Tuesday, October 29, 2013

Healthcare Debate among Christians

My thoughts these days are on the healthcare reform. The PPACA (Obamacare) rollout has provided cannon fodder to those opposed to it in principle. Anyone who has worked in our industry can see clearly that the CGI engagement in building the healthcare.gov exchange has been deeply flawed in design. I can't blame CGI squarely for this either. Many critics allege that they had 3 years to fix it, but the reality is that serious work on this began only after the June 28 2012 Supreme Court ruling that Obamacare was constitutionally compliant. CGI needed to size the infrastructure, go through the hardware installation, design, application development and testing for a system that will handle the enrol-to-claim process, providing analytics, external party integration and reporting for 50 million people! And all this in slightly more than 1 year- in my experience, that is more than aggressive, and was destined for failure from the beginning. A lot of it has to do with the Obama administration, which is CGI's sole source of inputs on the business requirements, volume of traffic, compliance and all other related functionality.

The Act has also come under fire for the fact that many hundreds of thousands of 'sub-standard' health policies are getting canceled as they do not meet the standards set by the administration. When the policyholders switch to Obamacare, they end up paying higher premiums. Many who do not quality for vouchers to pay these premiums are being financially hurt. This was contrary to Obama's promise that 'those who like their current health insurance policies can keep them.'

Paul Krugman, who rarely pens articles that I find to be the 'whole truth', has written a great column in the New York Times titled 'The Big Kludge', talking about how the current complications are a result of bypassing a 'Medicare for All' law and settling for Obamacare.

My thoughts on this topic stem from my experience trying to sign up my mom for the PPACA. She is a green card holder, well above 65 years of age, but cannot get Obamacare or Medicare. These programs exclude senior immigrants who have not lived in the US for at least 5 years continuously.

There are some strident American voices out there who oppose including them in either program. Here is an excerpt from a blog post on an AARP forum:

Frankly I resent senior immagrants being eligible for any SS or Medicare.  They didn't pay into and for them to come to a foreign country and expect to take advantage a program they never paid into is appalling.  I respect your wanting to take care of your parents but you should be doing it on your dime and not on the backs of the citizens of your adopted country.  If you are so concerned about your parents maybe you should consider moving back to Argentina.  This may sound cold and unfeeling but SS and Medicare has been a political volley ball and is abused by  political parties, refuges and immagrants to this country.  Those that paid into and collect SS themselves have been cheated out of cost-of-living raises and have to deal with diminishing and inadequate health care.  There are countless senior citizens in this country that worked hard throughout their lives, paid into SS and retirement programs and still can't afford to live the comfortable life they had planned.  Social Security despite what you hear is NOT an enttilement program like welfare or programs you may get through a State.  This is a program that people pay into for their entire working life, it comes out of their checks and was meant to be used to take care of those retired/retiring, disabled workers or families where the bread winner has passed on.  The SSA has abused it by making it an entitlement program through SSI.  What does your native country do to provide for it's retired citizens and what exactly is it that you expect this country to pay for?

Observe the language "I Resent"... How could anyone resent a senior getting healthcare? If a new immigrant can be denied healthcare, why not go the whole hog and deny them access to water, emergency services, et al? After all, these are all taxpayer-funded. In these days when cities go bankrupt, perhaps we should throw off our veneer of compassion and demand that no services be provided to these needy and helpless people. Maybe they should be looking to their home country to supply these.

But this is a fairly typical sentiment- that those who do contribute should not receive anything. While the government should use its taxpayers' money effectively, this is, of course, completely contrary to Christian teaching- and when Christian caregivers or payers refuse to provide for such people, they refuse Christ himself:

"And when was it that we saw you sick or in prison and visited you? And the king will answer them, 'Truly I tell you, just as you did it to one of the least of these who are members of my family, you did it to me." (Matthew 25: 39-40 NRSV)

Matthew 25 does not talk about people who paid into the system. Christians MUST care for such people- through setting up proper health insurance for them, period. Those trying to influence public policy on gay marriage should remember that influencing public policy on healthcare on behalf of the helpless is virtuous.

The difference in perspectives comes from how we view people. Abe Lincoln's parents were very poor. If they lived today, it is unlikely they could have afforded decent health insurance. However Lincoln became president, and today we sing the praises of Nancy Lincoln. But if she were alive today and Lincoln were president, we would refuse her health insurance because she did not pay into the system. Or did she? Did she have anything to do with Lincoln's achievements? Of course, she did. We are not of our own making. We all have to thank millions of people for everything we are and everything we have. But our idolatrous culture defines contributions as monetary in nature. We consider mammon to be the most important reality in our lives. Nothing else matters.

There is another perspective, however- this one views human beings as those made in God's image, and intrinsically worth saving. That is the ONLY perspective a Christian should have.

Earlier this year in April, a Christian hospital illegally deported (via a process called 'medical repatriation') an 'illegal immigrant' despite his life-threatening injuries. Fully knowing that this man desperately needed timely care, he was sent to Mexico to die. The strident voices who responded to this column, presumably Christian, claimed that the man had essentially killed himself because he 'chose' that when he decided to enter the US illegally.

One sane voice had this to say:

First, the article is about ontological arguments on religion and sickness and NOT of the burden of state. You can't call yourself a good christian without following his teachings, and as far as we know Jesus would not have thought twice about going bankrupt if it meant helping everyone. 
Could the hospital contacted an in country hospital with the facilities necessary? Yes.
could agencies better oversee illegal workers working in dangerous environments cutting corners to save the boss more money in safety and wages? Yes.
I'm a medical dr. And i see often people without insurance for free because once upon a time when i was young, and illegal, and hospitals turned me down for treatment (good "christian" hospitals) a doctor stepped in and paid, and helped me ever since to pay for school. Now i am returning the favor.
Isn't this wonderful? Doesn't it put to rest all the nonsense about the 'moochers'? My own parents had a big part of who I am today- and I have contributed more than my "share" into the well-being of this country. But the idolaters of our country would deny them healthcare and justify it with arguments that will one day be heard at the judgment seat of Christ. We already know the verdict from Matthew 25. Here it is (NIV):

41 “Then he will say to those on his left, ‘Depart from me, you who are cursed, into the eternal fire prepared for the devil and his angels. 42 For I was hungry and you gave me nothing to eat, I was thirsty and you gave me nothing to drink, 43 I was a stranger and you did not invite me in, I needed clothes and you did not clothe me, I was sick and in prison and you did not look after me.’
44 “They also will answer, ‘Lord, when did we see you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?’
45 “He will reply, ‘Truly I tell you, whatever you did not do for one of the least of these, you did not do for me.’
46 “Then they will go away to eternal punishment, but the righteous to eternal life.”

Emma Lazarus' poem 'The New Colossus' contrasts the brazen giant, Collosus of Rhodes with the new, gentle Colossus, the Statue of Liberty.

Not like the brazen giant of Greek fame,
With conquering limbs astride from land to land;
Here at our sea-washed, sunset gates shall stand
A mighty woman with a torch, whose flame
Is the imprisoned lightning, and her name
Mother of Exiles. From her beacon-hand
Glows world-wide welcome; her mild eyes command
The air-bridged harbor that twin cities frame.
"Keep, ancient lands, your storied pomp!" cries she
With silent lips. "Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door!"

Would Emma Lazarus stand by these words today? Or have become the brazen giant ourselves?

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