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Non-Binary Conversations

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It’s a struggle to move beyond binary thinking. Both Jeff and I (and Julie Kuhl in her thoughtful comments) struggle in different ways to find a healthcare language beyond Left and Right, beyond Liberal and Conservative, and beyond Rights versus Responsibilities. How often political and policy conversations degenerate into either/or confrontation! The beauty of Respectful Conversations, like the beauty of some forms of Christian theology, is to entertain three/four/more approaches to a topic.

However, this beauty sometimes minimizes real disagreements that help to move conversations ahead! This unfortunate possibility is higher when there is so much respect between participants that they are afraid to disagree. When Jeff began his first essay with such kind words about my own writing on healthcare and about my former employer, Texas Tech University, I started to worry that we would not have sufficient scope for difference. I do appreciate Jeff’s kind words, but even more I appreciate his deep engagement with the conundrums of the American healthcare system. Fortunately, I discovered key differences that I hope will move the conversation productively.

Healthcare in America: Principles and Problems

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First, I would like to thank Dr. Cochran for his excellent and edifying essay, “Healthcare in America: Diagnosis. Cure?”  There are many commendable observations and suggestions found in it.  I’m particularly struck by Dr. Cochran’s generous and conciliatory tone.  Throughout his essay, Dr. Cochran maintains a posture of what I will call firm civility.  At no time does he compromise his hard won and long considered positions, yet, he makes his case in a respectful and moderate tone.  In what is best about religiously-based discourse, Dr. Cochran writes with a genuine Christian meekness, and that is much appreciated. 

 

My plan in this initial follow-up essay is to do two things: I will discuss two of Dr. Cochran’s “fundamental Christian social principles”.  I will then discuss one practical problem with America’s healthcare system and a couple of ways that problem may be dealt with.

 

Healthcare in America: A Thorny Knot

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I am working with the famous aphorism attributed to Karl Barth – I have my Bible in one hand and a newspaper in the other.  I try, however imperfectly, to make the Word of God the rule for my life in all things.  As I read it, I find precious little guidance as to how a government should structure the services it provides to its citizens.  In particular, I find nothing, either approving or disapproving, large-scale, top-down provision of health care services to a polity.

            A.  I find a strong injunction in the New Testament to give myself for the benefit of my fellow suffering human being, who Jesus likened to himself in Matthew chapter 25.  I am to visit the prisoner, feed the hungry, and yes, care for the sick.  Indeed, what’s sobering about this little parable in Matthew 25 is that Jesus seems to say that the Christ follower’s salvation depends on how conscientiously he attends to the physical needs of others.  This parable is a biblical personification of the little ditty “if it is to be, it is up to me.”  If the sick are to be cared for, it is up to me. It’s not another’s responsibility.  It’s my responsibility.  If I am to demonstrate my faith in Jesus, well, I really have to do it and get out there find some sick people to minister to.  I don’t mean that I can curry God’s favor by doing good deeds.  What I do mean is that I show Christ himself and the world that I am truly his disciple if I get down to peoples’ suffering where they are.

Healthcare in America: Diagnosis. Cure?

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An overly ambitious title? Ridiculously hopeful? Yes. Of course. We’re talking about healthcare after all – a subject almost as contentious as race or immigration. And twice as complicated. We’re considering a system that accounts for 20% of the entire economy and that touches every person. It is both highly technical and deeply personal. A mix of government (at all levels), of private, for-profit institutions, and of not-for-profit, often faith-based organizations.

There’s little disagreement that healthcare in the United States is broken; yet also little understanding of how and why. And no consensus on a fix or fixes.

Current Topic (#9): Healthcare in America (May 2018)

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Leading Questions: Is healthcare a public good that everyone has a “right” to (and therefore government has a role to play in securing that “right” for everyone) or is healthcare a private good; a “privilege” that is primarily the responsibility of each individual with minimal governmental assistance? What are the problems with the healthcare system […]

A Hopeful Appeal

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In the contentious political environment that we currently occupy, it is too easy to retreat from political disagreement and instead seek the security of agreement or avoidance. It is a rare pleasure, therefore, in contrast, to be able to discuss economic inequalities in this forum. In her second contribution, Dr. Johnson raises a collection of important arguments, and has identified some areas where we see things differently. Her depth of reflection about the way theology can inform public life has challenged me to think very carefully about things that I care deeply about. This is a great gift. In this final contribution I will reflect on these areas, returning to some of the themes of my original post, and then finish by thinking about what I have learned from our dialogue. Broadly, I would encourage Christians to think hard and long about economic inequalities, and the injustice that they can point to. Because some Christians inhabit a powerful cultural and economic position in the world, it is important for us to study and highlight the dimensions of our tradition that push us to fight these injustices, reconcile with our neighbors, and live into our calling. I will try to share some of my hope and optimism that even if we see significant setbacks, real progress is possible.

Does Theology Have Legs, and If So, What Ground Do They Stand On?

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My intellectual hero, Peter Maurin, once wrote about what happened when he went to a university looking for advice on his project to animate the economic order in line with Christian tradition:

A few years ago,
I asked a college professor
to give me
the formulation
of those universal concepts
embodied
in the universal message
of universal universities
that will enable
the common man
to create
a universal economy.
And I was told
by the college professor:
“That is not my subject.” 

How do we Seek Economic Justice?

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The careful reflection that Kelly Johnson provided last week is a great starting point, and I am looking forward to seeing what she writes as the month goes by. While this conversation is designed to create a space for long, careful, and respectful disagreement, it is worth noting from the outset that I found her initial contribution to be illuminating, and there is very little in it that I disagree with.  I agree that economic inequality is a first order moral problem, that Christians are called to care deeply about the material well-being of their neighbors, and that inadequate regard for economic disparities is deeply woven into our culture (and apparently, we both find compelling the doctrine of the universal destination of goods). Hopefully this common ground will set the stage for a fruitful dialogue.

The Stories We Tell

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First , I want to offer my appreciation for Dr. McMullen’s post, which avoids ideological home bases in favor of practical and serious work to promote human well-being. I know, because I faced it, what a challenge it is to respond to these questions, and I applaud both the clarity and attention to complexity that he captured.

A key area on which we agree is that questions of poverty and wealth are questions of moral import, political questions in the sense that they require discernment by a community about what is good. The economy is not just a procedure, a quasi-mechanical system; it serves an end. Economic interests do not necessarily create good results, if left to themselves, and some very important goods, particularly public goods, need to be fostered by means other than the market. Such goods are beneficial in ways that have to do both with a good business climate and also with humanity. In short, I found much in Dr. McMullen’s vision thoughtful and clearly driven by moral concerns as well as scholarship.