upon his election was health care reform.  While his administration did not craft its own bill, President Obama charged Congress to:

• Insure all or most Americans
• Give equal coverage to all—no denying for pre-existing conditions or penalizing later for illnesses.
• Offer government subsidies to those whose employers don’t pay their insurance
• Keep down costs

From January to June 2008 three House committees and two Senate committees created three separate bills.  Two Senators wrote two different bills and three committee chairmen in the House created one.  There were basically two questions in the debate posed by the majority party:  1) whether to require all Americans to have health insurance (like car insurance) and, 2) whether to subsidize insurance to keep the cost down (the “public option”).  The American Medical Association, the insurance lobby and labor unions generally supported requiring everyone to have insurance.  And generally physicians and labor unions have supported subsidies for the poor.  Drawing charges of “socialism,” the public option became so contentious that 51 Democrats from conservative states calling themselves Blue Dogs announced they would not support a public plan based on any extension of Medicare.  More moderate Democrats proposed only paying subsidies in the future if insurance companies did not act in good faith.  The projected cost of the reforms would be $1 trillion.

On July 14 the House unveiled the 852-page Affordable Health Choices Act.  It would expand Medicaid eligibility, increased Medicaid payments to physicians, and close a gap in Medicaid prescription coverage.  Other permutations of plans inspired by Ted Kennedy and drafted by Max Baucus (D-MT) were floated through June and July.  Before recess, the bill primary made it through two House committees but the Congressmen were not prepared for the hostile public reactions they would meet with in town halls across the country.

Protests and demonstrations shocked the President and his supporters.  President Obama explained that the outbursts that sometimes resulted in violence and injuries were “staged protests and scare-tactic statements that the House bill supported ‘death squads’ that would urge senior citizens to forego life-extending treatment in order to keep down costs.”  So he took to the offensive with his own town hall meetings and an address to a joint session of Congress on September 9.  There the President took off his gloves and announced, “The time for games has passed.  Now is the time for action.”  However, the most dramatic moment of that session occurred when Rep. Joe Wilson of South Carolina yelled out, “You lie!” in response to Mr. Obama’s assurance that the plan would not insure illegal immigrants.

By October 13, the Senate Finance Committee had brought out the Baucus plan securing the swing vote of Republican Olympia Snowe of Maine. The bill was a compromise plan that would have created insurance exchanges supplemented by the federal government to make coverage affordable.  While it promised to cover 29 million more people it would leave 25 million uncovered, including about 8 million illegal immigrants.

The House completed revisions to its bill on October 29.  The Affordable Health Care for America Act would provide coverage for 36 million people.  Though it promises to reduce the national deficit by $104 billion dollars through savings in Medicaid and the addition of new fees, its projected cost over the next ten years would be $1 trillion.  After compromises on federally funded abortions to satisfy conservative Democrats, the Act passed in the House in a late Saturday night vote (220-215) on November 7. 

The Senate version of the bill made it to the floor on November 21 as the Patient Protection and Affordable Care Act.  By establishing a new public insurance plan to compete with private insurers, it promises coverage to 31 million people.  Its 10-year incremental cost of $818 billion is supposed to be offset by payroll taxes on high-income workers and a new excise tax on “Cadillac” (high cost) health care plans.  By December the Senate bill was stalled by arguments over public funding of abortion and Democratic National Committee Chairman Howard Dean’s public criticism of the bill as favoring insurance companies. 

After Senator Brown’s election, both Senate and House Democratic leaders have expressed doubts that such wide-sweeping reform as was being proposed would be possible.  Nevertheless the President in his State of the Union address promised it would be pursued.

My concern is not to address the political intrigue or maneuverings but rather to begin a dialogue about the biblical principles and mandates touching the debate on health care.  The responsibility of the pulpit is to exposit the Scriptures and exemplify application that can be imitated by the people in every area of life.  Radiating from the pulpit ministry is the organized church’s responsibility to minister the gospel in evangelism, fellowship, education and mercy (Acts 2:42-45).  Therefore in regard to health care the Church’s responsibility is first to teach the biblical principles.  Out of that teaching the Church must encourage its members to apply those principles within its fellowship and education.  An example of such application would be the Lutheran, Catholic and Christian Church practice of providing parish nurses to treat minor health needs and provide preventive health education of their members.  The Church can provide opportunities to put those biblical principles into practice through evangelism as we do through Medical Campus Outreach, the Christian Medical and Dental Association and “Saline Solution” conferences.  And those biblical principles must be put into practice in corporate and individual acts of mercy as we are doing through Christ Community Health Services, relief efforts in Haiti, and financial aid to those with large medical bills.

So let’s start the conversation so we can act. . .

Despite the challenge, the President read a letter written by Sen. Kennedy who had died on August 25 which insisted on the ethical nature of the debate:  “Health care is above all a moral issue; at stake are not just the details of policy but fundamental principles of social justice and the character of our country.”

By October 13, the Senate Finance Committee had brought out the Baucus plan securing the swing vote of Republican Olympia Snowe of Maine.  She made her own statement regarding the ultimacy of the issue, “Is this bill all that I would want?  No. . . Is it all it can be?  No.  But when history calls, history calls.  And I happen to think that the consequences of inaction dictate the urgency of Congress to take every opportunity to demonstrate its capacity to solve the monumental problems of our time.”

[1] E. J. Brown, “How to Bake a Health Care Cake,” Advance 25 (December 21, 2009):  11-21.