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MY SERMON ON HEALTH CARE PREACHED AT ST. JOHNS INDIO JUNE 28, 2009
2 Samuel 1:1;17-27 Psalm 130 Corinthians 8:7-15 Mark 5:21-43
+ In the name of God, Creator, Redeemer and Sanctifier, AMEN.
When I was a small boy about 3 to 4 years of age in Forest Hills, in Queens, New York, I had the unfortunate experience of living as an asthmatic child in a household with parents who were both smokers. My asthma attacks were frequent. I could hardly breathe, and just like the little boy on the billboard we used to see, I felt like a fish out of the water. My mother would call the doctor and the doctor would come to the house, give me a shot of adrenaline, comfort me and go on his way. And I can recall my mother paying the doctor a few green leaves for his services. I remember the doctors of my childhood as kindly men who were doctors for all the right reasons, that is, to care for people, not just make money.
Fast forward to 1987. I was 36 and the owner of what was then a struggling small business where I provided health insurance for not only myself but also for my workers, even though it meant I had to accept a less luxurious lifestyle as a result of that decision. My comfort level with our insurance company, and my impression of the medical profession underwent a very rapid metamorphosis when I was stricken with a very severe asthma attack that necessitated a very urgent trip to the Emergency Room at Anaheim Memorial Hospital. Unlike Jesus in today’s gospel, who healed a poor woman suffering from intractable pain from ongoing hemmorages and raised up from near death the daughter of a synagogue official without any concern about whether he’d get paid, the first thing that concerned the intake nurse at the Emergency Room was not whether I could breathe, but whether I could pay. Rather than offer me the oxygen I so desperately needed, she demanded my insurance card. Luckily I did have my wallet with me and it was there. Based on her attitude, I was absolutely convinced this nurse would allow me to die if I didn’t show it to her.
Only then did they escort me into a treatment room and undertook some very strenuous efforts to save my life. I can recall praying, “No God, not yet, I’m not ready to die.” Like Jesus raised up Jarius’ daughter, God raised me up and I’m here today.
After about ten days in the hospital, when it was time to check out, the nurse put me in a wheel chair to go home, but she did not wheel me to the door for my waiting ride. Instead, she wheeled me to the finance office, where I was informed that I owed a $2,150 co-payment. I told them I did not have $2,150 to pay them because I needed the money for my office payroll and that my employees were more important to me than some big hospital corporation. The woman there became really angry when I told her that. She was used to submissive people doing what she told them. When she started in on her usual, “you have to pay your obligations” mantra, I raised my voice and let out a few choice expletives to express my disapproval of her so-called “businesslike attitude.” She finally agreed to take $50 a month. She probably agreed because she wanted to get me out of there real quick, because at 36, I was pretty much still a pretty much a hot wire personality with a very sharp tongue.
But I was in for an even bigger shock when I got a letter from our health insurance company that they weren’t going to pay my claim because my asthma was a pre-existing condition, even though I had not had an asthma attack that required medical treatment in over 15 years. Now, what had been a $2,150 problem now became a $11,000 problem. I can assure you, that insurance company got quite a few letters and phone calls with very strong language, but that got me only minimal progress in resolving the issue. I decided maybe a little more Christ-like approach might work. I don’t recall the exact name of the adjuster who was handling my claim, but I do remember it was very unusual name and that the insurance company was somewhere in Kansas. In those days we did not have the Internet, but we did have directory assistance, so I had the operator check the surrounding area for all listings with that last name, and lo and behold there was a listing for that name within a few miles of where that insurance company was located. I called the number and I recognized the adjuster’s voice when the phone answered. She remembered who I was. She was a bit irritated that I called her at home, but her irritation vanished when I asked her if she went to Church and she said yes, she did. I don’t recall exactly what Church it was, but I do recall it was one of those protestant denominations that takes scripture as seriously as I take incense, so you can guess they took their Bible very seriously. I told her I wanted to talk about Jesus, and she was all ears. I told her that Jesus healed sick people and didn’t ask about money—He just healed them. She agreed with me about that. She then told me all the inside information I needed to get my claim paid. She told me exactly what documents I needed to send and exactly what I needed to say in my letters, plus what I should not say or send. I did what she told me, and the claim got paid.
Some people would say I cheated or manipulated the system, and perhaps that is true. But the kinds of people who would be critical of what I did are precisely the reason this country has the problem it does today with healthcare—the people who are in it for the money, who reduce human health to a cold contract, who see other people’s misfortunes as an opportunity to profit, rather than an opportunity to extend God’s healing love in the way Jesus did in today’s gospel. This country needs to change the basic assumptions underlying the delivery of health care – from a delivery of a service in exchange for money into an extension of divine generosity, of God’s love working through us as it did through Jesus in today’s gospel.
Today’s gospel asks the question: is healthcare a privilege for which one must pay, or is it a right to which all are entitled, regardless of whether we can pay the price selected by those who provide it? In today’s Epistle. St. Paul recognizes money, but his orientation is communitarian rather than the self interest so typical of this country. Today’s Epistle is set in the larger context of an appeal on behalf of the churches of Macedonia where the believers show a great deal of enthusiasm but have little money, like a few churches in our Diocese. The essence of St. Paul’s argument is precisely the principle underlying all insurance policies—spreading risk, rather than imposing on each individual the entire burden of an unforeseen event beyond the individual’s control. St. Paul talks in terms of sharing our “surplus,” that is, whatever we have that is more than what we need. St. Paul says we should share whatever surplus we might have now with those in need of it and that the surplus of others is there for us when we need it. When applied to health care, this Epistle invites us to question why some physicians and health care executives think they need to live in million dollar homes instead of working for less money to lower prices for healthcare consumers. I just don’t understand why they can’t just live like the rest of us and work in health care because they care about people.
As I hear the various policymakers discuss healthcare, there is a noticeable absence. That absence is Jesus. Why isn’t Jesus part of the discussion? Although from a legal viewpoint we live in a political system that separates Church and State, that doesn’t mean we as Christians fold our tent and keep our mouths shut on important issues. The right wing sector of the Christian world is very quick to invoke what they believe to be God’s word on sexuality related issues, but where are they when it comes to healthcare? Why don’t we hear the TV evangelists asking this country to follow Jesus on the issue of providing healthcare as a right rather than charging money for it? The canonical Gospels are replete with story after story where Jesus heals someone. In Mark alone, Jesus cleansed a leper, cured Simon’s mother-in-law of a fever, gave a paralyzed person the ability to walk, straightened a withered hand, relieved several people of mental illnesses, bestowed on a deaf man the ability to hear, opened the eyes of two blind men, and cured an epileptic. If Jesus were around today among us in the flesh and practiced medicine in today’s world and achieved the same results he did way back when, he would certainly be a very wealthy doctor.
Yet Christians generally, and the Episcopal Church in particular, are not vocally active in the news headlines on establishing health care for everyone as a right instead of a privilege for people who have money. We have two healthcare systems in this country—one for those who have money and/or insurance, and another for those who don’t. As someone who has insurance, I can get regular checkups and see my doctor promptly to prevent a little problem from becoming a big problem. But those who aren’t as lucky as I am wait until their health care needs reach a crisis level that drives them to the emergency room, the most expensive way to deliver medical care, particularly to treat routine illnesses and minor injuries. But that’s just the tip of the proverbial iceberg: those who cannot afford to pay for healthcare have more medical problems and shorter life spans because not only do they delay getting care—they sometimes make unwise health choices to forgo buying medication to pay other living expenses.
Holding each individual responsible for their own health care costs on a fee-for-service basis is, literally, bankrupting this country: just recently I read a new story that said 61% of all bankruptcies involved families that needed to dump healthcare costs they couldn’t afford to pay. Imagine the depths of despair they feel. Today’s psalm, a response to the feelings of Kind David to the death of Saul expressed in today’s lesson from the Hebrew Bible, captures our very human feelings when our spirits are at their lowest ebb as we pray forGod’s mercy to care for us and shield us from unfortunate circumstances. Only recently do we have politicians acknowledging the human despair that flows from the lack of an appropriate system to deliver healthcare based on health related concerns rather than on ability to pay. The folks who are getting in the way of changing the health care system are those are those who insist that market forces should continue to drive health care decisions without regard to human concerns. Look at the large number of new doctors who forsake family practice for specialties because the specialties pay more. Look at the reaction of the medical profession recently when the President proposed cutting Medicare reimbursements. My reaction was, do we really care if doctors and health insurance company executives have to drop their country club membership and travel coach instead of in a private jet?
An unfettered free market as an allocator of resources is a failure when it comes to health care. Other countries that see healthcare as part of the commonweal instead of as a vehicle for exorbitant private profit, have higher life expectancies than ours. Today’s lessons should serve as a starting point for Christians to get involved on healthcare issues in the public arena. It has to go beyond just writing letters to politicians, although that is important. The Episcopal Church, indeed all Churches, should be speaking out forcefully on this issue to change the landscape from a system motivated by private profit to one overflowing with compassion for people. Unfortunately, Christian churches tend to see themselves as “pillars of society” rather than tear down those pillars that oppress the least fortunate among us, such as those who need healthcare but can’t pay for it.
But it can’t be just talk, it’s got to be action, too. We have to clog the chariot wheels. We have to think of this problem in terms of a deliverance, of a setting free, or a liberation. Perhaps you will recall the Exodus from Eqypt, where the wheels of the Pharoah’s chariots clogged up with sand and the chariot drivers got stuck in the mud. Perhaps a good idea might for us 2,000,000 Episcopalians would be to undertake a collective effort to tie up the phone lines, websites, and fax machines of collection agencies that pursue people to pay medical bills. Just like God did to the chariot drivers, we can inhibit the oppressors of our own day to slow their pursuit of those who are poor and sick. Not only would we attract attention to the issue, we as a church would make a tangible impact on those who are engaging in some very oppressive activity.
What we need to do is encounter Jesus in our lives out there, beyond the Tabernacle, and make his presence real in ways that count for everyday people. As we receive Jesus today at Mass, think about the senior citizen who has to decide whether to pay the rent or buy prescriptions. Think about the cancer sufferers who are the victims of insurance bureaucrats more concerned with what their policies cover than whether their insureds live or die. Think about the people who lost their lives because they did not have enough money to pay for care to stay alive. Think about their families who grieved over their death as King David grieved over the deaths of Saul and Jonathan. Then ask yourself, do we accept the status quo, or do we make it our mission as Christians to bring about change? Remember that the mission of Jesus is to change the existing systems of power and domination, not maintain them. The Body and Blood of Jesus we will receive today will energize us to change those systems. Jesus wanted sick people healed, costs notwithstanding. So should we. AMEN.