weekend roundup

Had a good weekend. Busy, but good.

Dad beat me to the post, but we saw SiCKO, Michael Moore’s documentary on the ills of the American healthcare system, on Friday night. To be honest, I was floored. It wasn’t typical inflammatory Michael Moore … he simply let the stories of those affected negatively by healthcare in this country speak for themselves. For those of you who have seen SiCKO, what did you think? If you haven’t seen it, please refrain from commenting on the movie. (because it’s probably quite different than you think) Questions for everyone: What is right/wrong about healthcare in America? Do the poor get shafted by our system? What, if anything, could/should the church do about this?

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Yesterday (Sunday), we joined many close Boston friends in blessing and sending off our dear friends Aaron & Amy Graham. Aaron and Amy are moving to Washington, D.C., where Aaron will serve as the National Field Organizer and Justice Revival Coordinator at Sojourners / Call to Renewal. The Grahams have been über-active in the Boston community the last several years, planting a church in Dorchester (a rather dicey neighborhood, crime- and poverty-wise), earning master’s degrees at Harvard (Aaron, public policy) and Boston University (Amy, social work), running an inner-city community house and internship program, organizing international development projects and trips around the world, and starting from the ground up the Boston Faith & Justice Network. Yeah, they’ve been busy.

Aug.jpgOn a personal level, the Grahams were some of our best friends over the last year, and their presence in our lives this first year in Boston has been such a help and encouragement. Last March (2006), we sat in Aaron & Amy’s living room and shared the vision God had given us about participating in His work in Boston. We realized then and there that God was indeed doing something mighty in this city, as was evident in the similar calling on the lives of the Grahams and many others they told us about. And as couples, we clicked immediately … in a big city, it is vital to find other God-seeking couples with whom to spend time. The time we spent over the last year with the Grahams has been precious.

But as it always is in the church, “goodbyes” don’t exist. It is merely “see you later.” If not in this life, then the next. But we definitely plan to stay connected to this amazing couple in this life as well.

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Last night, we wrapped up a year of service on the leadership team of the Boston Faith & Justice Network. We have decided not to renew our spots on the team for another year. Our reasons are twofold: 1) We’re trying to commit to less outside of our neighborhood, in an effort to connect more deeply with our immediate community; and 2) The organization’s emphasis on political and corporate advocacy, which I’ve questioned before on this blog.

We transition off the team with mutual understanding (I think) with the other leaders, as well as a year of deepened relationships and work toward Christian justice in our city. As I shared with the team at our year-end reflection meeting last night, this experience has exposed to us a remnant of Christ-followers in Boston who are committed to “preaching good news to the poor.”

Praise God.

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Finally, the following prayer was shared last night as we closed.  Pretty powerful stuff:

Disturb us, Lord, when
We are too well pleased with ourselves,
When our dreams have come true
Because we have dreamed too little,
When we arrived safely
Because we sailed too close to the shore.

Disturb us, Lord, when
With the abundance of things we possess
We have lost our thirst
For the waters of life;
Having fallen in love with life,
We have ceased to dream of eternity
And in our efforts to build a new earth,
We have allowed our vision
Of the new Heaven to dim.

Disturb us, Lord, to dare more boldly,
To venture on wider seas
Where storms will show your mastery;
Where losing sight of land,
We shall find the stars.

We ask You to push back
The horizons of our hopes;
And to push into the future
In strength, courage, hope, and love.

&emdash; attributed to Sir Francis Drake, 1577

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24 responses to this post.

  1. Posted by Lynn Holt on July 9, 2007 at 3:22 pm

    After working in the health insurance industry for six years in the 90’s, I have typically defended insurance companies. I saw “Sicko” last night and was equally floored. I was especially stricken by the testimonies of U.S. citizens who have chosen to live in France and the stories they tell about the way France takes care of their own. It was a powerful movie. Something has to be done about the dreadful problem we have in this country! I think the wife of a former president really tried and was shot down on every side.

    Reply

  2. We have a catch 22 going on with regards to health care.

    the system we have has some major flaws. but socialized medicine has massive flaws as well (I’ve seen a documentary short on youtube chronicling people in canada who have to come to the US to get treatment to keep them from dying, as well as people who didn’t make it to america, but ended up with severe issues because of rationed canadian health care)

    The problem with our current system isn’t that the free market intentionally rips people off. Its that when the government offered companies tax free dollars to buy group insurance for their employees, it created an insurance system where people don’t see the increase in health costs when they use it frequently. They never see the premiums go up, so they don’t change their habits.

    So when it only cost you personally 10 bucks to go to the doctor, its an easy decision to go, even if your symptoms are minor.

    The same will occur under a government system, and instead of outright denial of service, they just have to ration it, like in canada.

    And the thing that sucks about Canada’s system is that you can’t buy your own care. Private health care is illegal in the country. Quebec’s supreme court recently ruled that it shouldn’t be illegal because the rationing was causing massive problems.

    I don’t know exactly what the answer is. It isn’t leaving things the way they are, and it isn’t single payer government health care. My solution would involve government dollars, health savings accounts, and doing away with large group plans. When people are forced to get their own insurance (and are getting paid more at work) the cost of personal health insurance will drop due to competition. The answer is people using insurance like it was originally intended… for catastrophic events, and the government can even give people tax credits for putting money into their personal health savings accounts to pay for drugs and doctor visits.

    And by the way, if you want to see where actual cubans get health care, not americans that can pay in hard currency in cuba, check out

    http://www.therealcuba.com

    Reply

  3. Posted by Chris on July 9, 2007 at 5:01 pm

    Did your good friends Aaron and Amy not have some say in the direction the BFJN took, since they started it? Just curious.

    Reply

  4. Justin: First, have you seen the movie?

    Second, folks will arise from every corner to present reasons why our gov’t should not provide healthcare for its citizens. Your objections are real, and abuses and other issues we have not even thought of will arise. But such objections are not things that can not be worked through, nor are they things that have not been anticipated by those who propose gov’t sponsored healthcare. In fact, I’ve got a feeling that countries that have free healthcare for their citizens have aleady addressed these issues and more.

    None of these issues present reasons why we shouldn’t work toward providing healthcare for every man, woman and child. It can happen and it must happen. It will require that we rearrange our priorities, which will raise many more objections from some industries, healthcare providers, drug companies and the like.

    I hope that all of us would try to think positively about this rather than simply listing reasons why it can’t be done.

    Reply

  5. Posted by Steve on July 10, 2007 at 8:22 am

    Good comments all. I like the idea of people having taxpayer-supported healthcare to fall back on, with private medicine available if I can pay for it. Basically, the British system. I’m sure there would be drawbacks, as there would be in any system. But basic care would be provided to the poor, which is my main concern. The trick would be getting doctors to buy into it for the good of the whole.

    The thing that gets me is that so many programs are socialized in this country, not least the military. We have no problem “all pitching in” to drop bombs on other countries so we don’t have to fight the terrorists here, but suggest that we do the same with healthcare and you get major backlash.

    Chris – I’m not quite sure what your question is implying, but our decision to leave the BFJN was because of our own situation, and not everyone else thought the same. Others, including the Grahams, really feel called to political action to bring about justice, and we aren’t going to stand in anyone’s way. We simply had to make a decision for ourselves. (as a note, they are going to D.C. to do a similar thing on a much, much larger scale … see http://www.sojo.net for more info)

    Reply

  6. Not yet, but I’ll either see it this week or next. We’re on a strict budget right now starting out being married. We’ll probably see a matinee.

    I guess I just have issue with a single payer system because it causes the exact same problem we have now. The reasons cost goes up is often to slow down demand to keep from having shortages. If we’ve got as many doctors as is possible in a given market, and, its free or ten bucks to go to the doctor (read single payer or business group insurance) and the doctors are seeing as many patients as possible. Whereas they would normally raise prices in order to weed out those that could probably go without seeing the doctor for a little while, insurance prevents cost increase from having any effect on the demand. This means doctors have to refuse people because they do not have time to see everyone. And, because there is no real price attached, and supply and demand aren’t meeting up like they would in any other market, people who would be willing to pay more (who most likely would need the service more) are unable to use that bargaining to get the service they need.

    My plan would be this. Get rid of large group plans. The government can give people vouchers to pay for a personal or family insurance plan with a high deductible. (which is what insurance was supposed to be in the first place). And also give some sort of credit to poor people to put into a health savings account which is used for medicine and regular doctors visits. This will drive down cost, because people are using real dollas to pay for things, which makes one think twice about going to the doctor when you have the sniffles, it keeps the government out of things to the biggest extend possible while still providing catastrophic coverage as well as sum of money to pay for doctors visits and medicine.

    I mean, obviously, the best thing would be is if christiain doctors did like Ron Paul, who refuses medicare on principle, but will pay for services for a medicare patient.

    Reply

  7. Posted by Daughter on July 10, 2007 at 1:18 pm

    Justin,

    When I first graduated from college, the HMO’s were in their early stages. One local Boston HMO was Harvard Community Health Plan. At that time, they not only were an insurer, they had their own health clinics. One of the best features they had, IMO, was an evening walk-in clinic. This allowed people to stop in, talk to a nurse practitioner about your symptoms, and they would let you know whether you should make an appointment to see a doctor or not.

    I share this story because one of the things in your post that I question is that people always know whether or not something merits a visit to a doctor or not. For all the stories of people going to emergency rooms for the sniffles, there are as many stories of people ignoring symptoms that didn’t seem serious until it was too late. Something like the walk-in clinic I described above could help bridge that gap.

    Reply

  8. That is true, but I’m not just talking about people that abuse the emergency room here.

    What I’m talking about is what economists call “moral hazard”. Another example of this is that people tend to drive rental cars more recklessly than they would their own. They aren’t going to see the financial issues that arise from stomping the accelerator or any number of behaviors that put stress on a car that aren’t immediately harmful to their pocketbook.

    Its also the same premise as to why public property gets treated worse than private. For the most part, when someone owns a piece of land, say their yard in a neighborhood, they are going to want to keep that yard looking nice, without trash, etc, to keep their property value up, whereas public parks, people throw litter down because its not their issue to clean and they don’t see firsthand the extra cost they will pay in taxes to keep it maintained.

    Its the same thing with health insurance and co pays. Since the cost is spread out over so many people who pay premiums and don’t go to the doctor often, those who go all the time for things that could be fixed with some claritin or benadryl don’t see the increased cost their frequent visits to the doctor cost other people.

    Reply

  9. Posted by Matt C on July 10, 2007 at 10:11 pm

    The moral hazard argument that Justin alludes to can be summarized as the idea that insurance has the paradoxical effect of producing riskier more wasteful behavior. As Malcolm Gladwell writes in his essay The Moral Hazard Myth, universal Pepsi insurance would lead people to consume more Pepsi. However, people don’t derive the same satisfaction in going to the doctor as they do in drinking that free Pepsi. How many people do you know that would choose to go to the hospital in place of reading a book in the park or playing a game of golf?

    Justin describes an “allergy visit” as one way to reduce costs(very minimal in the grand scheme of health costs, by the way). However, let us also consider the “freckle visit” and the “my blood sugar is a little too high” visit. Unfortunately, there is a gap between the public’s knowledge and their actually health. That changing freckle might just be skin cancer. And that high blood sugar might seem innocuous enough at the time, but in the long term, that patient will face much more serious and costly consequences.

    Proponents of the moral hazard argument will naturally argue for solutions such as health savings account. This would effectively make preventative care rarer and rarer, as patients will find much more pleasant ways to spend that $200. However, this would lead to greater costs and worse health outcomes. It is much more expensive to treat complications than it is to prevent disease and prevent complications.

    A single payer system is the only long-term viable solution. You can learn much more about this issue at the Physicians for a National Health Plan website.

    Reply

  10. Matt, you made some convincing statements, but I don’t see how we can say definitively that single payer is the only viable solution. What of the rationing of care that we’re seeing in Canada? And what about the lack of drug research that comes from a government care system. What of the pharmaceutical companies from Europe that have moved over here because profits needed to do R and D for new drugs aren’t availible in Europe? I’m not being snarky here, just wondering.

    Reply

  11. Posted by Matt C on July 10, 2007 at 11:45 pm

    Justin, The below website is a good intro to the Canada waiting time question. Briefly, there is no good evidence about their waiting times (but it is most certainly exaggerated), the system is underfunded (compare their per capita cost to the US), and waiting times in the US also exist. At Harris County Health District, patients often have to be admitted to the hospital because the waiting list is too extensive as an outpatient. http://www.amsa.org/studytours/WaitingTimes_primer.pdf

    As for pharma, that is a big issue, and I don’t want to take up too much space on the blog. I would encourage you to look at the percent that pharma puts into R&D–not very much. Much more is spent on advertising to the public and sending MBAs to “teach” MDs about their drugs. Much more R&D is coming from the government and academic institutions (this money would not disappear with single-payer). Drug companies would not disappear or go bankrupt with single-payer, but they would have to adapt and their industry might only have the fifth highest profit margin instead of the highest.

    “The issue about what to do with the health-care system is sometimes presented as a technical argument about the merits of one kind of coverage over another or as an ideological argument about socialized versus private medicine. It is, instead, about a few very simple questions. Do you think that this kind of redistribution of risk is a good idea? Do you think that people whose genes predispose them to depression or cancer, or whose poverty complicates asthma or diabetes, or who get hit by a drunk driver, or who have to keep their mouths closed because their teeth are rotting ought to bear a greater share of the costs of their health care than those of us who are lucky enough to escape such misfortunes?”–Malcolm Gladwell

    Reply

  12. I think that Christians should help those people when the need rises, but I think its unethical to steal from some to give to others. Our country isn’t supposed to be Robin Hood, and Jesus wasn’t Robin Hood either.

    I think the biggest question is, what is your definition of fairness? Is it fair to be handed everything on a silver platter or is it fair to work hard for a living? Is it fair that one person has to make up the cost for someone else to get the best health care possible, just because they have more money?

    Reply

  13. Posted by Steve on July 11, 2007 at 9:00 am

    Fairness. Interesting concept.

    Typically, I’d be right with you on the solution being the church stepping it up. And I agree that the church should help people when needs arise.

    But this issue goes much deeper than just “rich” versus “poor.” Middle America — the run-of-the-mill, making ends meet folks of this country — is being raked over the coals by our healthcare system. The poor suffer as a result of our system — that’s a given. But the story Moore told in SiCKO was of the many, many hard-working, average — white — folks who have been refused care, buried in hospital expenses, and basically been left out to dry.

    So I ask you — these people are doing everything “right.” They work for a living, sometimes more than one job. Some of them rushed to Ground Zero after 9/11 to help in the recovery effort, only to become sick from the toxic air they breathed. One woman was refused a necessary surgery for her brain tumor because the insurance company downplayed her condition — she later died as a result of it.

    Like I said, normally I would be with you that the solution isn’t political. But on this issue — I dunno. I think it’s more basic than that. It’s how we treat each other as a society. How we uphold our responsibility to help each other out when things are tough. At the very least, not let anyone die when it could be prevented. (or because someone wants to make a better commission or bolster the bottom line)

    I’m sure there are negatives to any system our finite minds can think up. But what if we centered our brainstorming around the principle that in civil societies, we all pitch in to uphold the basic rights of everyone else. You know as well as anyone that the “pull yourself up by your bootstraps” myth doesn’t work in real life — and it doesn’t work as it relates to healthcare. It’s just too big a bureaucratic barrier to clear for most.

    Reply

  14. “not let anyone die when it could be prevented”

    How does one do that? Like I said, single payer does many of the same things as our current insurance process, and if you support the British system, the rich will always get better care than the middle class and poor because they can afford to get treatment immediately and from the best doctors possible.

    You have a couple options with regards to solutions to health care. Either everyone gets the exact same care, which will cause rationing, which will cause some people to get the shaft. Or you have a system in which everyone is covered, but the best care still goes to those who have money. None of that seems “fair” to me.

    I guess when I look at the situation that’s not going to be perfect either way, I would prefer to err on the side of liberty for people rather than government. When people have choices, things can change more easily than when things become law and government gets involved. That’s why I don’t have a problem with government dollars or tax credits paying for HSAs and for plans, because people still have a choice.

    You also run into other problems with a single payer system. Some people don’t agree with certain procedures, and would have issues with their taxes going to pay for these procedures. For example, sex change operations, vasectomies, tubes tied, breast implants and other plastic surgery, abortion, etc. While I wouldn’t have a problem paying for some of those things, some of them I would, and I wouldn’t want my tax dollars being used in that way. That’s another thing the private sector can work out that the government can’t.

    Reply

  15. Posted by Steve on July 11, 2007 at 9:33 am

    Did you go see SiCKO yet, Justin? Catch it while it’s still in the theaters. It’s worth it.

    Reply

  16. Posted by Chris on July 11, 2007 at 9:44 am

    Once government pays for health care what is the next step because you can rest assured it won’t stop there. The next think you know, government will be asked to make sure everyone has the right to certain standards of food, housing, regardless of their income. Before you know it we will be a complete socialistic state with nanny government taking care of everyone with our taxes.

    Reply

  17. Posted by Steve on July 11, 2007 at 9:52 am

    Ahh, the slippery slope argument. Moore discusses this, as well as our programmed negativity toward socialism, in SiCKO. I’d recommend seeing the movie.

    One of Moore’s strongest points from the documentary was that we already have tons of “socialized” programs in this country. The Post Office. Public schools. The military. In other words, every one of us helps to pay for these programs, whether we agree with their existence or not (for instance, I hate the fact that my $ goes toward the construction of bombs and tanks…).

    Public education is seen as a basic right of all children in this country, so we make it free. I guess my question is this:

    Is basic healthcare every bit as much a right for Americans as public education?

    (Canada and Britain haven’t slid into complete socialism, by the way)

    Reply

  18. Posted by Steve on July 11, 2007 at 10:07 am

    …government will be asked to make sure everyone has the right to certain standards of food, housing, regardless of their income. Before you know it we will be a complete socialistic state with nanny government taking care of everyone with our taxes.

    Hmmm … doesn’t sound so bad to me.

    That’s unlikely to ever happen in this country, though, because competition and wealth creation are such high priorities here. (I also think the chances of us seeing socialized medicine in America are slim for the reasons above, but the conversation is still worth having)

    Reply

  19. I’m not denying that we all ready are a quasi socialist state. I just think the government is far too large all ready, and I’d like to see it shrink, or at least slow down its growth.

    No, Canada and Europe haven’t turned into fully socialist states, but their economies are stagnant and unemployment is high (especially in France and Germany).

    Mr. Holt and Steve Jr, would ya’ll walk to your neighbor’s home and demand that they pay for your health care, or housing, or food?

    The problem with socialism is that it sounds great and it works… for a while. It may work for 50 years or for 100. But eventually, free people when faced with taxes that get higher and higher, will cease trying to make a profit. And when the taxes are mostly geared at those making 200 thousand a year or more, those who typically own businesses or are executives in companies, and those people are disincentivized from profiting, they will stop working as hard because the reward isn’t there, or will move their operations to a country where they can receive reward for their work. This is the point at which socialism causes a complete rebellion or the government decides to take over private property. Socialism always leads to tyranny. A powerful state always leads to war. These are not things that I desire for me, or my children, or anyone for that matter.

    Our country was founded on the belief that people are free first and government should only protect those freedoms. That the freedoms are given by the creator, not granted by government. When we continue to have the government pay for more and more things for us, we are sacrificing freedom for security. Its just what’s happening with the patriot act, and other legislation like it. Its the same that happens when you surrender control of things to the government under the guise that they can protect you from anything… sickness, terrorists, poverty, etc.

    We’ve had a war on poverty, a war on drugs, a war on terrorism, etc etc etc for years and years, and we’ve seen little if any results. How much money has been spent on entitlements in this country and have the impoverished classes improved? Not much if any at all. The government creation of the income tax and the federal reserve have caused more harm to the poor than capitalism ever could have. Government programs are not designed to help anyone. There is no incentive to the government for ending poverty, but there is incentive to create dependency because it gives people who likely all ready crave power more power.

    I feel like if I have a choice in who rules me, I should choose the person who wants to diminish their own power rather than increase it because it affords me the ability to serve others more easily and show the world that Christ is the savior and not Uncle Sam.

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  20. Let’s see: highways, bridges, police departments, armies, air forces, navies, post offices, utilities, prisons, libraries…

    Can’t we find a way to insert healthcare into this list of government funded items? Is any one of these more important than simply helping people stay healthy or alive? Which?

    How many people could we insure by cutting the military budget in half? or doing away with the postal service? or issuing a moratorium on highway spending for 10 years? Or by increasing taxes on baseball tickets or lottery tickets or CEO salaries or Humvees or alcohol or NASCAR?

    We could easily fund healthcare for every person if we really wanted to and not miss many of the luxuries we enjoy.

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  21. Justin, I forgot to answer your question… Since we moved from East Memphis to Midtown, I’m not sure many of our “new” neighbors have health insurance. They would probably gladly opt for health care over some of the items I listed in the comments above.

    By the way, Mitch and the Rocketboys GREATLY appreciated your hospitality when they passed through N’ville recently. Thanks so much for welcoming them in. Hope you didn’t have to feed them!

    Reply

  22. I cooked them waffles in the morning actually. I wanted some, so I figured it wouldn’t be a hassle to just cook a ton up. We got a nice waffle maker for our wedding and I wanted to use it.

    I am all for a tax on goods rather than an income tax. I’m all for the government cutting back military expenditure, getting rid of the postal service monopoly, and cutting back FEDERAL spending on most everything. The constitution just doesn’t allow it (but we’ve done it anyway). States were supposed to determine these things so that power would be more directly in the hands of people. I have much less of a problem with CoverTN than I have with a federal controlled health care system. And I might even be in favor of a federal health care system, one that allowed profit in the medical field, and had as little government control as possible. I’ve said that several times.

    The point is that spending in washington is out of control because our government is out of control. And if its even possible, I trust people in washington less than I trust massive corporations. At least corporations are semi accountable for their actions, whereas government has shown us time and time again that the opinion of the people doesn’t matter.

    Reply

  23. Posted by Matt C on July 11, 2007 at 11:46 pm

    “And I might even be in favor of a federal health care system, one that allowed profit in the medical field, and had as little government control as possible.”

    Great. Then you might actually consider supporting single-payer. Contrary to other comments, not every single-payer system is equal to the UK’s. Or Canada’s. One option floating around is to create a solution modeled after the federal reserve, a pseudo-governmental agency, that just happens to be funded by tax dollars. Might be a nice thing to cut out the current 25% of private insurance that goes to bureaucratic waste (and you thought the government was a big bureaucratic mess).

    Physicians, medical groups, pharma, etc. would still make money. The doctors just wouldn’t have to hire an army of filers to be on hand to manage so many different insurance plans.

    Please watch out for the socialism-communism argument pertaining to this issue. Lobbyists are being paid millions of bucks to circulate this fear, as a few specialized interests have much to lose.

    Reply

  24. I don’t need special interests to warn me about socialism. I’m an economics guy, and I’ve read a few history books, so I know what happens when you try to ignore the laws of supply and demand.

    If we all went to even, government funded HSAs and a government catastrophic insurance plan, that all tax payers paid into, I might be ok with it. I just think that people need to think about cost regarding their regular doctors visits, and medicines, etc. When they are spending their own money (even if it was put in the account by the government) they will be more likely to go to walmart and get a 4 dollar generic rather than pay for the name brand drug. This would force the name branders to lower their prices to try and compete.

    And I’m not big on the Federal Reserve. Its been instrumental in the inflation that is destroying the middle class and the poor.

    Reply

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