Church and Health Care

Religion that is pure and undefiled before God, the Father, is this: to care for orphans and widows in their distress, and to keep oneself unstained by the world. James 1:27 (NRSV)

As you go, proclaim the good news,  ‘The Kingdom of heaven has come near.’ Cure the sick, raise the dead, cleans the lepers, cast out demons. You received without payment: give without payment. Matthew 10:7,8 (NSRV)

Christians in the early centuries of the Church were known for the care of those in the margins, this included caring for the sick. I recently painted the icon of St Camillo who had a chronic health condition, and founded a religious order for the care of the sick and the wounded on battle fields. In the history of the United States Christian denominations saw it as part of their Gospel mandate to found hospitals and health care institutions. Whatever one’s politics if one is a member of Christ, the care of the sick and the disabled is part of the mandate of the Gospel. We may disagree how that should be achieved but our views of how best to achieve must be motivated by this: that the care and healing of the sick and disabled, especially those who cannot provide for themselves and who are vulnerable and abandoned by society is part of what it means to live out the Gospel of Jesus Christ.

In our moment how might members of Christ, given the Gospel mandate, evaluate and act around the government’s role within a for profit health care system where having health insurance (or the type of health insurance one can get) determines one’s access to health care? Reflecting on our call in  terms of “charity” and “solidarity”, may offer a means to discern what the current out working of this call should look like.

 “Charity” –

Some wish to argue that the Gospel only calls the church to be charitable. Those with access to health care and the wealth enough to buy insurance, need of their own free will to give some part of their wealth to organizations or directly to people to help those who aren’t able to provide for  their own health care.  “Charity” says the  Gospel mandate is to be achieved through the more well-off Christians giving of their money to make sure that the less fortunate are provided for.

The limits of “charity”-

My denominations hospital in Chicago, Swedish Covenant Hospital, has a good charity care program. My wife and I have benefited from this when we have received treatment there that we could not afford and insurance didn’t cover (or when we didn’t have insurance.) Even though Swedish Covenant has good charity care, to receive it we still had to go through a process to prove that we indeed needed it and couldn’t pay our medical bills. I understand this. But this is the limit of “charity” it places the less fortunate as petitioners and secondary status in which the poor must prove in some way that they truly need help. I understand why this is so, in providing charity one wants to be sure that the charity is being received by those who truly need it.  But the necessary result of this need is to create a division between those who provide “charity” and those who receive that “charity.”

Several of St. Paul’s reflections on giving in the church were written as he was seeking to raise money for the church in Jerusalem, which was in need. There are two outliers in responses to St. Paul’s Jerusalem collection: The Macedonian churches who gave without bidding and enthusiastically and the Corinthian church who when asked began with enthusiasm and then were contributing little and reluctantly.  Those who made up the churches of Macedonia were largely poor yet they gave with joy and more than the Corinthian church was contributing to the collection, though on the Corinthian church was wealthier. The Corinthian Church was giving out of charity, while the Macedonian churches was giving out of solidarity. The Macedonian churches knew what it was like to be poor and so was motivated out of being with the church in Jerusalem in their suffering. The Corinthian church were giving to charity in their actions they show themselves to be distant from the plight of the church in Jerusalem and in giving out of charity are weighing if they should. Whereas for the Mecedonians there seemed to be no question of giving to aid those in a similar position as them. Being poor they understood experientially the situation of the Jerusalem church, while the wealthier Corinthian Church was giving out of their relative comfort showing pity towards the Jerusalem church. The motivation of acting charitably wasn’t as powerful a motivator as solidarity.

“Solidarity”-

So, what is “solidarity”? “Solidarity” is care with others through identification and not as an act of momentary condescension to aid someone in need. Solidarity seeks either in some literal way or through compassion identifying with and seeing things through the eyes of the poor, not to merely help them but to be with them and in their suffering in a way that also can alleviate that suffering.

Charity and solidarity interpret our call-

I don’t believe that charity and solidarity are at odds, but charity without solidarity has severe limits and often puts burdens upon the recipients of charity and can let the “more fortunate” remain comfortable in their distance from the conditions of those whom they are choosing to help. Those who are in the position to give out of their abundance remain in their abundance and often charity fails to lead to a sharing in the conditions that bring about the poverty or suffering. In contrast, Solidarity requires feeling with those who are in need. It is either being willing to enter into another’s experience or to recognize our shared needs. Solidarity is to put oneself in the place of those who can’t, in this case, provide for their own health care. This may lead to charity (as it did in the Macedonian churches), but it also may mean doing more than simply giving out of one’s abundance.

Charity is a response to the Gospel call. But what of solidarity? What does empathizing with those who risk losing what they need to maintain their health and to eat or have a roof over their head? Also, in solidarity seeks to understand the fear and the concern of those disabled persons who protested in front of Mitch McConnel’s office on capitol hill.  Can you put yourself in place of those who need to make choices between food, shelter and health insurance? The question I’m  asking is what changes if , our charity follows solidarity, on the way to fulfill the Gospel mandate.

Giving priority to solidarity

I don’t know what is the “best” way for the church, in our moment, to ensure that healing is brought to those who can’t afford health insurance apart from government assistance. But I do know that many of those who couldn’t afford health insurance and/or to pay for their own health care, are provided for under the ACA and its expansion of Medicaid. My fellow members of Christ, are you truly prepared to stand with and care for those who can’t afford needed health care except through the provisions of the ACA that repeal and replace threatens? Are our hospitals and health care systems prepared to take up the slack should ACA be repealed? I stand in support of the ACA, not because I think it is perfect, but because I know from experience that it helps those who were unable to afford health insurance. And, the law the Republicans are proposing would eventually leave me and many in my position without access to health care except through charity care.

One way or another, either through supporting government policies that ensure that all have health care (not simply “Access”) or through institutions of the Church, we as members of Christ are to care for the sick and provide healing without cost.

We, as the Church, must ask ourselves is letting the market dictate how health care is distributed truly in keeping with the Gospel and following the path of Christ? I urge you to consider that the conception of free market provision for people’s health is not consistent with the Gospel and the Mind of Christ. However, if you don’t agree and reject that the government provide for the health of your fellow citizens, then you should be able to show me the foundations and institutions and the money you will give to those institutions in order provide for those the free market will abandon on the way and walk on past without a care. “You received without payment: give without payment.”

As of right now, I don’t see the church in the United States being able to step into the gap that “repeal and replace” will leave. In the absence of the means to ensure the health of my fellow citizens I oppose the law proposed by the Republicans in congress and do so as a member of Christ. From my conviction based upon the Mind of Christ, I support the imperfect law of the ACA. This all demands prioritizing solidarity over charity so that at this moment we may live into the Gospel demands to heal the sick and care for the marginalized, without payment.