The Dynamic Center: Non-government Run Health Insurance and the Churches

Posted by ikabod Crane on 07.20.2007

Alexis de Tocqueville, Civil Society, Religion, Politics and Health Care – How can this column go wrong?

Recent debates and films (I have not seen Sicko) have raised the issue of universal health care in the United States once again. In some sense, the issue never left us. Roughly 15-16% of U.S. citizens do not have health insurance. That means roughly 45 million U.S. citizens do not have medical coverage. So, the issue is real and pertinent even when politicians do not talk about it.

Are There Alternatives to Nationalized Medical Care?

Let us assume two propositions to be at least generally true in the U.S. context

1. 45 million without health insurance is a bad statistic for that 45 million and because the non-insured raise medical prices for all.

2. U.S. citizens generally dislike government run industries/programs

Where does that leave us as a nation? Recently, President Bush said, ''I mean, people have access to health care in America, … After all, you just go to an emergency room.'' Bush is correct in a thin sense of the word correct, but as stated above, sending the uninsured to the emergency room for a fever only slows hospital services down and raises health care prices for everyone. The emergency room as medical access does not serve the common good due to being slow for the uninsured sick and expensive for the entire society. Clearly, the emergency room solution is D.O.A.


Alexis de Tocqueville and Civil Society

Tocqueville believed that democratic societies flourished when the citizens were bound together in community groups. Such groups allowed citizens to have strength in numbers and resist government and economic tyranny (Wal-Mart and Big Brother can be stopped only by citizens working together). We can describe the conversations and actions citizen groups engage in to be Civil Society. A robust civil society helps communities form corporate identities that can resist depersonalizing tyranny. The biggest problem is that citizens of democracies tend to isolate themselves from one another. Civil Society takes effort and must intentionally be created. It is not a given. This is one reason Tocqueville believed Churches to be so important to democratic nations. Churches draw people from self interest toward the transcendent and toward the interests of the community. Much the same can be said of secular communities as well, but communities were important for Tocqueville. This is so, because isolated democratic citizens are easy to dominate. Concerned citizens with a united purpose do not fall victim to economic or political tyranny nearly as easily. For example, think how the communities of African American Churches were able to resist Jim Crow laws in the 1960's.

Churches Going Old School?

If we can agree that strength in numbers exists, then maybe other paths are available to help confront the health care crisis. The early Christian communities placed special emphasis on caring for widows, orphans and the sick. The sick … Some of the loudest critics of government run health care are religious conservatives. If being conservative means promoting a restoration of the old ways, then maybe the Churches need to be more active and clever in addressing this problem. What if the various mainline Churches and Roman Catholic dioceses of the United States divided various health issues up? For instance, could the Episcopal Church raise funds to cover vaccinating the uninsured while the United Methodists covered diabetic screenings, the Presbyterian Church USA pushed for preventative medicine and the Baptists along with the Roman Catholic Church helped with prescription drugs?

If critics of socialized medicine are going to say this is something charities should cover rather than the government, should they not be more charitable?

If the above proposal is too complicated (and it might be), I have two more simple proposals.

1. Churches make a point of providing all preventative medicine for the uninsured – Glaucoma, vision and diabetes screenings, dietary planning, physicals, and vaccinations. This could be done by asking all of the dentists, doctors, nurses, optometrists, med techs, physicians assistants etc. in a given congregation or parish to give two days per year to make-shift health clinics held in areas of need. This would not solve the problems of the uninsured, but it sure would help.

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2. The various Churches could create some sort of combined health appeal for their members. People could donate money to create an endowment for purchasing insurance. This fund would have a percentage of donations invested and a percentage going toward immediate problems. This money would come from an extra collection plate being passed around now and again. The board would have a member from each ecclesial body to make sure the money is not wasted. The fund would also need to have an external audit. The money would be used to purchase insurance for as many of the uninsured as possible.

It is unlikely that any of these plans would reach 100% coverage, but once again it could cover many uninsured people and this in turn would drive down the cost of health care because doctors and hospitals would not have to pass so many bills for covering the uninsured to those with health insurance.

Dan, Is This a "Christian only" Approach to the Problem?

No. I do not want to get into providing proof texts, but clearly Judaism has a charge to care for the downtrodden. I have no doubt that many Synagogues would jump at contributing to a combined health appeal or that many Jewish medical professionals would volunteer their time. One of the five pillars of Islam is giving alms to the poor. Those alms could contribute to buying insurance. The eastern religious principle of Ahimsa calls for non-injury to all life. Promoting health fits the philosophy of Ahimsa. Many atheists and agnostics also want to see health care access increase for the uninsured and health care prices drop for all.

Communitarian Solutions Do Not Necessarily Mean Government Solutions

I started with Christians because the charge is often made that this is a Christian nation and a Christian culture. Another charge is made that charities ought to handle a lot of the problems the government handles. I am a student of Church history. If Churches once provided the back bone of care to the widows, orphans and sick of the Roman Empire, can they not do something similar today? It would seem that a Christian conservative would want to at least attempt to emulate the past. Such an undertaking would require a major effort to be sure. It would require motivating many people who are currently under involved in their communities because the many existing Christian social outreach programs and Church based volunteers are already stretched very thin in trying to meet the needs of the causes they serve.

However, if people are going to argue the Christian character of a nation, or the strength of non-governmental charities, it is time to put actions where words reside. In a real sense, if strong community organizations, religious or otherwise, work together on health care, the problem may not be insurmountable. Of course, communities could always be lazy and say, "Just pass the tax increase to create a government agency to solve the problem."

Either way, something should be done, but I prefer to seek solutions through Civil Society first. The trick is trying to transform the apathetic masses into a vibrant community. This takes work, but in the long run a nation with strong communities is worth the work.