Healthcare Reform and the Bible: Healthcare Costs (submitted by Nov 13 panelist and board member Dr. Terrill Wade)
The first article on this topic (in a three-article series) declared that the Bible definitely has answers to the healthcare crisis in America. The answers aren't simple, nor will they make everyone happy, but they're certainly clear. A robust biblical worldview bears on every part of life and culture. So, naturally, I believe the Bible is where we must begin if we are to adequately address any problem — including problems of this magnitude.
As was seen in part one of this series, the Bible very clearly outlines specific instructions on justice, mercy and caring for the needy. But another big problem in American health care that the Bible addresses is that of finances. The costs of personal health insurance coverage as well as the expenses associated with high-quality medical care itself are, to say the least, astounding. Such costs increasingly limit the access of patients to useful healthcare in this country.
Probably each of us knows a family struggling to afford the costs of healthcare. We have heard stories about those who have lost everything in bankruptcy due to overwhelming medical bills. While this article may not comprehensively address every tragic situation, the Bible does address the core issues of profits and business practices of the health insurance and medical care industries.
Thinking about money always puts American Christians in a dilemma because the free market system presents money as our ultimate goal. We are rewarded with comfort and respect if we have enough of it and there are certainly many passages even in Scripture praising hard work and the comfort of possessions as work's reward.
Yet as Christians directed by Christ's example of sacrifice, we understand that everything we possess is God's, not our own, even if we earned it by the sweat of our brow. We know that those goods are of no value in our real home and that we will not be able to take even a single dollar bill into heaven with us.
On earth we are to be stewards of those goods, to use them to bless others, and be willing to lose them if that serves God. How easily, though, does the love of money nestle into our hearts right along with the wise and reasonable desires for family stability, old age preparedness, and health care provisions. We understand the problem, and yet we still let it happen. At this time and place in American history, the need to control healthcare costs is a call to rigorous self-examination — individually and corporately — regarding our attitude towards money.
The first area that we must examine when looking at what an individual can do to affect healthcare costs is that of whether we take responsibility for self-control in the area of food and exercise. Increasingly we are becoming aware of the disastrous effects on the collective health of this nation from rampant overeating and under exercising. One in three adults are already obese, and even our children, who have generally been thin because of their constant growth, higher metabolic rate, and continuous activity, are now developing obesity in alarming numbers. This portends a huge wave of diabetic related diseases in the near future, with massively increasing costs to our already overloaded healthcare system.
Yet the Bible contains numerous admonitions to be self-controlled, not to let any sin have dominion over us, not to be gluttonous, and to care for the body because it is God's temple. We know what we have to do. It doesn't cost anything to stop eating oversized portions and to reduce the amount of food we eat, or even to choose healthier foods (although I acknowledge that buying the really healthy food can be more expensive). Most of us can choose to exercise more. Here, at last, is a way to reduce the costs of healthcare that is completely within our ability. Are we doing it? Are we obeying God by exercising self-control in this? We must do it; both for our brothers and sisters and for ourselves.
On the other hand, as patients, we often want the best treatments and the most recently discovered tests and drugs, despite their lack of proven effectiveness and high costs. After all, America is the land of innovation and discovery and we should benefit from it. Any outside limitation of our choices tends to be seen as unwarranted intrusion on our individual rights.
In the understanding, however, that we gave up our "rights" to God when we committed ourselves completely to Him, and the knowledge that the United States doesn't have unlimited resources, we should look to Christ's example of giving up all of His "rights" and choices in heaven for our sakes. We need to carefully consider what the commandments to bear one another's burdens and to think of each other more highly than ourselves might require of us in the health care field.
We certainly know that those commands apply to the way we function in our families and our churches, but they may also operate in our relationships with those we are called on to love. Is it possible that, as Christians operating within the larger community, we may need to voluntarily accept less than the optimal testing and treatment for ourselves in order to bring down the costs for others?
Those of us who are members of the healthcare industry need to consider whether we have succumbed to our culture's view of income. It doesn't matter if we are healthcare providers, insurance agents, hospital administrators, drug company representatives, or scientists developing new drugs and diagnostic tools, we are all susceptible to the "I deserve it" mentality.
Such a view says that, because of our long and difficult studies, on-call schedules, long hours and high responsibility, we deserve the highest pay that the market will bear. Thinking this way is the "normal" American mindset, but is it possible that the love of money is inflating our perceived income requirements and contributing to the spiraling healthcare costs?
For businessmen in the healthcare field there is a special challenge. A free market economy has the view that a business is a business is a business, and therefore, since profit is what a business is about, the higher profit the better. Here are two questions that need to be answered in the light of Scripture:
(1) Is health care really an industry like other industries?
(2) Is unlimited profit a biblical viewpoint?
The answer to the first question is "No." Industries usually make profits for their investors by increasing the consumption of their product, continually raising the prices as high as the market will bear and whittling down the workforce costs to the minimum. It is easy to see how treating healthcare as an industry not only contributes to the spiraling costs related to the continual research, development and introduction of expensive new equipment and drugs into the medical field (often minimally different from other cheaper ones on the market), but also to dehumanizing the "consumer" (the sick person who is in no position to assess his choices), and minimizing the healthcare provider availability for the compassionate care that illness requires.
Jesus continually linked healing the sick to preaching the good news of the kingdom and demonstrated God's love by spending time with the needy while healing the body and ministering to the soul. I would suggest that Scripture shows healthcare should be a compassionate non-profit ministry, not an industry. Obviously, changing that viewpoint has lots of ramifications for the way healthcare is reformed.
Dealing with the second question, it can be seen that while Scripture definitely supports business and profit, it also lays out the model that businessmen are not to pursue unlimited profit to the detriment of the needy.
a) God's law for Israel in Leviticus 19:9-10 requires the businessman (field owner) not to collect all of the possible profit from his field specifically so that food is made available for the poor to collect.
b) Even more startling was God's requirement that in every 50th year (the Jubilee year), all land that had been bought from another Israelite in the last 50 years had to revert to the family of the original owner. This did two things. It restored lost capital back to families who had become poor, giving them a fresh start. It also kept rich businessmen from building huge empires, which could cause oppression of the poor or the middle class.
So I would suggest that there is a reasonable biblical base for suggesting that companies — especially those involved in the health care field — should consider curbing excessive profits in order to benefit those who need care.
Lastly, I would point out that God continually calls us to fair business practices by emphasizing the use of honest scales (Lev 19:36, Deut. 25:15) and not preying on the poor or making unjust gain (Ezek. 22:12, Is. 10:2, and Am. 5:11).
Currently, our health care practices are such that people who do not have insurance are often charged far more (sometimes by thousands of dollars) for exactly the same procedure that is provided at a lesser price to those who are covered by insurance (the insurance company's negotiated rate). While I understand the worldly explanation of large number negotiations bringing down prices, the practice looks very much like those condemned by God, in that the people most adversely affected by the different prices are the poor. Healthcare reform needs to address fair pricing arrangements.
We have now looked at how Scripture calls individuals, healthcare providers and businesses to carefully examine their role in healthcare costs, and we need to pray that God will give us the courage to make needed changes.
But is there more to be done? The next article will consider whether Scripture informs us about whether government has a role in the health care field, and if so, what that might look like.
Here is a two-minute video clip of the healthcare reform event from which this blog entry was adapted...