Saturday, August 29, 2009


From the sole of your foot to the top of your head there is no soundness—only wounds and welts and open sores, not cleansed or bandaged or soothed with oil.

                        Isaiah 1.6

In memory of Senator Edward Moore Kennedy (1932-2009) 

Physical Health

My father suffers from severe gout. He has no grip in his right hand, which makes mundane tasks like driving, putting on shoes and socks, opening jars, and signing checks impossible. Recently, he wept while telling me how useless this condition causes him to feel. I flushed with rage because, unlike hundreds of truly debilitating diseases, gout has moved from the “treatable” to the “manageable” category of conditions. For over a year, a new product that restores full mobility to gout patients has been available. But my father’s healthcare providers won’t approve its “first-line” usage and none of his physicians will prescribe it. His insurers’ preferred alternative was discontinued due to his allergic reaction to the medication. Just yesterday, he finally found a physician willing to prescribe the new treatment. To access coverage, the doctor first had to prescribe the preferred drug. He told Dad to buy the pills, throw them away, come back in a month, and he’ll qualify for the new product. So my father needlessly lived in pain for a year, spent inordinate time finding a physician clever enough to thwart bureaucratic indifference, and is forced to flush money down the toilet to get help he needs.

This is the healthcare system so many people are fighting to preserve. I shudder to think what millions of Americans with far more grave conditions and far fewer means reckon with. I wonder how many lives end prematurely, how many homes are destroyed because our sick have no access to help. Despite the relative insignificance of my dad’s case, it proves the future of healthcare in this country is not a “rights issue”—it’s a moral dilemma. And, as a Christian, I can’t reconcile Christ’s command to love others as our ourselves with anything but demanding total healthcare access for all.

Spiritual Malaise

The first chapter of Isaiah makes one thing very clear: a physically ailing nation is a sign of its people’s spiritual malaise. Isaiah begins his prophecy by brutally indicting Israel for its neglect. In verse three, he quotes God’s statement to him: “The ox knows his master, the donkey his owner’s manger, but Israel doesn’t know, my people do not understand.” Isaiah continues the tirade: “Ah, sinful nation, a people loaded with guilt, a brood of evildoers, children given to corruption! They have forsaken the LORD; they have spurned the Holy One of Israel and turned their backs on him.” (v4) The prophet and God alternate in accusations that Israel’s rebellion has led to neglecting the principles of God in exchange for ritualized worship. They’ve confused going to church with serving God. Consequently, sickness has infected them from head to toe. They’re wobbling. Yet their false piety has deceived them into believing they stand strong and righteous before their Maker. Not so.  “From the sole of your to the top of your head there is no soundness—only wounds and welts and open sores, not cleansed or bandaged or soothed with oil.” (v6) Finally, in exasperation, God tells them what must be done to regain His favor and reestablish sound standing in His sight. Forget all your fancy worship, He says. “Wash and make yourselves clean. Take your evil deeds out of my sight! Stop doing wrong, learn to do right! Seek justice, encourage the oppressed. Defend the cause of the fatherless, plead the case of the widow.” (v16-17)

A Christian Imperative

Healthcare reform isn’t a Democratic or Republican issue. It’s a Christian imperative. Any true follower of Jesus must realize this. It’s not about taxes or “socialism” or how long it takes to get a doctor’s appointment. It’s about countless people left beaten and bloody along the wayside, like the wounded man in Jesus’s story of the Good Samaritan. As the man lay unconscious and helpless, a priest and a lawyer pass him without a second glance. It takes a Samaritan, a person deemed unworthy by the religious majority, to pick him, dress his wounds, and pay for his care. It shames me to say this, but our current healthcare debate is nothing more than the clamor of self-serving priests and lawyers who have no concern how many helpless and hopeless, oppressed and abandoned souls they step over. And they can blow as much smoke in our eyes as they’d like with scare tactics about “death panels” and subsidized abortions and personal freedoms. But if we’re in tune with God’s Word and sensitive to His Spirit, their smoke dissipates immediately. We see inexcusable infirmities and heinous neglect. We’re appalled by rank injustice and class-based hostility. We recognize why America’s wobbling closer and closer to moral collapse. We know what we must do to help her regain her stability.

Jesus taught us to love our neighbors and enemies and tolerate their sin. But nowhere did He even slightly suggest our tolerance should carry over into blanket permission. The wrongs currently levied on the disenfranchised and underprivileged are not acceptable. This is not a matter of personal opinion. It’s a certainty of what’s right. Political affiliation or personal preference brooks no relevance in our decision to support or oppose the proposed healthcare initiative. As Christians, we have no choice. Just as God spoke to Israel in Isaiah’s day, He speaks to us: “Stop doing wrong, learn to do right!” While our nation wobbles with unsoundness—suffering from head to toe with wounds and welts and open sores it has neglected to clean or bandage or soothe—we must stand firm in our commitment and convictions. When asked our views about healthcare reform, we must resolutely declare our support because our Christian obligation compels us to do so.


(Tomorrow: Now)


Luke said...

Ah yes the healthcare debate. Well I work in healthcare pharmacy to be exact. This year makes year 5 for me and I am about to also start working in a hospital pharmacy as well. I know first hand about high drug costs, what seniors deal with, prior approvals, private insurance bureaucrats, etc. Dealing with insurance companies has made my job terrible. I bill insurances all day. I hate going to work everyday and I am sick and tired of Third Party Rejects. TPR's are the bane of my existence at work. Ever wonder why your script takes 30 minutes or more to fill? How bout your insurance company for starters. Not only that but they promise to pay us then go and pay less than promised. Yes there are other problems in healthcare but private insurance is just awful. I'd love to have gov't run healthcare. Seniors already have that anyway i.e. Medicare (A/B/D). Although reform won't change the fact that prescribers can refuse to write for anything they aren't ok with. Another little known fact is that pharmacists can refuse to fill your script without any reason at all. In every state they have the right to say no. The only reason he had to flush his pills is because of his insurance company because of step therapy and they wont do a PA unless you have tried and failed the cheaper drug first. The only ones who want it the way it is are those who are profiting from the current situation and those who are paralyzed by the fear of change. Ok getting off my soap box now.

Tim said...

Luke, thanks for jumping on the soap box. Those who defend the status quo haven't stopped to consider how far the madness of our current system reaches. Everyone I know who, like you, works in healthcare avidly supports reform. My work takes me to the heart of "big pharma" and they're aching for reform.

Consumers don't understand a big chunk of medication costs go to' staffing lawyers and experts to navigate the maze of insurance demands. Those reps you see at the doctor's office,? Odds are they'll spend whatever time they get trying to resolve product billing issues or updating customers about formulary changes, reimbursements, etc. They catch the heat for endless prior authorizations, insurer inefficiency, call-backs, etc. (That's why office visits are so expensive, too; they hire more clerical than medical staff to deal with insurance hassles.)

You're right, currently proposed reform won't fix this end of the system. But once we join the rest of the world and establish open access to our citizens, what happened in England, France, and elsewhere will happen here. When England enacted National Health Insurance during WWII, most people held on to their private insurance. Today, 90% of the nation is on NHI, and the system--including the back office stuff--is far more efficient, due of uniformity.

France's system is the gold standard. My partner and I visit there often and are amazed at what we see. Because conditions like diabetes and obesity add avoidable costs to the system, the entire nation takes measures to live healthy. Recently, they supported the government's demand that soft drink manufacturers reduce sugar content by half. And when their obesity rate hit 8%, they responded as if it were a national crisis.

It's our Christian duty to see that people receive care their need. But I think you're right, it's also our civic duty to break the insurance piggy bank and the stress it causes all of us. It's making us sicker by the day.

Thanks for the insights. And I pray you'll have a great week at work--despite the lunacy!