Healing, hope and health-care reform.by Tim Stoltzfus Jost
In Luke 4, Jesus began his ministry on earth by claiming Isaiah’s message of healing and hope for the oppressed. Throughout his ministry, Jesus healed the sick and preached good news to the poor. After his death and resurrection, the church has carried on this ministry.
Today our country wants to make the healing power of modern health care available to all. While all other wealthy nations insure all their citizens, the United States has 50 million uninsured people. Each month, tens of thousands more people lose insurance. The United States has the most costly health-care system in the world. Although we lead the world in medical innovation, we rank 19th in avoidable mortality from disease.
One Senate and three House committees have now passed health-reform bills. All are complicated bills addressing a complicated subject.
The provisions of the bills are similar. All expand Medicaid, the current program for poor Americans, so that all Americans earning less than 133 percent of the poverty level (which is $10,830 for an individual or $22,050 for a family of four) would be eligible. The bills also provide “affordability credits” to help uninsured lower- and middle-income families earning up to 400 percent of poverty purchase health insurance. These subsidies diminish on a sliding scale as income rises. Because the average employment-related family insurance policy costs $12,680, subsidies are necessary to make health insurance affordable even to middle-income Americans.
The proposed legislation bans pre-existing conditions insurance clauses and discrimination based on health status. It assures that insurance is available to those who need it most. The legislation also establishes “exchanges” so purchasers can find and purchase the insurance that best meets their needs. It may include a public plan. In many markets, private insurance is not competitive. In Harrisonburg, Va., one insurer controls 86 percent of the market. A public plan would bring down prices by offering an alternative. Although some fear the public plan would drive private insurance companies out of business, the nonpartisan Congressional Budget Office estimates that only nine to 10 million Americans would enroll in the public plan.
The proposed legislation requires larger employers to offer insurance to their employees or pay a penalty. Most Americans are already insured through their jobs. Many would see improved coverage. Individuals would have the security of knowing that if they lose their job, they will not lose their insurance. Small businesses would be given special assistance.
Finally, the legislation includes many improvements in the Medicare program, initiatives to increase the availability of primary care and to encourage healthier lifestyles and new ideas for improving the quality and reducing the cost of health care.
The legislation does not encourage euthanasia, as some suggest. It may offer Medicare funding to allow doctors to discuss with their patients responsible end-of-life care, a basic stewardship issue for Christians. Under recent House amendments, the law prohibits public funding for abortions other than for cases of rape, incest or life endangerment. It does not require rationing of care, although it promotes research to help distinguish effective from wasteful care.
The legislation may cost $600 billion to $1 trillion over the next 10 years, a high cost but just 3 percent of the total estimated cost of our health-care system over the next 10 years if we change nothing. Much of the cost would be covered by cost-savings within the health-care system, savings that may grow over time.
There are differences of opinion about how best to reform our health-care system, but two things are clear. Our current system is not viable—health care and insurance costs continue to grow, and Americans are losing health insurance at unsustainable rates. Second, the private sector won’t solve these problems on its own; public intervention is necessary at least to provide health care for the poorest among us.
Mennonite Church USA adopted a national health-care resolution in the 2009 delegate assembly. It asks members to urge their legislators to support legislation extending access to all Americans, especially the poor and disadvantaged. It did not endorse particular proposals. As we speak to our legislators, may we, like Christ, hold healing and hope for the poor and oppressed as our highest priority.
Tim Stoltzfus Jost is a professor at the Washington and Lee University School of Law and a member of Community Mennonite Church in Harrisonburg, Va.
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