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22.3.10

Obamacare: An Attempted Christian Response

I said I don’t comment on politics very often, and I try not to, mainly because I lean liberal and don’t want to put any one off with my political views. I have had both conservatives and liberals agree with things I’ve said on this blog, and I want to keep it bipartisan in an effort to bring people together under the banner of Jesus’ love and for learning ways we can act as a church community and individuals in the here and now, rather than devolving into party line bickering. As a result, I’ve refrained from direct political commentary in a lot of respects, though, after reading several of my blogs, one would probably get the sense of some of my political stances.

There is one debate that is on the lips of every (even remotely politically active) person as of late, as a result of the House of Reps’ actions on Sunday night. At this point, since 1. A few people have asked me my opinion and this is the best format to create and display my argument, and 2. I feel like I cannot refrain from commentary on this issue, especially since Christians on both sides are heavily and emotionally divided, I have decided to post. Therefore, consider this my comprehensive post on what is colloquially called “Obamacare.” I have tried to cover every aspect of the debate that I have encountered, and therefore this entry is extremely long. I trust, however, that you will take the time to read and consider what I have to say on each of the issues (the specific ones of which I have put into headings).

Brew yourself a cup of fair trade tea, sit back, and try to have an open mind to what I have to say.

What Do We Want in a Debate

There has been a lot of mud and poop flung by people on both sides of the health care debate, along party lines, along the rich-poor gap, along age and gender lines as well. This morning, as I sat down to my devotions, I thought about my goals in debating. Having been a debater in high school, and a naturally competitive youngest child – the only sister to two older brothers – my goals in debate are not usually to find the truth. I will be honest about that. In the shower this morning, I turned the health care debate over and over in my head, thinking of different ways I could win, different arguments I could put down on page that were, prima facie, logically sound and hard to beat. Rather than searching for truth, I found myself wanting to win.

And it is something many of our representatives in Congress need to realize as well. I think we have stopped looking at this issue as “how to make this better” and instead started looking at it as “how I can win this debate. Both sides seem to have forgotten the common ground that this debate began with: That the health care system needs reform. There are 30 million (that’s 1 in 10) Americans uninsured, which results, often, in preventable and unnecessary death, rising health care costs, and what is generally agreed to be a broken system. Believe it or not, both sides agreed on this, in the beginning.

What the true disagreement is about is one of philosophy: how involved should the government be in fixing the problem? Essentially, if I may water down the debate to simple terms, conservatives tend to be in favor of a free market system which doesn’t have government infringement on company policies and balks at governmental regulation of industry. Liberals, on the other hand, see the government involvement as necessary in order to protect the people from being trampled on by big business.

As a result, one side sees government regulation/involvement in the health care industry as a necessary solution, and the other as an unnecessary infringement on basic human rights.

I have struggled for a long time about where a Christian, especially a social justice advocating Christian, fits into this spectrum of belief. In recent months, I’ve heard tossed around the saying: “When I feed the poor and help them, you call me a saint. When I ask why they are poor, you call me a communist.” While trite, I think what this statement does is sums up a lot of the feeling on the liberal social justice end of things, and happens to be where I fall.

A Kingdom Orientation

Let me explain for a moment. Jesus, when he came to earth as the Incarnation of the one true God, did not merely heal the poor, though it was a large part of his ministry. He also spent much of his time calling out church authorities that helped create the poor in the first place. He questioned the structure, which, at that time, was heavily integrated with the government. Keep in mind that when the Jewish authorities wanted to get rid of him, the issue did not merely remain as part of the church, but went to the governmental authorities of the area. While Jesus said, “Give to Caesar what is Caesar’s,” he also spoke up against oppression by particularly church authorities, and reigning governmental authorities.

Jesus spoke continually of the “kingdom of God” or the “kingdom of Heaven,” using phrasing that called into the minds of his followers not a violent overthrow of the government that posits Jesus as the bloody Caesar ruling over all, but a following of peacemakers that has kingdom of heaven priorities for the oppressed and the poor. That doesn’t mean entirely separating oneself from the government as a Christian, but instead, acting not to oppress others with one’s theology, but speaking out against those strictures that create oppression in the first place.

This is how I try to view politics. I question those structures which create oppression – in this case, the current insurance system, which allows the child born with asthma to not get coverage – and do what I can to reform them, or, if need be, peacefully fight against them. Martin Luther King, Jr., writes in his Letter from a Birmingham Jail:You deplore the demonstrations taking place in Birmingham. But your statement, I am sorry to say, fails to express a similar concern for the conditions that brought about the demonstrations. I am sure that none of you would want to rest content with the superficial kind of social analysis that deals merely with effects and does not grapple with underlying causes. It is unfortunate that demonstrations are taking place in Birmingham, but it is even more unfortunate that the city's white power structure left the Negro community with no alternative.” He saw, at the heart of his mission, the need to question the overall structure that oppressed his people.

As a follower of Jesus, the poor are my people, and I have to question a structure – whether it be government or Big Insurance – that oppresses the people.

Hopefully the preceding clarifies some of my view. I see it as perfectly within (and eventually an obligation of) the rights of a Christian to question government tactics, and to question the systems in which we live, especially if they are systems that create oppression. This is something I hope Christians on both ends of the political system can agree with – we have a right and obligation as Christian to respond to oppressive authorities, whether that be governments or insurance companies.

Health Care Reform Itself (Click for a brief summary of what is actually in the bill!)

In a vote late Sunday night, the House of Representatives passed one of the largest and most gigantic pieces of reform legislation of recent years. Obama and his staff/Congress have been debating heavily about this issue essentially since the day Obama was sworn into office (and before, during election season).

In the course of the debate, Republicans made a singularly disastrous move: They refused, from the beginning, to compromise, to deal with the Obama administration on what should go into Health Care Reform. It was a decision made strictly along party lines, and essentially destroyed any possibility that this would be a [relatively] smooth process. Instead, the debate became embroiled in slurs, name calling, poor characterization of opponents on both sides, and imprecations of character.

The debate divided along party lines and became much more about winning than finding a solution.

In that sense, this was the wrong time to attempt health care legislation, or at least a package so large. With the amount of misinformation, internet rumors, and yelling and crying pundits, this would have been a battle at any time, but to have it be the first major piece of legislation for a president, in war time, during a recession, was a poor decision. In my opinion, Obama should have made moves to end the war in Iraq, and establish himself as a peaceful president, rather than embroiling himself in a health care battle right out of the gate.

That said, I don’t have a lot of problems with the legislation itself. The current system of privatized health insurance leaves millions uninsured, unable to pay for necessary medications, and often suffering unnecessarily. “Pre-existing conditions” result in health care costs being hiked up, or people unable to find good coverage because they are already sick. Pharma companies make people pay $600/month for medication that costs $10 to make.

The current system is built around making money, around the profit margin, and not around serving people or helping them in their illness.

This is a problem. When a system becomes more concerned about a material object – making a profit – than it is about human life, there is a problem. As Christians, this is a fundamental flaw in our capitalistic system I believe we need to question: It’s all well and good to exercise your inventiveness, your cunning, and your skills as a businessman. I’m fine with that part of capitalism – I think it’s great and right to encourage people to be the best that they can be. But, as a Christian, I have a problem with a system that naturally oppresses those who are not good enough. Those with skill should turn around and help those without. Instead, American capitalism has become about whether or not I can make a dime off of your suffering, to put it bluntly. At least, that’s how it is in the insurance industry works (and numerous insider testimonies corroborate this idea).

In this sense, the health care reform recently passed by the House is a good idea. It will eventually (by 2014) eliminate the problems of pre-existing conditions, put caps on what insurance companies can charge, and stops insurance companies from dropping you from their coverage when you get sick.

Now, is all this government involvement a bad thing? Again, this brings us back to a debate on philosophy: Should the government get involved in the regulation of the free market? Well…the American health insurance industry is one of the few industries NOT regulated by the government. Think of it this way: the insurance company puts out a product – insurance coverage for medical care – and the government is seeking to make sure that is safe for the American consumer. In the same way, there are government regulations on our food, on the cars we drive, on the toys we give our children, and on public education. Government involvement, then, is nothing new. This is simply regulation of a business that has, in many respects, gotten out of control.

BUT IT TAKES AWAY MY FREEDOM!

This is where (if it hasn’t already), this debate is going to turn heated. I’ve heard a lot of yelling and crying about how “this legislation is going to take away my freedom!” “We’re going to be no better than those socialist countries over in Europe!” and “It’s positively un-American!”

First, I want you to walk away for a moment, take out a sheet of paper and write down all the things you think America is about. This is a big question, but it needs to be asked: What, precisely, do we mean when we say that something is un-American? What, exactly, is an American way of doing things?

Have you done that? Do you have a good idea in your head about what is or is not American? Can you picture that in your head, with a red, white and blue flag waving behind it, stars and stripes forever, etc.

Now think about America as it is.

Does your picture include executives lining their pockets with money from soaring insurance premiums?

Does it include the mother who has to take her asthmatic child to the ER because they couldn’t afford a simple inhaler?

Does it include the 23 year old involved in an accident with a drunk driver who is now going to be in debt for years to come because of medical bills?

Regardless of what we want America to be, this is what America is. We have let insurance companies who are concerned mostly about profit take our money and hold us in a tight grip of worry about our prescription coverage, our ER visits, and our preventative care.

Does this fit with your picture of a free America?

Now, I know the counter argument: Governmental health care is no better – it takes away my freedom of which doctor I can visit and when, etc. It’s on a slippery slope to socialism.

I’d like you to scroll back up and read through the Reuters summary of the HC legislation again. If there is a point where it requires you to leave your private insurance plan (probably provided by your employer) in order to take the so-dubbed governmental Obamacare?

It’s not in the bill.

As much as Glenn Beck, et al, would like us to believe, this plan, while large, is far from a socialist take over of the government. The major tax hikes come on the optional service of tanning beds (because they up peoples’ chances of getting skin cancer immensely), on people who earn $200,000 or more a year, and redistributes tax dollars to subsidize a governmental health care plan for those who are fall under 400% of the poverty line (for information on the federal poverty line, look here).

Ahaha! REDISTRIBUTION! That’s SOCIALIST! AND SOCIALISM IS BAD.

Not quite.

Let’s take a look at our definitions of socialism. Socialism is an economic policy mandating that any wealth one makes be taken by the government and given to the poorer neighbor, commonly referred to as redistribution of wealth. Socialism and Communism have frequently been conflated (much thanks to Glenn Beck and compatriots for that one), but the first is an economic system, and the second is a governmental system. While they do, frequently, go hand in hand, neither is occurring with this legislation, nor will occur. The redistribution of taxes merely pushes the money that was already coming into the federal government in a different direction. It doesn’t, except for the wealthiest, take necessarily any new money in.

You’re already subsidizing someone else’s health care costs on the current system. The only difference is it’s through a private business that is concerned about making money, rather than through the federal government that is concerned, one would hope, about the health of its people. If I am uninsured, get sick, and am unable to pay for care, the hospital passes that cost along to other insurance companies, which then pass along the cost to you, the consumer, by way of higher premiums and less coverage. You’re already subsidizing the cost of the poor and uninsured through the premiums you pay to insurance. NPR’s This American Life did a great podcast about this a few weeks back – have a listen.

But what about the requirement that you have health care? That’s heavy governmental involvement! The requirement that each person be on health care, whether or it be the governmental plan, which is determined by necessity of income level, or through private plans (which are NOT eliminated as a option, contrary to popular opinion), is a definite mark of government involvement in one’s life.

But I ask you: how is this different than mandated minimum coverage on your car? The reason the state mandates that is because, if you get in an accident and you aren’t covered, the cost of those repairs gets passed on to other people (ironically close to the current health insurance system, eh?). Governmentally mandated auto insurance ensures that the cost and penalty for failure to have basic coverage will remain with the individual responsible, rather than passing the cost along to someone else. Hmm, sounds a lot like “personal responsibility” to me…

Why do we care more to insure a material possession than the health of our bodies, something ultimately much, much more important?

Okay, okay, I hear the counter argument now: Governmentally mandating this coverage is wrong. If that’s wrong, than you have to be willing to argue that governmental regulation on ANYTHING is wrong. That means you have to be okay with handing your child a toy that hasn’t been inspected and doesn’t meet safety standards. You have to be okay with eating food that hasn’t passed an inspection and doesn’t have a governmentally mandated expiration date. You have to be okay with attending a college or high school with teachers who haven’t been certified to teach, and may tell you completely wrong information.

Extreme examples? Sure. But they are examples of governmentally regulated industry in everyday life. This bill simply extends already existing governmental regulation to health care and the health insurance industry. It’s good to know that, even if I fall in dire straits after I have children, my kids will still be covered, even if it is by a governmental plan.

But, but, ABORTION?

Ah, we have finally reached the source of much controversy and problems. Are my tax dollars going to pay for abortions?

In the new exchanges market set up by the bill – a plan that allows one to select which insurance policies to buy or not (private plans vs. governmental), and allows people to shop around more – there are two policies that are offered: one with abortions and one without. The new language inserted into the bill this weekend mandates that those who choose the abortion policy, even if it is the plan subsidized by the federal government, must pay a small surcharge, with funds that are kept separate from the overall policy. So yes, the plan allows abortions – that’s a debate that won’t be settled any time soon – but with the new language, the money is kept in separate areas. It might be a “bookkeeping exercise,” as some Republicans have called it, but it’s an important one.

Your federal tax dollars do not fund abortion, something that Obama is drafting an executive order to insure (see above link). It’s been pretty well settled.

Conclusion?

After 7 pages (typed in MS word) of my coverage on this bill, it’s a little hard to sum up, but I’ll try.

Essentially, it goes like this: [1] The Republicans cut themselves off from having a reasonable voice when they declared they wouldn’t compromise. [2] This was probably the wrong time to launch the bill, but what’s done is done. [3] The current system is broken and oppressive, something that Christians on either side need to realize and act upon. [4] Governmental regulation is nothing new. We are not on a slippery slope toward socialism. This plan is not a governmental take over of health care. Private plans are still offered and available, and will hopefully be, in fact, better. [5] Socialism is not going to be the result. Indeed, socialism has been used mostly as a way of scaring a lot of the older generation, but when the specifics of the bill are examined, there isn’t much that one could point to as socialist. [6] Your federal tax dollars are not going to fund abortions. Period.

I don’t support the way the Dems went about getting this legislation out there (it created much more divide and part of the blame for the lack of compromise lies squarely on their shoulders as well), and it will be interesting to watch it be implemented, but I am, overall, excited that 30 million people are going to be able to get affordable coverage now, and that the insurance industry will be reigned in.

It is not perfect, but it is not going to destroy America either. If anything, it will make us better because it will show that we do, indeed, care for the least of these, and that, indeed, is admirable above all.

10 comments:

  1. Diana,

    I really appreciate your thorough discussion of this topic. It is nice to know that not everyone at church ignores the side of the Other. For what it's worth, I tend to agree with you. By the way, I enjoy your writing and plan on checking in on your blog more often. Hope the thesis defense went well. See you sometime.

    Aaron VanValkenburg

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  2. When I say "the Other" I mean that most of my social connections are Republican and so Democrats would then be "the Other." I am still unsure about a lot of political issues, but in many ways, "the Other" would be the Republican party for me.

    Aaron

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  3. Dianna:

    Nice post. I think it is unfair to characterize Republicans as wholly responsible for the partisan divide in participation on the bill. One of the problems I have with the bill is more a problem with legislative process in general than this specific piece of legislation. The kind of ad hoc line item vote-buying that squeezed this bill through was the only sort of participation offered to republicans who wanted to reform health care. Their hyperbolized objections to sitting down to discuss the bill stem from a real and persistent problem in American politics. There was no option to sit down, re-establish middle ground, and work toward a solution everyone could agree on. When Obama asked them to participate in the process of building the bill, he was really asking them to contribute small additional pet projects and ideas, the very same kind that make this bill c. 1000 pages long.

    There are a number of standard-establishing and policy defining sections of this bill that cannot adequately be considered in the context of the major concerns of the bill. Marriage counseling is addressed in this bill, as are training standards for those working with people suffering from dementia. The Washington Post reported on student loan amendments appended to the bill (I searched the bill for nearly an hour and couldn't find these, however). In addition, there is the tanning bed tax. These inclusions are not necessarily bad, but they have not been given due process of debate and consideration that they would have had as separate bills.

    The part of this bill that likely wouldn't have passed without the rest of its ridiculous monsterousness was the part that MANDATES purchase of health care. I am opposed to a continued privatized system that mandates purchase of a product. There is a reason health care stocks skyrocketed today.

    The health care system needs overhaul. Health care is not a free-market product; no one whose grasp on reality is not in question will refuse medical treatments for major illnesses, no matter the cost. A product you cannot live without is a product whose quality and price cannot properly be dictated by consumers, the way products should be in a free market system.

    This was a shoddy way to go about reforming health care, democrats must bear their share of the blame for the partisan effort, and what really requires reform is the legislative system that permits the passing of the kinds of disparate reforms and programs that this and other recent bills (I'm looking at you Stimulus 1 & 2, Jobs Bill) have included.

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  4. Dianna, this is a really well-reasoned response to a very complex issue. Thank you for your thoughtful consideration on this matter. I, too, have struggled to make sense of this whole conversation from a Christian perspective, and many of your thoughts reflect my own internal dialogue on the matter. I'm happy if this bill is an answer to prayers for many, and if the widow and the orphan are cared for as a result of the passage of this bill, then surely God will be pleased. I'm equally sure that if greed and power are suppressed and resources are shared from richer to poorer, the God of Jubilee will smile. I am not altogether pleased though, and I'm sure most of us can find something wrong with this or any other committee-composed document. But the thought of "government-regulation" being conducted by a group that put this bill together in one of the most "cloak-and-dagger-esque" type environments in recent memory makes me more than mildly apprehensive. Which brings us to the conduct of the Republicans. The question of "Who holds the government accountable while their regulating health-care" is the essential answer to why the Republicans did what they did. They intend to use the November elections as a massive "accountability" process, ousting any democrat who voted passage of this bill, and if they'd been involved in the construction of "Obamacare" it would have been difficulty to do so with the same authority. Like it or not, they (the repubs) thought they were working on behalf of the American people. I wonder, many times, whether anyone is REALLY working on behalf of the American People, or if we've all turned to go our separate ways.
    Thanks again Dianna, for this very insightful piece. Really well done!

    Steve J

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  5. David -

    I agree with your point on the bipartisanship - I attempted to acknowledge that in a parenthetical, but I guess it wasn't clear. I apologize for that slant - a lot of this kerfuffle started with the lack of bipartisanship.

    On the mandating the purchasing of a product, I would have a problem with this if it wasn't what is already happening in several different systems - car insurance, passports, bus tickets for public transport, stamps for the postal service, etc. This just extends it to something much larger. What we have right now, as I described, is far from the free market.

    My point, essentially, is that we don't have to worry about the free market disappearing. It's not like mandated car insurance destroyed the auto industry. It's not like having a US postal service destroyed competition among packing companies. And it's not like mandating health care coverage is going to destroy the health care systems - it might immediately hurt some insurance companies, but in the long run, it's going to lower costs for everyone.

    It's not going to destroy the free market system - it simply creates regulation so that it's not so naturally oppressive to the poor. I'll be the first to admit I know nothing about economics, but I fail to see how this, in the long run, is a bad idea.

    I agree that the system (meaning both HC and the legislative one) is broken, but we're probably not going to see a revolution any time soon. And that being the case, I choose to support those programs which better the lives of those around me, even if they take a little money out of my pocket and hurt the "free market" system which oppresses them in the first place. As I said, when a system becomes oppressive, as I feel American capitalism (particularly insurance companies) has, then it is well within our right to step up and question the structure.

    I agree that this was a crappy way to go about creating the system - it would have been wonderful to see this instituted with more dialogue and support from both sides, and both sides are to blame for that not happening. It would have been nice to start anew, but, this is also the nature of polarized American politics. *shrug* I'm okay with a lot of what the bill does; it's just the wrong time.

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  6. Steve -

    Yes, indeed, the way the bill was implemented is quite frustrating, and that's why I say there are a lot of problems with the way the bill was passed, though I think a lot of people, if they knew what was actually going to happen with the bill, would be rather supportive of many of these efforts.

    I suppose execution is quite separated from passage, and I do indeed hope that the government is able to handle the actual implementation of the bill in a better manner than they handled the passage. I suppose only time will tell on that front. Gov't accountability is always a tough question (I think the number of skeevy politicians discussed daily on various news networks demonstrates this fact). It will be interesting to see how this all pans out, and I think that's about as much commentary I have on the future, because, haha, I don't really have a crystal ball. We'll see.

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  7. thank you thank you thank you for posting this. I hope you don't mind if I tweet a link out for others to see...

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  8. No problem. It's posted with the purpose of hopefully clearing things up and creating a cogent discussion. Tweet away!

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  9. On the mandating the purchasing of a product, I would have a problem with this if it wasn't what is already happening in several different systems - car insurance, passports, bus tickets for public transport, stamps for the postal service, etc. This just extends it to something much larger. What we have right now, as I described, is far from the free market.

    Car insurance is mandated by some states, not the nation (and I don't think that it should be mandated either--however we would have to agree not to help those uninsured for this not to simply be a further societal burden). Bus tickets are not mandatory purchase items you have (decidedly inconvenient, but not monetarily punishing) options. The postal service is also not mandated in the same way that health care will be. You can definitely choose not to mail things. You cannot choose not to purchase health care as of this bill passing.

    Of course, my point is not that coverage should not be mandated, but that this is not an effective way to provide health care. Paying for Fire and Police protection is mandatory, these items are similar to health insurance in that they are not items for which a free-market economy is effective. Just like health care, no sane person would refuse police intervention when their lives were threatened. Private police could effectively charge whatever people could pay, and people would pay.

    You are not wrong that the mandatory coverage requirement is better than nothing, or in saying that the health care system doesn't work.

    A Separate issue:

    This bill should have been multiple bills. I object to the passage of this bill on the grounds that many many concerns did not receive proper consideration, politicians (and through them, their constituents) did not get to voice their opinions on numerous secondary and tertiary issues because the primary issue was of such importance to politicians. If it couldn't pass on its own merits, it shouldn't have been passed. If the secondary and tertiary concerns of the bill couldn't pass on their own merits, this bill shouldn't have passed. Our government is supposed to enact change at a glacial pace. This helps slow the build-up (its getting late) of bureaucracy, and make sure new measures get proper consideration. Modern procedural modifications have changed the speed with which legislation can be passed (I am glad that the dems at least failed to pass the bill using the "slaughter-rule" as that might have opened the floodgates of abuse.

    To reiterate, it is not the mandatory purchase of health care that I object to, it is the passing of the bill itself, in the form that it exists.

    Final issue:

    The window in which I have to write comments for your blog is really inconvenient, and on topics that I have less of an itch for sensible discussion about, it will prevent me from commenting. =(

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  10. David (I have to ask, which of the many David's I know is this one?) -

    I think you and I are in agreement, except for the idea that I think this bill, unwieldy as it is, is better than nothing at the moment. While, yes, it definitely should have been broken into multiple pieces and multiple bills, I think the Obama administration was getting sick of the fight, and therefore just, as many Fox News commentators put it, rammed it through. There definitely should have been more thought. But as to the actual elements of the bills, there are few that I have problems with, though execution's going to be the beast.

    Make sense? I agree with the intent and many of the probable results of the bill, but not the method. In which case, I think you and I are in the same boat.

    And thank you for letting me know about the comment window. Something messed up with the formatting on this post, making the entire blog change. I'm working on fixing it. :)

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