Health Care IS a Matter of Faith
Health Care IS a Matter of Faith
Presentation by Matthew Ellis
Diocese of Maryland
June 9, 2010
The title of our program is Health Care IS a Matter of Faith. I would like to begin by suggesting health care should no longer be a matter of faith. Faith in the sense of desperate hope. We should not have to hope we will have access to health care. We should not have to hope that the fee to see the doctor will be reasonable. We should not have to hope our insurance won’t be cancelled due to an extended illness.
The Lottery of Birth
It is 24 hours before your birth, and a genie appears to you. He tells you that you can set the rules for the world you are about to enter — economic, social, and political. Sounds great, right?
However, before you enter the world, you will pick one ball from a barrel of 6.8 billion (the number of people on the planet). That ball will determine your gender, race, nationality, natural abilities, and health — whether you are born rich or poor, sick or able-bodied, brilliant or below average, American or Zimbabwean.
This is what Warren Buffett calls the ovarian lottery. “You’re going to get one ball out of there, and that is the most important thing that’s ever going to happen to you in your life.”
Buffet says “We should be designing a society that doesn’t leave behind someone who accidentally got the wrong ball and is not well-wired for this particular system.”
Yet for many, this is exactly the society we have designed:
- A system in which their ability to work is dependent on their ability to maintain a car and insurance because public transportation is either unreliable or nonexistent.
- A system in which child care costs nearly as much as some families earn.
- A public education system in which some children receive a world class education, while others hope simply to literally survive.
- And we have a system that often does not allow for even an occasional, never mind serious, illness to be addressed without enormous repercussions to employment and family finances.
There are real arguments to be made about the role of government in our society. I’m sympathetic to those who maintain a healthy skepticism of large government that seems to have all the answers. However, the sentiment that government is incapable of doing anything well and that private enterprise is always the answer is also false. Our government was designed to include a system of checks and balances. So too, must our larger society utilize checks and balances between government and private industry. We’ve seen what happens when this balance is not maintained. Despite our idealistic notions that free markets will force companies to do the right thing because it is best for business over the long term, we see again and again that short-term greed often goes unchecked, particularly when there is much to gain. The mortgage lending crisis. The oil spill in the Gulf Coast. Health insurance companies removing patients from their insurance plans because the patients had breast cancer or AIDS. These are current reminders of the need for vigilance in oversight and accountability.
In health care, these checks and balances are most critical, as the stakes are much larger than mere profit margins. Not only in extreme cases of life and death, but the quality of life for all of us is intimately joined with the status of our health and our ability to receive accessible, affordable care. That’s become a critical issue for our nation in recent years. Accessible, affordable health care is not only a matter of whether or not you like your plan or doctor. For me, it means an affirmative answer to questions like the following for everyone in our society, especially those who are at risk:
- Do you have a regular doctor or medical home?
- Do you have access to well child care, including vaccinations and developmental screening?
- Does the system work to encourage positive health and is it reasonable in cost for everyone?
The United States has the highest abortion rate amongst advanced democratic nations, despite abortion being free and legal in many other countries. Why might this be? A recent Washington Post article suggested it is because these other nations have widely available, affordable health care.
In that article, Cardinal Hume of Great Britain explained, "If that frightened, unemployed 19-year-old knows that she and her child will have access to medical care whenever it's needed, she's more likely to carry the baby to term.”
A young woman in Britain added another explanation. "If you're [sexually] active," she said, "the way to avoid abortion is to avoid pregnancy. Most of us do that with an IUD or a diaphragm. It means going to the doctor. But that's easy here, because anybody can go to the doctor free."
Now, whether you are pro-choice or pro-life, I think we can all agree that it’s in everyone’s interest to reduce the number of unwanted pregnancies. Evidence suggests making health care affordable and accessible just might be the best way to accomplish this.
The Best Health Care System in the World?
During the health care reform debates, you heard some say repeatedly that we have the best health care system in the world. When pressed, you would often hear references to specialist surgeons, followed by anecdotes of people coming here for rare treatments done nowhere else. These arguments often ran in circles because ‘best health care system in the world’ was never defined the same way twice. I ask you: How can we claim to have the best system, when a nation as wealthy as ours so often sends children to bed hungry while many others struggle with obesity? The United States should be leading the world in overall health indicators, yet by almost any measure our people are sicker than those in comparable societies. Is this evidence of the ‘best health care system in the world’?
I participated in an organizing group that went on to become Faithful Reform in Health Care. We outlined a vision in four areas that we deemed necessary to achieve if health care reform was to be successful. I’ll mention them here briefly, as I think it might be useful to you as this discussion continues throughout the day. The four areas of vision were these:
- Inclusive: Health care is a shared responsibility that is grounded in our common humanity.
- Affordable: Health care must contribute to the common good by being affordable for individuals, families, and society as a whole.
- Accessible: All persons should have access to health services that provide necessary care and contribute to wellness.
- Accountable: Our health care system must be accountable, offering a quality, equitable and sustainable means of keeping us healthy as individuals and as a community.
The Impact of Health on Each Other
I would like to quickly touch on one particular story with which we are all familiar. In a sermon on the Good Samaritan, a German preacher once said, "If you are the broken man by the side of the road, you can think of a reason why every person passing by should stop and help you. And if you are traveling down the road and see the broken man, you think of every reason why he is someone else's responsibility."
We are all capable of someday being ‘the broken man’. Perhaps those with more resources can increase their odds of staying healthy, but no one is immune from the possibility of cancer, heart disease, or dementia.
Let us also acknowledge that health does not occur in a vacuum for any individual. Each person’s health impacts the lives of those in the community around them. This occurs in more than just obvious ways, like secondhand smoke. A mother who sends her child to school while ill because she has no one to care for him at home risks spreading the illness. This risk becomes compounded when that child delays seeing a medical professional due to either actual cost or fear of cost.
Likewise, vaccines and preventive care impact the larger population: It helps all of us if others receive medical care early. As a result, we all have an interest in increasing the overall health of those around us.
“Love they neighbor as thy self” – The thing about affordable, accessible health care is that it is ultimately a selfish act. By taking care of others, we take better care of ourselves.
The Episcopal Church and Diocese of Maryland on Health Care Reform
The Episcopal Church, including this diocese, understands how critically important health care is in preserving the rights and dignity of the individual. Recent resolutions have called for parish discussions about health care coverage and urged passage of federal legislation, even going so far as to call for a ‘single payer’ program. The Diocese of Maryland in particular has supported via resolution congressional efforts to provide every citizen and natural or lawful alien with comprehensive and affordable health care coverage.
Why is it Important for Religion and Health Care to Interact?
There are many moral arguments one could make favoring health care (You may remember these words: `Truly, I say to you, as you did it to one of the least of these my brethren, you did it to me.') However, aside from our Gospel imperative, this is not merely an expression of our mission. There are practical reasons as well for churches to be involved in health care.
- There are few places where people of all ages, all socioeconomic levels, and all ethnic backgrounds congregate on a regular basis as happens in religious communities. This makes religious organizations an ideal route by which to provide health screening, health education, and other disease detection and prevention services.
- A few studies have shown that health education programs in churches can affect diet, weight, exercise, and other health behaviors, and this is particularly true for minority communities who often do not have easy access to such information or to preventive healthcare services.
Dr. Koenig made three recommendations:
- Consider partial government support for parish nurse programs that provide disease screening, health education, lifestyle change, and volunteer recruitment for service delivery.
- The public should be taught how to talk with their clergy about initiating health programs within their congregation. If the 500,000 religious congregations in America all had such programs, then two-thirds of the U.S. population would be exposed to disease detection, disease prevention, and health promotion efforts.
- Since persons of all ages participate regularly in religious congregations, this means that health education efforts would occur at all ages.
How Individual Parishes Have Organized Health Ministries
So, let’s take a closer look at congregational health ministry.
Resolution AO77 urges the congregations of The Episcopal Church to explore and implement health ministry as a vital component of outreach and pastoral care by 2012; and encourages congregations to raise awareness of health ministries and promote the understanding that health includes body, mind and spirit.
What Are Some Benefits of Parish Health Ministry?
- Health ministry functions as an outreach program: I can’t tell you how many new people have come to my parish of St. Paul’s because they heard about work we were doing in the community and wanted to be involved.
- Expansion of pastoral care: More hands on deck create a greater sense of community and bring members of the parish closer together, while making sure no one person is responsible for all.
- Enhanced management of chronic conditions allows parishioners to be active longer and fully participate in the life of the church.
- A parish nurse can help prepare clergy on what to expect with patients, including a quick heads-up on the potential seriousness of a condition.
- Parish education: In addition to creating an atmosphere of health and wellness and encouraging good choices, a parish health ministry can also address stigma by educating about HIV/AIDS or initiate a family discussion of end of life care through a program night.
We have numerous examples of health ministry right here in the Diocese of Maryland. As I looked around, the information I gathered suggests that nearly all of your churches are currently involved in some form of health ministry. For instance:
Light House Homeless Prevention Initiative in Annapolis is assisted by:
- Epiphany Episcopal Church
- St. Anne’s Episcopal Church
- St. Margaret’s Episcopal Church
- St. Philip’s Episcopal Church
- The Church of the Ascension in Westminster provides prayer shawls and other handmade items through the ‘Hearts in Hand’ ministry.
- They also have the Shepherd's Staff program, an ecumenical ministry helping those in need with back to school supplies, clothing, winter coats, prescriptions, and an annual Thanksgiving Dinner.
- St. Mary’s in Abingdon participates in Holy Family House, the only transitional housing for intact families in the county. They also host regular AA meetings.
- St. Philip’s in Annapolis provides an Angel Food Ministry.
Of course, health ministry need not be complicated. Thanks to the generous talents of St. Anne’s in Annapolis, people all over the country learn about various health topics while in the restroom of all places. The Backdoor Readings series has proven to be one of the most popular of all health ministry programs. I would be remiss if I didn’t acknowledge Carol Sullivan, who for years has worked tirelessly to promote health ministry in Province III.
These are just some of the wonderful health ministries being done in the Diocese of Maryland. Think about the lives being transformed by this wonderful work. For many of those being served, these ministries are critical to their survival, both physically and spiritually. How much transformative work could these ministries do if they were able to complement our health care system for these families, instead of replacing it?
Now, a few comments about what may be the most difficult issue to address: personal responsibility.
First, we must acknowledge that we must be “Well to Serve.” We might get by in the short term, but maintaining our physical, mental, and spiritual health is critical to be able to fully serve over the years ahead.
Review of Medical Trust health claim data from 2009 shows, for a second year in a row, members are not utilizing benefits for annual physicals, age appropriate screenings, dental exams or the employee assistance program.
A Healthy Lifestyle Requires Planning:
- Scheduling medical tests and appointments
- Planning healthy meals
- Making time for exercise and sleep
Of course it would be nice if we all engaged in proper self-care. So often, that simply doesn’t happen. So that’s where the second part comes in: accountability.
I absolutely believe congregations should expect clergy to engage in proper self-care and be active in assisting clergy in this regard. After all, a clergy person’s job performance is profoundly impacted by the state of his or her health. Therefore, it is entirely appropriate and necessary for the vestry and congregation to expect clergy to take care of themselves and to ask what clergy are doing in terms of their own personal wellness.
I recently had a church insurance risk officer tell me he always asks about clergy wellness. He said “I check the stairwells, the floors, the roof. But the clergy person is the single most important machine in that church, and it’s necessary to know their condition as well.”
Now, vestries and congregations must be prepared to hear that they are part of the problem! For instance, are clergy made to feel guilty for personal time spent in renewal? Is the clergy’s Sabbath day respected?
Please, help your clergy be well. Don’t feed them lasagna every meal. Instead of sitting in the office or your home, go for a walk. Encourage them to get their annual physicals. And if this conversation is uncomfortable, if the vestry does not have a close relationship with the clergy, find someone to help mediate it!
National Episcopal Health Ministries recently had its national conference with Jubilee Ministries and Episcopal Community Services in America. Our topic was domestic poverty. We had the Presiding Bishop, the President of the House of Deputies, and some wonderful speakers. However, after several days, it was a bit overwhelming. You try to tackle a topic like domestic poverty or health care, and it’s easy to feel like you’re drowning. You begin to wonder: Can we ever make a difference?
Our closing speaker was Wayne Muller, author of ‘A Life of Being, Having, and Doing Enough.’ Wayne helped us to see the importance of being in the moment, of giving ourselves over to being fully present, and to recognize that it is truly, enough. There will always be another problem, always a to-do list to accomplish, but if we don’t give ourselves permission to embrace our day’s successes and say ‘Today, I’ve done enough’, we are setting ourselves up for failure, for burnout. Listening to Wayne, I was reminded of the first motivational story I can remember reading. Maybe because it was the first, maybe it somehow struck a nerve with me, I don’t know… something about the Starfish story rings true to me even today, after all these years.
One day a man was walking along the beach when he noticed
a boy picking something up and gently throwing it into the ocean.
Approaching the boy, he asked, “What are you doing?”
The youth replied, “Throwing starfish back into the ocean.
The surf is up and the tide is going out. If I don’t throw them back, they’ll die.”
“Son,” the man said, “don’t you realize there are miles and miles of beach and hundreds of starfish?
You can’t possibly make a difference!”
After listening politely, the boy bent down, picked up another starfish,
and threw it back into the surf. Then, smiling at the man, he said…
”I made a difference for that one.”
We may not be able to ‘save’ everyone (whatever that means), but we can make a difference. Health care IS a matter of faith. We can serve in ways the medical community often cannot. While the medical community is largely focused on curing, we are intent on healing. There is a big difference in those two objectives.
I encourage each and every one of you: Strive to see where you can do ‘enough’. Strive to make a difference for that one, even if that one is you.