16 February 2009

Socialized Medicine: Disaster or Opportunity?

The recently-passed pork package 'Stimulus bill' contained several provisions to start us on the road toward socialized medicine. As wrong as I think this is on a philosophical and Constitutional level, our family still has to deal with the fall-out of this decision.

Caring for the sick is a mandate from Christ to his people. Up until the 20th Century, life spans were short and hard, filled with pain and suffering.

As the church matured, caring for the sick became an important focus of ministry. According to Wikipedia:
The adoption of Christianity as the state religion of the [Roman] empire drove an expansion of the provision of care. The First Council of Nicaea in 325 A.D. urged the Church to provide for the poor, sick, widows, and strangers. It ordered the construction of a hospital in every cathedral town. Among the earliest were those built by the physician Saint Sampson in Constantinople and by Basil, bishop of Caesarea. The latter was attached to a monastery and provided lodgings for poor and travelers, as well as treating the sick and infirm. There was a separate section for lepers.
Health care, in the context of the Christian church, was viewed as an opportunity for ministry.  Just as we will always have the poor with us, so we will always have the sick with us, simply because we live in a fallen world.  This attitude, that caring for the sick is a ministry, continued on for most of history.  Think about the country doctor who would deliver a baby in exchange for a couple of chickens.  He lived among those he ministered to and, even if he didn't become rich, was held in high esteem by the community.  His care wasn't just technical; it was ministry, based on love and compassion.  (edit: A friend told me Sunday evening that he knew doctors who worked like this up to the 1980's.)

Then someone, somewhere, suggested that, if we wanted more doctors of better quality, we should pay them more and medical care became a business. This lead to people entering the medical profession for the money, not for the sake of ministry and compassion.  Doctors became businessmen more than ministers.  (Do I have to say it?  Okay.  Not all doctors are in it for the money - I know those who aren't - I'm speaking in general terms.)

This new attitude brings us to our current situation.  Health care is big business.  But it's not really a free market.  Because of tax laws that don't tax health insurance benefits, to save money and attract high-quality employees, employers began offering health insurance as an extra benefit.  However, those who were covered forgot that their health benefits were part of their pay, earned just as their paychecks are earned.  Because costs of health-care weren't coming directly from their own pockets, they stopped comparison shopping and considering if certain tests and procedures were truly necessary and beneficial.  We haven't had a free market in health care.  (There are exceptions in certain specialties that aren't covered by insurance, such as cosmetic surgery, and the free market has worked well, encouraging competition, comparison shopping, dropping prices, and higher quality.  No, I'm not planning on cosmetic surgery - it's simply an interesting microcosm of what the free market could do for medicine in general, if it were given a chance, although it wouldn't solve every problem (more below).)

With the nationalization of health care, rationing will be the order of the day.  The first thing done was to create a national committee to oversee health care (signed into law today in Denver).  You may pay for a procedure or a medicine (either out of your own pocket or through your insurance company), but this committee can and will call your doctor and tell him not to do the procedure or to stop the medication, all in the name of cutting costs.  Doctors who try to buck the system will be fined and fined heavily.  They won't be able to do what you and the doctor together think is best, but will have to abide by decisions of an unelected (and thus unaccountable) bureaucrat in Washington.

Nationalized medicine is a very bad thing, but it could turn out to be a golden opportunity for the church.  The church must step back in and care for the sick as a ministry.  Families should be prepared to care for their own.  When there is no family available, or if the family is unable to care fully for their own, then the church should step in to help.  At this point, we won't be able to offer medications (there's even a drive to make medicinal herbs available by prescription only), but we can offer comfort, compassion, nourishment for body and soul, a human touch, and love.  These are vital components of caring for the sick that have been largely lost in the rush to make it a business instead of a ministry, components that the family and the church can and must offer.

We will be learning how to care well for someone who is sick: how to change bedsheets while someone is in the bed, how to avoid bed sores, how to feed the sick so as to help and comfort them, possibly light massage to help ease aching muscles.  I'm going to work more on my kids' ability to read aloud well, in preparation for caring for someone who needs human companionship, to hear a human voice, yet who might not be up to conversing.

And yes, I've got some selfish motivations here.  As cost becomes everything, euthanasia will grow, not all of it voluntary (do a little research on euthanasia in the Netherlands for a peek at where we're headed).  My kids have assured me that I won't be left to the vicissitudes of a bureaucrat's arbitrary decisions regarding whether I live or die if I ever become simply a 'worthless eater'.  They plan to care for me at home out of appreciation for my work in caring for, educating, and raising them.  Now that's a health care system I can believe in.

SDG!

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