I’ve been preparing to write this post for months, and putting it off for the last several weeks. Truthfully, I don’t want to write it, because I’m actually expecting a lot more backlash and disapproval than I expected (but surprisingly, didn’t get) from my most-read post: “The Post That May Just Offend Everybody.” But I’ve been alluding to writing about this for some time, and have done a lot of research in preparation, in hopes that I can present a clear, detailed perspective that just might clarify one of the biggest issues facing our nation right now. That, and I think this is one of those ones that God told me to write (OK, truthfully I know God leads me to write all of these, but this one seems to be one he won’t let up on). So, with that ominous introduction, I will attempt to share my understanding and position on the Affordable Care Act (ACA). (1)
Bear with me on this one, I beg. I know it’s all over the news, but I’m hoping I can provide some reasonable perspective. I won’t claim to be totally objective, or unbiased, because I’m not. I’m getting kind of passionate about the topic of health care reform. What I hope to do, though, is to be clear what my biases are (as I understand them), as well as trying to address other perspectives as objectively as possible. I’ll lay out my biases and motivations shortly, but my objective in tackling this controversial subject is to try to advance a reasonable dialog that might just provide an impetus to achieving real, productive improvement to our nation’s health care system.
I’m going to have to break this up over several posts, because it’s a complex subject, and trying to cover it in People magazine-style, let alone TV news sound bites, or Tweet-format, is not only impossible, but also a recipe for inaccuracy (see, for example, “you can keep your plan”). Part of my reluctance to start has been simply that I wasn’t looking forward to all the disagreement, but I would hope that we can have a more reasoned discussion here, among friends, than is taking place in the media, or the halls of Congress. The rest of delaying has been in trying to figure out how to organize this thing. I’m probably going to tax WordPress.com’s publishing capabilities (I’m certainly going to exceed my abilities to use the site to organize a complex document), but I want to ensure that I provide good jumping off points for further research, or to at least demonstrate the due diligence I’ve performed in my research. To that end, I’ll be posting a “bibliography” of sorts. I’ll try to link to specific sources for statistics or quotes I reference. I’m also going to provide my definition the problem as I understand it. I will describe several possible approaches to solving the problem, and how those approaches are incorporated within the ACA. Either embedded in that discussion, or separately (depending how all this comes together for organization purposes and readability) I’ll identify what I see as the strengths and the shortcomings of ACA. Finally, I hope to talk about what I believe is the best path forward. Somewhere in all that, I’m going to try to tackle a lot of the misperceptions that are out there today.
I mentioned earlier that I’m biased, and indeed passionate about the topic of health care reform. I guess the passion comes from the fact that I used to be pretty strongly biased against anything that smacked of government assistance. I wrote papers in my undergrad days decrying the need to provide health care, unemployment, welfare, or any other type of handout. I’m guessing my old Econ professor has probably departed this earth by now, but if he hasn’t, and were to read this today, he’d probably be dead from shock before he finished. At one point, while acknowledging that the welfare system had become a multi-generational issue, I went so far as to advocate for systematically and forcefully removing all children from these dysfunctional welfare homes in order to break the generational cycle (one of the reasons I don’t get too excited about what any public figure over the age of 40 wrote, studied, or read while in college!). As the saying goes, though, there’s nothing worse than a reformed smoker, or in this case, reformed ultra-conservative. I believe that in the richest country in the world, that spends more per capita on health care than any other nation in the world, that people should not be impoverished because of catastrophic health issues, nor should they be forced to go forego necessary treatment because they can’t afford it.
So what happened to bring about this radical change in my thinking? Several things. First, somewhere along the way, I figured out that I had been the beneficiary of blind luck (ok, I don’t believe in luck, but providence gave me something that I never once sought or planned for). I have had (virtually) free health care for all of my adult life, courtesy of the US government. Even when I retired from the military, my annual expenditures for health care for my entire family, including annual premiums, co-pays, etc, was less than the monthly premium most people paid for private sector health insurance, not even considering deductibles, co-pays, and other out-of-pocket expenditures. I wasn’t some genius who planned out how to achieve this level of health care security; I just joined the Army to jump out of airplanes. Free health care came with the package–not that it meant anything to me when I signed the contract.
But my free government health care alone wasn’t enough to reform me; for many years my mantra was that I earned it through my service. What really started me doubting my convictions that anybody could pull themselves up by their own bootstraps, was when I started discovering friends who had worked way harder than I had, and were much stronger than me, whose bootstraps had broken. I have a friend who owned a construction company, who literally built million dollar homes. His work was amazing, and his business skills were quite good, but he lived in a rented duplex, and couldn’t afford health insurance for his family. He wrenched his shoulder one day helping me get my snowmachine unstuck, and still has problems many years later, because he never went to the doctor to get the damage repaired. He couldn’t afford it. He eventually had to shutter his business, and go to work at a large company that offered benefits, just to take care of his family’s health needs. I have another friend who is an amazing mechanic, and worked for many years on military vehicles as a civilian contractor. Bouts with cancer and other medical issues, even with employer-provided medical insurance, bankrupted him, and continues to wreak havoc with his finances. I just recently discovered that since he was medically retired, he no longer has the insurance he needs to pay for his liver transplant, and has been removed from the list. Neither one of these guys were welfare bums; heck, they work harder than I do! They are both smart, talented, and hardworking; they just ended up on a different life path than me; not through destructive choices, but because they decided to open their own business, in one case, or contracted some nasty disease in the other.
The final straw was when I started studying Christianity–that belief system that I have devoted my life to trying to live by. The Bible says that man is created in the image of God; that all human life has intrinsic value. Jesus didn’t give us the option to pick and choose who we would love or show Christian charity to; in fact in response to a religious legalist, who was looking for justification that he was loving his neighbor, and thereby obeying God and earning eternal life, Jesus told a health care parable. Around the same time I was confronted with my own hypocrisy, the health care reform debate was going on in earnest, and I’d started blogging. I wanted to engage in the discussion, but I wanted to do so from an informed position, so I started researching the issue, and writing about it. (If you click on the “Health Care” category in the right column, you’ll get a list of posts I wrote starting back in 2009 on this topic, before ACA became law). The more research I did, the more I discovered that our health care system in our country isn’t getting the job done, and lives are lost, and ruined, because of it.
Jesus said that I’m supposed to care for “the least of these,” and through his life and teaching demonstrated that I don’t get to pick and choose who is worthy of my love and my care. I don’t get to decide who doesn’t deserve adequate health care because they don’t meet my expectations of supporting themselves, or because they had too many babies, or whatever other reason I find for them to be unworthy. The Bible is VERY clear that judging others is outside my scope. I’m just supposed to love them. That doesn’t mean think fuzzy puppy thoughts about them, that means meet their needs. Jesus was in the healing business. Unfortunately, too many folks in the US think us Pentecostals are crackpots, so although the same healing power that Jesus used is available to his followers today (see John 14:11-14, despite the desperately twisted hermeneutics John MacArthur and his friends try to employ to deny it), until such time as more Christians of this country are all filled with the Holy Spirit, we’re going to have to go to plan B or plan C.
More on those in the next installment.
1. The Affordable Care Act is the name for the 2010 legislation commonly (and derisively) referred to as “ObamaCare”. I’m going to refrain from using that term, and instead stick to “ACA,” to try to take some of the venom out of the discussion.