The Worth of a Person, Part 1

Originally preached at Mt. Level Missionary Baptist Church, Durham, NC, February 24, 2013

Ephesians 1:3-14

Just this week the news reported that North Carolina now has the harshest policy for helping the unemployed.  A couple hundred dollars a week for twelve weeks is all that the state is willing to do to help hardworking people hold on while they try to find a job.  Cutting back on money that would all flow directly back into the economy makes little sense.  And as you have heard me say before, penalizing people who lost their jobs because of the immoral, criminal acts of others who destroyed the economy goes against any notions of justice.  It raises a question in our minds about how people value the lives of other people.

What if a stranger were to approach you in this room of people and point out someone, then ask you, “How much does he cost?” or “What is his price?”  Certainly it is not a question you are used to hearing.  After the initial shock, it would probably be an offensive question.  Buying and selling Africans and their descendents remains close at hand in cultural memory in this land.

       Moreover, it seems to our sensibilities a misguided question, a question that transgresses our categories of reasoning.  We are well-schooled in markets and commerce, but not everything is appropriate to a market.  For us, talking about costs or prices is a category mistake when assigned to people.

       On the other hand, if we take the question out of this hypothetical situation and ask it differently, if we change the context around, if we do some critical analysis of events in our world, we might uncover ways in which this kind of question is being asked every day.

       For instance, the debate about making sure everyone has access to good health care is one way of asking what is the worth of a person.  Both of the major political parties are unwilling to support the most efficient way to provide health care, a single-payer plan for universal health care, because they know that funding it would entail changing how we put money into the health care system.  Instead of paying premiums to private companies, the money would flow through a single system by means of taxes. 

Ooooh, that dirty word taxes gets people all stirred up.  When someone starts talking about taxes these days, people start feeling like they are getting their pockets picked.  Don’t bother to explain that most be able to save money by using a single-payer system rather than making their own private payments to for-profit insurance companies or so-called non-profit companies knee-deep in cash that looks to anyone else like big profits.  Somehow the idea of taxes to make sure that no one goes without health care gets people upset.  Apparently, many people think that a whole lot of sick people out here just aren’t worth the money it would take for them to see a doctor or get medication.  

I recognize that many people in Durham, and here in Mt. Level, work in the medical profession.  I am not trying to make you out to be the devils in this story.  What I am talking about are vast structures, powerful systems that enfold patients and medical professionals both.  Strong and powerful interests and lobbies are more concerned about controlling the clinics and machinery of health care than making sure there is justice in how these resources get used.  Controlling the scanners and beds is worth more to them than the people whom those assets can help.  So the perspective of both political parties and the rich donors to whom they listen seems to be that a person is not worth the taxes it would take to provide universal health care.

       Any of you who have been through a difficult illness and watched the bills come in would know that health care currently calls for no small amount of money.   After my beloved Everly spent over a month in the hospital last year, we started seeing stacks of bills from hospitals, clinics, doctors, and labs, and quite a few of them ran as high as five figures before the decimal point.  In the face of winning or losing the battle for Everly’s life, I think you understand that all of those bills together don’t even approach the value of her life.  On the other hand, if we did not have the insurance we have, one or more of those bills might have brought our finances to ruin.  Thanks to God’s provision, I don’t have to stand here and beg for help.  We’ve managed to keep up with our bills because we are blessed with jobs that have insurance coverage.  For the millions of other people without health insurance now, an operation or a hospital stay may be all it takes for them to go broke, to lose their homes, or to fall into endless debt.  They may rightly conclude that their lives, their futures, have been sold out from under them. 

       A news story stirred in my guts late last summer and pushed me toward asking today’s question, “What is a person worth?”.  It is a story out of South Africa.  It’s a complicated story about the economic unrest in a land where masses are unemployed and the gap between rich and poor is vast.  But it is also a story that echoes back to the harsh days of apartheid when mineworkers were fuel and fodder for a violent, industrial machine.  At the largest platinum mine in the world, workers began to strike for better pay.  They make between $450 and $650 a month, which is a wage many other unemployed workers would love to have.  You and I know it would be a struggle to live on that amount.  A new, independent union is asking for $1200 a month.  It’s a big raise they want.  None of us would be surprised that the management does not want to give the raise.  As the stakes began to rise, people on all sides of the disagreement began to escalate.  Management threatened mass firings.  Workers threatened larger and longer strikes.  No doubt some people on either side showed some poor judgment and provocative behavior.  But what happened last summer harkened back to the struggles of organized laborers in South Africa under apartheid, of auto workers demanding better conditions and wages Detroit, of millworkers trying to gain recognition and justice in Gastonia, and people standing up for their worth in so many places.  Armed police were ready for action.  The conflict heated up.  And in a few moments, 34 more mineworkers lay dead.  During a week of unrest and violence some police had also lost their lives. 

Why were people dying?  The mining company was falling behind the goals their management had set for production.  Every day they did not run their mines at full capacity, they lost profits for their shareholders.  Police, also paid a worker’s wage, were brought in to risk their lives for the company’s production goals, and in the process the mineworkers’ lives were also put at risk.  Police and miners died for the sake of trying to get the mines back up to production.  Mining production was traded for the lives of forty-plus miners and police officers.  Killing workers seems thrifty when for every job there are hundreds more applicants who would work for less.  The struggle for jobs in South Africa is so great that competing unions get pitted against one another in these mining struggles, leading to misdirected violence between groups of the disenfranchised.  Death on the front lines of union organizing is not so remote in US history, either.  Is South Africa’s tragedy reminding us of the path that the current world economy is taking us down?  Will US employers soon be willing to trade the lives of their workers for profits in the same way?

In Mississippi, at the same time that these events were unfolding in South Africa, autoworkers at the Nissan plant were laying the groundwork to start a union.  Management threatened to close the plant if they unionize.  Although the same Nissan company operates with union contracts in many of its plants in other countries, they tell their employees in Mississippi that their lives are worth just so much.  If it means the hard work of their Mississippi workers would cost them a few cents more, then they would rather shut down their plant and stop making all those cars and all that money.  They would rather go find other desperate and beaten down people who won’t cost them so much, who aren’t worth much.  With automobile companies raking in the profits, an experienced, loyal worker is still not worth enough to have the company sit down at the table and arrive at an agreement fair to all parties. 

The Mississippi and South Africa stories remind me of a pair of texts in Isaiah.  Chapter 58 echoes chapter 1.  The prophet proclaims that God is not happy with the show he is seeing, a showiness of piety and outward worship.  The wealthy, who are putting on the show, are complaining that they have fasted but God did not give them what they wanted.  Isaiah speaks in the words of these unfaithful oppressors when he says, “Why do we fast, but you do not see? Why humble ourselves, but you do not notice?”  Then he gives them God's reply,

Look, you serve your own interest on your fast day,
and oppress all your workers.
Look, you fast only to quarrel and to fight
and to strike with a wicked fist.
Such fasting as you do today
will not make your voice heard on high.

            Oppressing workers, treating them violently—this was how the wealthy employers of Isaiah’s day were behaving. But we remember also from the first chapter of Isaiah that God offered a path to resolution of their sins for these people abusing their brothers and sisters. The KJV says, “Come, let us reason together.” The NRSV puts it more bluntly, “Come, let’s argue it out.” Sitting at the table, working out a path of mutual interest is what God would have us do. A solution to oppression is one that will be mutually agreeable to all parties and in accordance with the justice of God. Without it, all the dancing and shouting and fasting and praising turns out to be bad acting that makes God sick and angry with looking at us. God made us all, every one of us, because of love. God loves every person. God counts each one of us as good, as valuable, as worth being heard, being cared for, and being able to share in the bounty of this world. Reasoning that through in a way to be fair to everyone is what God expects. A person is worth that kind of effort.

"The Worth of a Person" is continued in Part 2, the next post.

 

Even if You Have Employer-Subsidized Health Insurance, You Don't Really

At the excellent "think-tank" blog on economics and finance, The Baseline Scenario, James Kwak has posted an article on health insurance that draws back the curtains, blows away the fog, and shatters the mirrors of illusion. The "in-your-face" title is "You Do Not Have Health Insurance." He says that unless you are over 65 in the U. S., the word "insurance" does not really apply. I'll quote the first section to spell out the heart of his argument, which will knock you over.

Right now, it appears that the biggest barrier to health care reform is people who think that it will hurt them. According to a New York Times poll, “69 percent of respondents in the poll said they were concerned that the quality of their own care would decline if the government created a program that covers everyone.” Since most Americans currently have health insurance, they see reform as a poverty program – something that helps poor people and hurts them. If that’s what you think, then this post is for you.

You do not have health insurance. Let me repeat that. You do not have health insurance. (Unless you are over 65, in which case you do have health insurance. I’ll come back to that later.)

The point of insurance is to protect you against unlikely but damaging events. You are generally happy to pay premiums in all the years that nothing goes wrong (your house doesn’t burn down), because in exchange your insurer promises to be there in the one year that things do go wrong (your house burns down). That’s why, when shopping for insurance, you are supposed to look for a company that is financially sound – so they will be there when you need them.

If, like most people, your health coverage is through your employer or your spouse’s employer, that is not what you have. At some point in the future, you will get sick and need expensive health care. What are some of the things that could happen between now and then?

Your company could drop its health plan. According to the U.S. Census Bureau (see Table HIA-1), the percentage of the population covered by employer-based health insurance has fallen every year since 2000, from 64.2% to 59.3%.

You could lose your job. I don’t think I need to tell anyone what the unemployment rate is these days.

You could voluntarily leave your job, for example because you have to move to take care of an elderly relative.

You could get divorced from the spouse you depend on for health coverage.

For all of these reasons, you can’t count on your health insurer being there when you need it. That’s not insurance; that’s employer-subsidized health care for the duration of your employment.

Once you lose your employer-based coverage, for whatever reason, you’re in the individual market, where, you may be surprised to find, you have no right to affordable health insurance. An insurer can refuse to insure you or can charge you a premium you can’t afford because of your medical history. That’s the way a free market works: an insurer would be crazy to charge you less than the expected cost of your medical care (unless they can make it up on their healthy customers, which they can’t in the individual market).

In honor of the financial crisis, let’s also point out that all of these risks are correlated: being sick increases your chances of losing your job (and, probably, getting divorced); losing your job reduces your ability to afford health insurance.

There is more in the article, explaining some further dangers about companies rescinding policies, denying claims, not covering various critical procedures, and COBRA that help us realize how precarious our health coverage is. As he points out, unless your job is insured (there is no way you can lose your job or go out of business), your access to health care is not insured.

We need this reform. Make it plain to your Congressional Representatives.

Making the Message Plain on Health Care

Here is a short video made for TV that makes the key point about why the public option is so critical. A single-payer system would be even better, but a public option will address the key problem of uninsured people and rising costs by creating a different playing field for selling health insurance plans.

Asking for Too Little on Health Reform

I have been a fan of the single-payer approach to funding health care since the 80s. When the possibilities for reform in the 90s went corporate, then crashed, I was disappointed. Ever since, what has happened is the consolidation of Big Health and more and more interference with our health care decisions.

I have had to change primary physicians three times since the mid-1990s, even though I have stayed on the same health insurance plan. I am having all kinds of trouble getting my daughter an appointment with a doctor of her choice now that she has grown out of her pediatrics practice. The current system does not allow us to choose our own doctors. Bureaucrats in corporate offices tell us who to see.

My primary care physician changed practices last year, and my wife's primary care physician followed him a few months later because the big behemoth health provider in our town was giving them too many regulations and rules on how to practice and to whom they could make referrals. Now their new practice has joined a "health management" firm, and I can already feel the regimentation squeezing me when I go for an appointment.

When the Presidential campaigns were promoting health care reform, which everyone knows we need, the head honcho of my insurance provider started funding a media disinformation campaign to make sure that his high-profit non-profit could prevent competition that might bring down our costs. This disinformation is now widespread, and Big Health is winning the battle.

An article by Jeff Cohen at truthout got me thinking. I was campaigning for the "public option" as a form of competition to reduce health care funding and improve services. Yet I keep hearing people say, "I believe in the single-payer plan, but since that is not going to pass . . . ." Well maybe it is not going to pass, but it is the best solution. Why not ask for the best, and see how close to it the policy debate will move? To provide for more people, to reduce overhead and paperwork, to end profiteering by excluding the sick, to stop proliferation of unnecessary procedures, to make sure no one loses access to health care, we need a single-payer system. As my friend Steve Bumgardner keeps telling me, the Medicare system works and is already in place. As Cohen says, "Medicare for All" is the solution. Tell your Congressional Representatives to support HR 676, the Expanded Medicare for All Act.