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Friday, April 27, 2012

Health Care - Another Point of View

My last two posts have been about the contradictory world views that impact our position on healthcare in general and on specific problems with the plan passed under cover of night in December 2010. I'll be the first to admit that a lot of it is tedious and depressing, but sometimes reality is just that. I'll summarize part of Dr. Gray's solution here, and put in my own two cents worth in the second part of this post.
Thankfully, there is a better way forward. Dr. Gray has written a paper entitled "Cutting the Gordian Knot" and I highly recommend you check it out at his website, www.CLGrayMD.com He describes five guiding principles that he thinks provide a way forward. They are: 1- craft a series of reforms, each addressing one clearly identified problem with the current system 2 - pass each reform separately. Don't try to change everything at once or you'll never know what really worked 3 - write understandable bills of a reasonable length whose proposals can be clearly communicated 4 - Keep each bill 'clean' and free of any payoffs, pork or other attachments 5 - make the final language public for 7 days before voting to allow for public viewing
Dr. Gray has listed 17 reforms on his website that he believes are essential. The one reform he mentioned Tuesday night was transforming Medicaid to a system of block grants to the states. He believes this one reform alone could save as much as $300 billion.
I believe that the current system we have of 'third party payors' through insurance of any kind contributes significantly to the problem. My own doctor can't tell me what a specific test will cost, for example, because it varies depending on what insurance company I use. If I choose not to use insurance, the price is higher. I can't think of any other area of commerce where using cash is actually the most expensive option, can you? Different insurance companies also cover different medications based on contracts with manufacturers rather than on patient need.
In addition, paying a flat rate for medical care leads to the "all you can eat buffet mentality." If someone is paying a flat rate whether they use a service or not, the human tendency is to get as much out of it as you can. Making the real cost of medical care inaccessible to the patient keeps all of us from recognizing its true value.
Medical Savings Accounts and limited insurance for catastrophic medical needs could go a long way toward curbing the abuse of the healthcare system. The price for services would likely come down for basic care, allowing greater access.
I believe we have a moral obligation to care for those in genuine need. Does that mean I am morally obligated to pay for an emergency room visit (the most expensive method of healthcare delivery) to treat an addict's non-life threatening healthcare needs? What if it is because the addict chose to rely on taxpayer funded healthcare that costs him or her nothing no matter where they go for treatment? I know this sounds harsh, but where does a civilized society draw the line?
A personal example: I have diabetes. This means I have to be more careful about what I eat, and my health in general, than someone without diabetes. Should I have the right to demand that you pay for my expensive medical needs if I decide not to take care of myself? If I develop heart disease because I decide eating candy is more important than maintaining healthy blood sugar levels, is it fair of me to send you the bill?
"Personal responsibility" is an awkward topic to bring up in a healthcare debate, because we all know that it is hard to draw a concrete line between personal habits and lousy genes or environment when our health fails. Some people who live extremely healthy lifestyles still get very ill, and some people live long healthy lives with terrible habits. But at some point we need to acknowledge that life just isn't always fair.
As individuals, we can come alongside those in genuine need, and make these difficult decisions on an individual basis. There is no way that a large government program can evaluate the difference between medical need and a lack of personal accountability.

Inside ObamaCare

This information comes from Dr. C.L. Gray, who has been speaking out on how world views find their expression in public policy since 1999. He has studied the Patient Protection and Affordable Care Act of 2010 (AKA ObamaCare) in more detail than most of us could handle. The following facts come from his recent lecture in Newark, Delaware.
Before I relate specific issues with the bill itself, refer to my last post describing the Complete Lives System published by a member of the White House panel that drafted this legislation. The paper was written in 2009, when our national debt was "only" $10.6 trillion. It is now $15.7 trillion, and interest alone adds up to $640 billion more per year. We hear on the news about the terrible impact of debt on our European allies, but did you know that US debt exceeds the debt owed by the entire Eurozone and UK combined? Americans owe more per capita as well.
These facts necessarily impact the amount of federal funding available for healthcare. In 2010, the federal government spent $524 billion on Medicare for the elderly and $427 billion on Medicaid for the poor. This explains why the PPAFA cuts $500 billion from Medicare over the next 10 years; there just isn't enough money available to meet the need.
The bill itself is over 2,000 pages long, but the regulations written so far to implement it exceed 10,000 pages. The bill grants authority to the Secretary of Health and Human Services to determine "appropriate" costs and levels of care, and whether the quality of care meets required limits for expenditures per patient. Dr. Gray showed us just two pages from Section 3007 of the bill. He highlighted 21 times in just those two pages where power was transferred from the physician providing the care to the HHS bureaucracy. In other words, the fact that your physician believes a particular course of treatment is in your best interest is no longer a valid reason for you to receive the treatment. Federal bureaucrats will make those decisions instead.
Section 3404 of the bill is just as disturbing. That is the section that implements the Independent Payment Advisory Board, or IPAB. This 15 member panel is to be appointed by the President. They are not accountable to the voters in any way, and the members of this panel will have sole discretion to "reduce the per capita rate of growth in Medicare spending."
In a truly hypocritical political maneuver, the recommendations of this IPAB automatically become law unless the Senate votes TWICE to reject their specific policies. This means your US Senator can vote against the board once to claim your support, while ignoring the second vote and allowing the recommendations to become law.
Doctors themselves have woken up to how destructive this plan will be. According to a recent study, 43% of doctors may retire in the next five years, and 9 out of 10 would not recommend healthcare as a profession. The American Medical Association may have heartily endorsed the PPACA, but that group only represents 14-15% of physicians in this country, and most of those are in academics, not patient care.
The health care system in this country has problems, no doubt. As someone with a chronic illness who is dependent on medications and durable medical equipment to get through the day I know that better than most. But the current plan proposes a cure that is far worse than the disease. Knowledge is power, so arm yourself with the facts and join this important national conversation. Next post - another way forward....

Medical Ethics in a Post Modern World

Dr. C. L. Gray, founder of Physicians for Reform and author of the recently published The Battle for America's Soul - Healthcare, The Culture War, and the Future of Freedom spoke at length Tuesday night in Newark. It was an eye-opening and disturbing overview of the current debate on health care in America and the historical trends that brought us to this point. He opened by defining post modern reasoning as the loss of "fixed truth" and the belief that truth exists only as the individual (or state) defines it. He then related this to government policy by reminding us of the Barbara Wagner case in Oregon, which many pro-lifers in the audience remembered all too well. Ms Wagner had cancer, and the state of Oregon refused to pay for her treatment under the state insurance plan but instead offered to pay for her physician assisted suicide. According to the state of Oregon, her life was not valuable enough to warrant medical care and therefore she should benefit the state by dying sooner than later.
Remember Ms. Wagner the next time someone tells you how noble it is for the government to provide medical care out of compassion. Whoever pays for that care has the power to choose what care is given, and in times of increasing financial insecurity, the state's goal is to maintain itself, not individual citizens.
The attitude that the welfare of the state takes priority is not new. As far back as Ancient Greece there were those who promoted the idea that the seriously ill should be allowed, or even encouraged, to die. Judeo-Christian ethics completely contradict this relative truth by asserting the unique value of each individual human life. These two world views stand in direct conflict, and no where is this more apparent than in modern medical practice. Which physician would you rather go to, one who has accepted the post-modern view that all truth is relative and the state has the right to define which citizens are worthy of protection, or one who values every human life and treats his patients accordingly?
Peter Singer is a leader in the modern movement to quantify the value of human life. His views include the idea that babies should not automatically have the right to life until they are 28 days old. He believes that infanticide is not only justifiable but preferable if the parents don't think their child will have a 'good enough' quality of life. As horrific and evil as this sounds, his ideas have been well received and he has been awarded many honors and influential positions in the academic world.
Mr. Singer is not some fringe character. In 2009, the NIH Director of Bioethics actually published a paper on something he called the "Complete Lives System." According to this system, when the government is facing financial problems, there needs to be a way to decide who gets the limited medical funding. His solution was a priority curve that only treats 15-40 year because they are of most value to the state. According to this view, younger people are not as valuable because not as much has been invested in their education and welfare, while older people have fewer useful years left and so do not warrant the investment of resources. This director, Ezekiel Emmanuel, was appointed to the White House Health Care Advisory Panel, and helped write the current health care bill now being considered by the US Supreme Court.
Francis Schaeffer once wrote that over time, ideas that were once unthinkable become thinkable, and ideas that have become thinkable eventually become acceptable. If you believe human life has value, that it is a gift from our Creator and not simply meant to serve the state, the ideas described above should be unthinkable. If we don't take a stand now, it will soon be too late, and we will leave as our legacy a world where relative truth is acceptable.

Monday, April 23, 2012

Faith and Freedom, Part 2

Saturday was too good to cram it all into one post, so here is a bit more... The event was hosted by the Faith and Freedom Coalition of Delaware, and the President of that group, John Radell, worked tirelessly to make it happen. He started the morning by reminding us of our common beliefs. He cited Psalm 33 and stated that we were gathered together because of our common faith in one God whose son died for our sins and our love for our nation. After all of the pastors and Dr. Gray spoke, the event turned more towards applied politics than principles. Gary Marks from the national Faith and Freedom Coalition spoke about that group's plans for reaching evangelical voters in the upcoming elections. He laid out their strategy for getting the message out that Christians need to not only vote in greater numbers, but consider their values and core beliefs as they do so. He delivered a rapid-fire dose of statistics, only a few of which I was able to record. Some interesting numbers to consider: In 2008, 17 million evangelical voters didn't bother to cast a vote, yet they still accounted for 23% of the total votes. That number rose to 32% of the voters in 2010, and FFC is working hard to increase that number even more in 2012. Social conservatives don't necessarily vote on social issues: in 2010, 43$ of these voters said the economy was the number one issue, and only 15% cited 'Obamacare' as their biggest concern. Many people will disagree with me on this, but I believe that honoring the God-given gift of life trumps all other issues. It is the first test of a candidate for me, and always will be. After the event, I spoke to Dr. Bryant and asked him what he found to be the most effective arguments to use in speaking to Christians who support the current administration. He suggested I ask them if they support abortion rights or gay marriage. If they answer no to both, then they can't stay true to their own convictions by supporting a candidate who does. The Affordable Care Act will require all of us to pay for abortion-inducing drugs, so any vote for a supporter of President Obama's health care plan is a vote for federally mandated abortion funding. That is a simple fact that no amount of political spin can alter. Newt Gingrich was the final speaker of the day. He used the opportunity to remind us of our history as a nation of faith and condemned the "gradually increasing anti-Christian bigotry" of our government. He pointed out the difference between our current leaders and President Lincoln, citing the 14 references to God that Lincoln made in his second inaugural address. I also gained a new perspective on Jamestown, the early settlement that I always thought of as a strictly commercial enterprise. I was surprised to learn that the very first act of the settlement founders was to erect a cross, and that they held church services 14 times a week. Good luck finding that information in a history textbook! God has blessed this nation abundantly, but in many ways we have turned away from Him and rejected His commands. There is no hope of restoring our nation's honor until God's people are willing to take a stand for the truth. I pray that you will join me in speaking out for the truth with a clear courageous voice!

Faith and Freedom 4.21.12

Prayers for America filled the hall at the Chase River Front in Wilmington on Saturday. Hundreds of Christians gathered to hear local and national pastors speak on how we can "engage and transform our culture", in the words of one of the speakers. That same speaker, Pastor Chris Rue, reminded us that the early churches were named not for their unique doctrines, but for the cities where they were located, the world in which they were placed to be examples of order and discipleship. Pastor John Betts cited several statistics that demonstrate how a spirit of abandonment and insecurity has gripped our nation in recent years as God has been removed from the public square. Government can never fill that void, and he encouraged us to bring restoration through the revealed truth of our position in Christ. Pastor Bill Schloneker reminded us that not only do we have a voice, but we are called to use it. He exhorted us to speak with courage and clarity, to call for caution as a warning against irresponsible government policies, and most of all to speak with compassion and consecrate all of our words by bathing them in prayer. Dr. C. L. Gray described the historical world views that define the opposing sides of our current health care debates. Starting with Hippocrates and Plato, he succinctly stated the clear conflict between valuing individual well-being vs the 'collective good.' He implored us to consider the impact of our biblical worldview on politics and health care. Fr. Tom Flowers showed us a video produced by the Catholic church that powerfully asked the question, "will you vote the values that will stand the test of fire?" He reminded us that there is no secret ballot to God and that the virtue of our elected leaders reflects on us as well. Pastor C. L. Bryant exhorted us to protect the endowment God has given us in this nation, including the rights to life, liberty and the pursuit of happiness. He spoke against the lies being promoted in our culture, including the idea that simply being poor or oppressed necessarily means one is more virtuous. His stand against black liberation theology comes from his own experience as the President of the Texas NAACP. He left that position when he became convinced that theology contradicted God's Word, and he has paid a heavy price for his conviction. Pastor Bryant believes we have been in a defensive posture too long, that we must now stand and be ready for this fight. There were two statistics that brought me to tears on Saturday. The first was that for the first time in American history, over 50% of 8-17 year olds have never been inside of a church. The second was worse; last year more black children in New York City were aborted than were born. As a people we have always banded together to resist an enemy from without, but now we face enemies from within, even within our own government. Will we stand together still?

Thursday, April 19, 2012

Do Not Grow Weary

"Let us not become weary in doing good, for at the proper time we will reap a harvest if we do not give up." Galatians 6:9

Once again its been too long since my last post here. I've been distracted by things going on around me, and allowed it to drain my energy. The Lord woke me this morning with a reminder of these words from Galatians, and I thought I was getting the point, that I'm not supposed to give up.

Then a dear young man called me, someone who is pouring out his very life to serve others in circumstances more difficult than most of us can imagine. Yet he spoke of knowing that his value and worth comes from God, and not from the things he does. I was ashamed to realize how small and insignificant are the things I do to try and earn God's acceptance. I needed the reminder that those small things do matter, and will have eternal consequences, but they don't change God's love for me one bit.

Experiencing His abiding love fills me with joy, and that joy in turn gives me strength. God has a purpose for each of our lives, and gives all we need to accomplish His will. I can avoid the despair of weariness by reminding myself of His great love. I can do good by sharing that love with those around me. And I can choose not to grow weary in doing that good thing.

Monday, April 2, 2012

Personal Responsibility

I just read an article this morning about the upcoming elections in France and the economic issues that nation faces [http://www.economist.com/node/21551461] As I was reading it made me realize that our situation here in the U.S. is not all that different. We may not be making the exact same choices as our European friends, but some of the underlying attitudes seem frighteningly similar.

There seems to be an assumption that the government is responsible for meeting all of the citizens' needs. Successful members of the society are condemned rather than admired for their hard work, and personal initiative isn't valued. Our country was once known for it's work ethic and self-reliance, but we seem to no longer honor those traits.

I believe that a people who recognize their accountability to their Creator are more likely to value personal responsibility. If you believe that you will answer to God for how you've lived your life, it makes a difference. Your decisions will be based on something greater than your own convenience.

A government, no matter how compassionate, can never be the ultimate source of our comfort. An attitude of worship for our Creator can't be legislated or mandated. Each individual must choose whom they will serve- the God of all creation,or the man-made constructs of a socialist or progressive state. It is a matter of personal responsibility, and every citizen must settle that issue in their own minds.

This is why I pray for our country. I don't pray for the government to be better [though that would be nice] I pray for the hearts of the people to turn to God, for them to recognize their responsibility to him, and his great love for each of us.