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CNN carried an interesting article recently about Obama’s efforts to reach out to communities of faith in the health care debate. The president is framing the discussion in explicitly religious terms, criticizing those who are “bearing false witness” against both the specifics of the plan and against those who advocate it. Particularly moving was this remark:
These are all fabrications that have been put out there in order to discourage people from meeting what I consider to be a core ethical and moral obligation: that is, that we look out for one another; that is, I am my brother’s keeper, I am my sister’s keeper. And in the wealthiest nation in the world right now we are neglecting to live up to that call.
Obama has often spoken in the past of the importance of the biblical idea of caring for “the least of these”. The paragraph above echoes this sentiment; but unfortunately, Obama also advocates one aspect of the plan that goes startlingly against this ethos. Seeking to reassure dissenters about the acceptability of the proposal, the president has also stressed that the plan will not provide health care to undocumented Americans.
Despite the fact that most so-called “illegal aliens” do in fact pay taxes, the mainstream political discourse in this country (including Obama, unfortunately) seems united, regardless of party, around the importance of excluding this group from health reform. Tragically, undocumented workers are among the most vulnerable in the present system, because of their fragile political status and the legal complexity of navigating American medical insurance. In the fullest sense, “illegal” immigrants are the least of these, those whom we as Christians are called to serve and to be in solidarity with. What we do to them, we do to Christ himself (Matthew 25.40).
Thus, Obama’s public exclusion of the least among us from his health care reform is a manifest failure, a compromise that is unnecessary and saddening. His attitude in this regard goes against an aspect of his faith that he has himself emphasized. Let us hope that he will awake to the puzzling inconsistencey of his words. And let us hope that as the much-needed reform bill continues to advance through Congress, there will be some at least who seek to broaden its scope to truly provide health care for all.
A young woman, only 17 years old, is sick — dying, in fact. She has already survived cancer, but her liver has been damaged. She needs a transplant. All the doctors agree on the procedure. They sign the necessary forms, and the family is given hope for their daughter’s life. But liver transplants are expensive — and the after-care for them costs more money still. The family’s medical insurance company doesn’t want to lose money. So the corporation delays approval again and again for payment for the necessary procedure, in order that the girl will die and after-care costs will be avoided.
The girl dies. Unnecessarily, disgustingly, criminally. She dies. Because the almighty dollar wins in the end.
This seems overly dramatic, too terrible to be true. But it’s real; it actually happened. The girl’s name was Natalie Sarkisyan, and the insurance company was Cigna HealthCare. This is just one example among many that demonstrates an ultimately irrefutable fact: the American health care system is exploitative and often deadly.
Indeed, health care in America has become a form of structural violence. Like racism, sexism, and other forms of systemic oppression, US medical insurance exploits one group (the patients) for the benefit of another (the corporations). All too often, monetary gain is valued far above the lives and livelihoods of the “insured”. This should be unsurprising: it is to be expected that a system based on the principles of greed (capitalism) would fare rather badly at protecting the helpless and defending the weak.
Christians should be especially alarmed by this, for we serve a Lord who stood precisely alongside the downtrodden (Luke 4.17-18), denounced greed and the excesses of material gain (Mark 10.17-31), and stood against all violence (Matthew 5.38-48). The exploitative, violent system of American health care has in many instances come to embody all that Jesus Christ himself combated. It has become a facet of what Walter Wink calls the “domination system”, a system that in the Resurrection is exposed as being ultimately powerless, even if still fearsome.
We as Christians must hold fast to hope. We must remember the words of Jesus in John 16.33: “I have said these things to you, that in me you may have peace. In the world you will have tribulation. But take heart; I have overcome the world” [esv]. The Powers of the world do indeed create much tribulation, tribulation which we see in cases such as that of Natalie Sarkisyan. But Jesus Christ has overcome those structures of oppression and evil, demonstrating in his Resurrection the final futility of their attempts to create death and destruction.
As William Stringfellow once wrote, “The essential and consistent task of Christians is to expose the transience of death’s power in the world.” Health care in America has become a system of death; but as a community that attests to the reality of Resurrection in we world, we must continue to expose the transience of that system.
Theses on the American Church and the health-care crisis.
- The current system of health care in America is broken. It is driven by profit, not by people; our application of greed-based capitalistic principles to this basic human need has succeeded only in creating structures that place the financial gain of insurers above the medical needs of patients. This is, undoubtedly, a great evil.
- The Jesus of the canonical gospels emphasized both ministry to and solidarity with the downtrodden, the marginalized, and the poor.
- Those among whom Jesus walked included the sick, and indeed in Luke 4:18-19, where the social implications of Jesus’ message become clear, the giving of sight to the blind is listed side-by-side with the preaching of good news to the poor and with the liberation of the oppressed.
- In America today, the health-care crisis has marginalized many, struck others into poverty, and taken its worst toll upon those who are already among the “least of these”. These are precisely the people with whom Jesus expressed solidarity. We too, as the Church in America, must take their side.
- Thus, the American Church must unite around the cause of providing adequate health care for all according to their need.
- Christians of good intent will undoubtedly disagree about how best this necessary goal is to be accomplished. Not all will favor any specific proposal, nor will all be able in good conscience to unite around any specific plan.
- Thus, in navigating the complexity of this crisis, we must maintain humility while remaining resolute in pursuing justice, mercy, and equity in medical care.
The Spirit of the Lord is upon me,
because he has anointed me to proclaim good news to the poor.
He has sent me to proclaim release to the captives,
and recovery of sight to the blind,
to let the oppressed go free,
to proclaim the year of the Lord’s favor.
[Luke 4.18-19 nrsv]


