A bipartisan prescription for health care

This is an Atlantic article from nearly eight years ago in which columnist Matthew Miller got Rep. Jim McDermott, long the Democratic standard-bearer for socialized medicine, and Rep. Jim McCrery, one of his conservative Republican counterparts on the House Ways and Means Committee, together to talk about how to fix the health care system; much to everyone’s surprise, they ended by thrashing out a rough approach to doing exactly that. Unfortunately, while there was real hope in the room that conditions were right to address this problem, circumstances (chiefly, I expect, the disputed end to the 2000 election, followed by 9/11) intervened to scuttle that hope. Still, it’s an excellent discussion, and I think points the way forward out of our current, increasingly unworkable situation.

Happy Canada Day!

Having lived five mostly good years in Canada, I couldn’t very well put up a post critical of one aspect of the country on the eve of Canada Day and then ignore the holiday; like any place, it isn’t perfect, but Canada’s a great country, and I loved my time there. (The fact that it included our first four years of marriage probably didn’t hurt. 🙂 ) So, to all my friends under the Maple Leaf: happy Canada Day!

Trust me, you don’t want Canadian health care

In the US, more and more people, upset by the rising cost of health care, want to turn the whole shooting match over to the government. “We want to be like Canada,” they say.I have to tell you, I lived in Canada for five years; I had surgery in Canada; I saw lots of specialists and the inside of five or six hospitals in Canada; my oldest daughter was born in Canada. America, you don’t want to be like Canada.That is not, incidentally, a slam on the people who make the Canadian health-care system go. For one thing, we were net beneficiaries, as a poor American student family living in Canada; we got a lot for not much, and I appreciated our host’s generosity. For another, we had some truly brilliant doctors, and some wonderful nurses, and the staff at BC Children’s Hospital were beyond superb; they cared deeply about their tiny patients and were past masters at making bricks without straw. The thing is, they had to be.The equipment was junk—they finally gave up on the blood-oxygen monitor on my little baby and took it off when it reported a heart rate of 24 and a blood-oxygen level of 0 (or the other way around—it’s been a few years now); while we were there, the provincial government tried to donate some of its used medical equipment, and no one would take it. The Sun quoted one veterinarian as saying the ultrasound they wanted to give him wasn’t good enough to use on his horses. Meanwhile, the doctors kept taking “reduced activity days,” or RADs (which is to say, they took scheduled one-day strikes without calling them strikes), to protest their contract. I was actually up at St. Paul’s in Vancouver for a scan one of those days; the techs were there, obviously, but no doctors. A hospital with no doctors is a very strange place.I could also tell you about the time we took our daughter to the ER (different hospital) at midnight; there were only a few patients there at the time, but it still took them three hours just to get us into a room, and another hour to see us. It was 5am before we walked out the front door. At that, we were the lucky ones—there were a couple folks still waiting to be seen who’d been waiting when we got there. Or I could tell you about friends who had other friends, or family members, die while on waiting lists for vital surgeries. Or I could tell you about doctors and nurses who got tired of it all and left for better jobs in the US. The list goes on.In case you think I only think this way because I’m an American, I’ll certainly grant you that many Canadians still loyally defend their health-care system; as I say, they have some wonderful people to defend. The fact of the matter is, though, there are many Canadians who don’t, anymore—including, among others, the (liberal) Chief Justice of the Supreme Court of Canada, Beverly McLachlin. The normal routine in Canada is, if you need a major procedure done, you get put on a waiting list. If you can afford to go south of the border and get it done in the US—or if you can get the government to pay for you to do so—you do that. If you can’t, you wait. When this system was challenged in court—a resident of Québec teamed up with his doctor to sue the province over its law forbidding private medical insurance—the Canadian Supremes threw out the law, and came very close to declaring the entire national system unconstitutional. They didn’t quite agree to do that, but they did indict the system in scathing terms; as the Wall Street Journal summed up the matter, their opinion essentially said that “Canada’s vaunted public health-care system produces intolerable inequality.”Which it did. And does, as do similar government-run systems in Britain and elsewhere. In one Ontario town, for instance, people buy lottery tickets to win appointments with the local doctor. The system doesn’t work. That’s why more Canadians are opting to sue; it’s why in Britain, seriously ill patients end up waiting in ambulances, not even admitted to the emergency room; and it’s why “the father of Quebec medicare,” Claude Castonguay, the man who started the ball rolling that produced Canada’s government-run system, now says it’s time to break it down and let the private sector take some of the load.And why not? After all, that approach is working in Sweden.

Calling all feminists for Zimbabwe

Doug Hagler has an important post up on the group Women of Zimbabwe Arise! (WOZA); like most Zimbabwean groups that care about anything other than keeping Robert Mugabe in power, they’ve been taking a pounding from the government and its affiliated thugs. In a pattern drearily familiar from corrupt and brutal tyrannies throughout history, the abuse of women to keep the opposition down is a real problem under Mugabe’s misrule, which makes it particularly important, I think, to support WOZA’s peaceful witness.

No, the sky isn’t falling—yet

I had a wonderful day today. We drove up to Lake Michigan to see one of our best friends from college (she was in our wedding party) and her family at their vacation cottage on the beach; she and her husband were there, and their three kids (generally the same ages as ours), and her dad, whom I also enjoy a great deal. I haven’t seen her since her oldest was a newborn, and I haven’t seen her husband (or her father, for that matter) since their wedding, so it was definitely too long. We had a great time talking church and family and work and other things, while the kids enjoyed themselves immensely playing together (mostly, though not only, down on the beach). I managed to burn myself in a few places due to misapplication of sunscreen—next time, I’ll go back to using the lotion instead of the spray—but no big deal.And then I got home to read the news from the PC(USA)’s General Assembly (GA): they voted to approve overtures to remove the 1978 Authoritative Interpretation, remove the chastity and fidelity clause from the Book of Order, and approve a new Authoritative Interpretation (AI) to allow officers to declare scruples with respect to ordination standards (which is to say, to declare that they’re going to ignore them). And then I spent some time reading the reactions from a number of my fellow conservatives in the church: Presbyterians for Renewal essentially conceding defeat, the Rev. Jim Berkley calling it “a sad, sorry episode,” the Rev. Dr. Alan Trafford declaring that “a line has been crossed” and that his congregation will no longer use the denominational seal, and perhaps most painfully, the Rev. Toby Brown shuttering his blog in grief. Clearly, there’s the feeling on the part of many that the disaster has come; the sky has fallen in.At the risk of making it sound like I think these folks are Chicken Littles—I don’t, especially as I think Jim’s exactly right that these actions “will precipitate much rancor and division within churches and presbyteries”—I don’t think the sky is in fact falling. Not yet, at least. Yes, this was a liberal GA, as most GAs are, and yes, it did what liberal GAs do, as do most GAs; but the actual effect of their decisions should be slight. Though these three decisions felt like “three hammer blows to the head,” I don’t believe they’ll turn out that way. To take them in order:Voting to remove the 1978 Authoritative Interpretation that declared homosexual acts incompatible with the will of God was a real and significant blow. However, it was one that was inevitably going to happen, whenever the liberal wing of the denomination decided they actually wanted to do it; and as long as G-6.0106b, which mandates “fidelity in marriage or chastity in singleness” for all officers of the church, is still in force, then this is still the meaning of our denominational constitution, whether there’s an AI to say so or not. Which leads to Voting to remove the “chastity and fidelity clause,” which would be a major change, if that clause were actually removed—but it won’t be. That’s an amendment to the Book of Order, which requires the support of over half the presbyteries, which isn’t going to happen. This one, for all the noise it’s stirring up, is merely sound and fury signifying nothing.Voting to declare that the constitution permits officers to ignore behavioral standards is potentially the significant change, since this doesn’t have to be approved by the presbyteries. However, I don’t believe this one will stand either, though it will take longer to see for sure. The roots of this one go back a ways. The last GA, in 2006, voted to approve an AI that said this; when candidates for ordination actually stood up and announced their intention to ignore behavioral standards, however, and governing bodies decided to ordain them anyway, that action was challenged in the denominational courts (Permanent Judicial Commissions, or PJCs), and the denomination’s highest court, the GA PJC, said, “You can’t do that.” On my read, their conclusion is that “‘shall’ actually means ‘shall,’ that if the church’s constitution says you can’t do something, then you actually aren’t allowed to do it,” and that “stealth amendments” that attempt to rewrite the constitution without needing the approval of the presbyteries (by simply declaring that the constitution doesn’t mean what it plainly says) are not allowed. As I wrote in a letter I sent to Presbyweb a few months ago, “GAPJC has laid down the law that the only way to amend the Constitution is by actually amending it, and that it is not possible to interpret it to say what it does not in fact mean. Stealth amendments such as this ‘Authoritative Interpretation, are in and of themselves unconstitutional.”I wrote on that occasion, and I still believe now, that we can and should expect GAPJC to say so, clearly, when they are given the opportunity to do so. If that happens, then the end result of these high-profile, high-angst votes will have been nothing of practical consequence. Should I prove wrong, then the disaster will indeed have come upon us, and it will be time for those of us who accept the authority of Scripture to pack our bags for final departure. I don’t expect that to happen, but one never can tell for certain with committees.At this point, however, I’m more concerned about the GA’s decision to rubber-stamp the Stated Clerk Nominating Committee and elect Dmitri Medvedev—excuse me, the Rev. Gradye Parsons—the new GA Stated Clerk. Apparently, they decided that the Rev. Clifton Kirkpatrick’s terms in office were so good that they should continue his administration by proxy. I cannot agree. I’m firmly convinced that one of this denomination’s greatest problems is that the playing field is deliberately tilted, the process skewed in favor of those whose positions are favored by denominational staff, such that violations of constitutional process which produce results the denominational hierarchy likes (such as those which result in practicing homosexuals in ministry positions) are winked at, while those which don’t (such as attempts by churches to leave the denomination with their property) are pursued to the fullest extent of the law. Those who hold liberal positions are given every hearing, while those who oppose those positions are squelched, silenced or overpowered by every means the hierarchy can use to do so. There is no attempt to make the process work equally for everybody, or to allow everyone’s voice to be heard equally. The root of this problem, I’m firmly convinced, has been the practice of favoritism (which is a sin) by our denomination’s highest administrative official, the GA Stated Clerk, the Rev. Clifton Kirkpatrick; I was hoping GA would have the integrity to elect someone who would have the integrity to change this. From what I can see, they didn’t. The defections will continue.

Thought experiment

I had a session of our inquirers’ class this evening—that’s the class I do for those who want to join the church and those who’re trying to figure out if they do—which left me, as I was driving back home, in a contemplative mood, just mulling over things with the church and praying a little; and as I was doing this, I’m not sure if it was merely my own thought or if perhaps it was God speaking, but I had this thought: Suppose God gave you a choice between two promises. Either you could ask that John McCain be elected president, and that would be granted (though Gov. Palin didn’t figure in here); or you could ask for a breakthrough for this church in attracting young people and young families who aren’t currently attending a church, such that we’d start drawing large numbers of younger folks, and that would be granted. The other might or might not happen, but whichever you chose, you could be sure would happen. Which would you choose?—OK, so it sounds artificial; I don’t dispute it. (That’s probably the biggest argument for it just being my own random thought, and even then, I don’t know where it came from.) Artificial or otherwise, though, the question came to mind; and while it will probably surprise some of you who’ve read my various political posts, I had no doubt of my answer: I’d choose for the church.Part of that, I’m sure, is a matter of direct personal welfare: whether or not this congregation grows will have a more direct and immediate effect on my well-being (financial and otherwise) than who gets elected president. That’s a consideration. It isn’t, however, the main one. The main one is the limitations of my own knowledge. If, through whatever combination of programs, circumstances, and whatever else, a lot of people of my generation and younger in this community started attending the congregation I serve, I have a high degree of certainty that this would be a good thing for our congregation (and, yes, for me and my family as well); and as to whether it would be a good thing for those folks, and for our community, I believe it would be, and I would be able to do everything in my power to make sure that it was. I can look at that possibility as a clear good.By contrast, while I truly believe that Sen. McCain would make a good president, and while I’m equally convinced that Sen. Obama would make a very bad one, I have far less ability to be certain of that. I don’t know Sen. Obama at all, and my only personal knowledge of Sen. McCain is secondhand; there are a vast number of unknown variables (on multiple levels) which will play into the success or failure of our next president; and Sen. Obama has a short enough track record that it’s more difficult than usual to predict how he would govern, making it unusually possible that he could surprise all of us. Then too, even if I’m absolutely right about what to expect from both of them (which is unlikely, no question), it’s possible that for the long-term good of our country, we’d be better off with a worse president for the next four years. I’m not sure exactly how that would work, but I can’t say that it couldn’t be—the ironies of history won’t let me.All of which is to say that while I know which candidate will get my vote this November, I’m content to leave the overall outcome of the election to God’s providence; indeed, I wouldn’t be presumptuous enough to think I could do better. I’m just not confident enough that I truly know for certain what’s best (nor should I be, nor should any of us be). On matters closer to home, within my purview and my circle of influence, I can be a lot more certain; and there, my responsibility is more direct, as well. (Which is why, if God actually did make me such a promise for my church, I would be thrilled.)

God language in a fog

One of the latest flaps sparked by the PC(USA)’s General Assembly this year (and why are there always so many? The one good side to cutting the number of assemblies in half is that it cuts down the number of fights they can start) comes out of the Committee on Interfaith and Ecumenical Relationships. The committee was considering a resolution which included the statement, “Jews, Christians, and Muslims worship a common God, although each understands that God differently”; when that raised objections, they rewrote it this way: “Though we hold differing understandings of how God has been revealed to humankind, the PC(USA) affirms our belief in one God, the God of Abraham, whom Jews and Muslims also worship.” As Viola Larson notes, that rewrite doesn’t actually change anything—it’s just the same thing in different words.Here’s my question. Some say that Jews, Christians, and Muslims “all worship the same God,” while others object, some vehemently—but what does that mean? What actually is the content and significance of that phrase, and what is it intended to communicate? I don’t think we really have a common understanding of it; our attempts to discuss Christianity, Judaism and Islam are muddled and blurred by the imprecision of our language. I suggest a moratorium on this phrase and all equivalents as counterproductive; whatever we want to say about the relative beliefs of these three religions, we should look for better, clearer, more precise ways to say it. We have enough issues with these sorts of conversations as it is—we don’t need a lack of clarity making things worse.

A bruised reed he will not break

and a smoldering wick he will not quench; he will faithfully bring forth justice.So it is said of the Servant of God in Isaiah 42:3; so it will be when he comes again. Right now, though, we live in a very different world. I was reflecting on this this morning, thinking about the state of affairs in Zimbabwe. If you’ve been following the news, you know that it looks like Robert Mugabe’s succeeded in hanging on to power (though he said he’s “open to discussion” with the opposition), since the opposition party pulled out of Friday’s presidential runoff in the face of the Mugabe government’s terror campaign, and opposition leader Morgan Tsvangirai sought refuge at the Dutch embassy in Harare. Freedom and justice in Zimbabwe are smoldering wicks, indeed.There is one small, very small, bright spot, though: at this year’s meeting of the PC(USA)’s General Assembly, the Peacemaking and International Issues Committee approved a resolution in support of the church in Zimbabwe, and against the Mugabe government. I hope and firmly expect to see the whole GA approve it; and I further hope that this encourages the Uniting Presbyterian Church of Southern Africa (UPCSA), to which the Presbytery of Zimbabwe belongs, to take a similar stance at their General Assembly in September. I miss being a part of the relationship between Denver and Zimbabwe—it’s perhaps the biggest thing I miss from having left that presbytery—and I wish I could have been there. I’ll have to get on top of the schedule and see if I can at least watch the plenary session when this resolution comes to the floor; I suspect my friends from Zimbabwe won’t speak then (since they’d be on video for the whole world, including Mugabe and his thugs, to see), but I’d at least be able to share the moment with them a little.Please, keep praying for Zimbabwe.

Love beyond reason

Most Christians have probably heard the line that the Christian life is a marathon, not a sprint, and we sort of get the idea; but since it would never occur to most of us to actually want to run a marathon, I don’t think the point really sticks with us. We understand that, yes, the life of faith is more than just brief bursts of activity, that there’s a necessary element of endurance there; but we still think that when it gets to the point that we don’t think we can run anymore, it’s OK to stop. The thing about running a marathon is, when you get to that point, that’s when you have to dig down and push through—and that’s the part of the parallel we lose. We basically believe that when it no longer makes any sense to us to keep trying, when we no longer seem to have any reason to do so, we can stop; but that’s not what Jesus calls us to. That’s not the radical obedience and radical discipleship he wants from us. Jesus calls us to a whole ’nother level of endurance.I got to thinking about that as I was reading Jared’s brilliant post, “Love Is Never a Waste.” It’s a long, deep post, and I won’t try to summarize it; but here’s an excerpt or two:

We likely all recall the time Peter came up to Jesus and basically asked, “When I can I stop forgiving someone who keeps wronging me? After seven times?” (I can almost hear him hoping, “Please tell me after seven times.”) But Jesus responds to him, saying “No, not seven times. Seventy times seven times.” . . .Now, Jesus is a smart guy. In fact, if we believe he is who he said he was, we know he has all the omniscience of the God of the Universe. So he knows this is a tall order. He knows it doesn’t “make sense” in our world of abuse and betrayal and pettiness and vindictiveness and pride and arrogance and egotism.So why does he do this? If he knows our capacity for love and forgiveness is finite, how can he call us to persevere in these things toward others? The short answer, I think, is because God Himself perseveres in them toward us. . . .Because God’s love toward us is a) despite sin worthy of eternal punishment, and b) relentlessly patient in its eternal perseverance, we have no Christian right to say to someone who has wronged us, even if they continue to wrong us, “You have reached your limit with me. My love for you stops now.” Doing so fails to truly see the depths of our sin in the light of God’s holiness. And if God, who is perfect and holy, will forgive and love we who are most certainly not, on what basis do we have to be unforgiving and unloving to others?I am guessing most of us agree with this in theory. There’s not too many Christians who will say, despite Jesus’ instructions, that it’s okay to hate your enemies and curse those who persecute you.I think the place where we really have trouble with this stuff is when it comes to people who are hurting us that we actually do really want to love. We really do want to keep forgiving them. But we are weary. They are wearing us out. We don’t know how much longer we can go on. We want to know if we can give up, but we’re scared what that might mean. Surely God does not want to us to keep enduring this pain. Surely he will understand if we just . . . give up. Things aren’t working. The results aren’t being seen. Efforts are not bearing fruit. I’ve changed, but he or she hasn’t.Most of us know 1 Corinthians 13 really well, but let’s revisit a piece of it again:

Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres . . . Love never fails.

That’s some scary stuff right there. For we who are used to thinking of love as romance or warm-and-fuzzies or butterflies or sex, Paul has Jesus in mind as the model of love when he tells us, “Love is about sacrifice and service. And it keeps going. It never fails.” . . .I don’t think “Love never fails” means “Love always gets the result the lover wants.” I think it means what it says: Love is not a failure.Love is not a failure regardless of the results.This is why: Because God is not a failure, and God is love. When we are loving someone with a persevering, sacrificial love, we are reflecting the eternal goodness and grace of God Himself. We are glorifying God, and there is no higher calling than that. None.We love—not because it will “change the world” (although it may)—but because God loves us (1 John 4:19). . . .Whatever happens, whenever it happens, your love is not in vain. You are not alone, for God loves you and has approved your love through the sacrifice of his Son. Cast off despair; cast all your cares on Him. Love never fails. Love is never a waste.

That’s powerful, true, and critically important; the problem is, we keep collapsing this to the limits of our own self-expectations. We know God says, “Never stop forgiving, never stop loving, rejoice in all things, love your enemies, turn the other cheek,” and the like, but we don’t believe he really means it; we get to a certain point where it just doesn’t make any sense to us to keep going, and we say to ourselves, “Surely God will understand if we quit now—surely he doesn’t want us to keep putting ourselves through this,” and then we quit. We quit because, as Jared says, we don’t see the results we want to see, and we’re quite sure we never will; we quit because it’s not reasonable to expect us to continue, forgetting that it wasn’t reasonable to expect Jesus to allow himself to be crucified for a bunch of smelly, vicious little ingrates, either. We quit because because it’s not fair to keep forgiving and forgiving someone who’s never going to change, forgetting that that’s pretty much what Jesus does for us; and we quit because the agony of loving someone who’s bound and determined to shipwreck themselves despite us is just too much to bear, forgetting that it’s in bearing precisely that agony that we are most truly sharing in the suffering of Christ.In short, we quit because we turn to God and say, “What more can you expect of me? I’m only human”; and he looks at us and responds, “No, you’re not. I’ve put my Spirit within you, and in me, you’re more than you think you are. That’s why I’m calling you to go beyond what you think you can do, beyond where you think it makes sense to stop, and trust me that it will be worth it in the end; I’m making you like me, and this is part of that work.” Ultimately, like everything else, this is rooted in trust in God—trust that we really can do what he’s calling us to do, and that it really will be for our good.At this point, someone’s probably asking, “Doesn’t this just open us up for abuse?”—to which the answer is, “No, but.” No, it doesn’t open us to abuse, because allowing people to abuse us isn’t actually a loving thing to do to them; that merely empowers them in their sin. But, avoiding being abused isn’t the highest good, either. In the Sermon on the Mount, Jesus said, “Do not resist the one who is evil. But if anyone slaps you on the right cheek, turn to him the other also. And if anyone would sue you and take your tunic, let him have your cloak as well. And if anyone forces you to go one mile, go with him two miles.” And you know what? He meant that, too. Our highest priority isn’t supposed to be self-protection; Jesus calls us to love and serve him by loving and serving others past the limits of what we think is safe, and trust that in truth, whatever happens, whenever it happens, indeed it won’t be in vain—because he who calls us is faithful.

The gospel according to Firefly

“Oh, but you did. You turn on any of my crew, you turn on me. But since that’s a concept you can’t seem to wrap your head around, then you got no place here.
You did it to me, Jayne. And that’s a fact.”
—Malcolm Reynolds to Jayne Cobb, “Ariel,” Episode 9, FireflyThis is from the crowning scene of perhaps the best of the handful of episodes we got of Firefly, one of the best scenes I’ve ever been fortunate enough to watch on TV. To explain this line to those not familiar with the show: during the episode, during a raid on an Alliance hospital, Jayne tried to sell out Simon and River Tam, the ship’s two fugitive passengers (Simon, a doctor, is also the ship’s medic, and the one who inspired the raid), to the Alliance. Unfortunately for him, the Alliance officials don’t honor the deal and he gets taken as well, at which point he starts fighting to save himself (and the Tams). They make it back to the ship, and Jayne thinks he’s gotten away with his attempted betrayal; but Mal’s too smart for him, resulting in this (note: there are a few errors in the captioning):

(For a transcript of the episode, go here.)I’ve always been struck by two things in this scene. The first is Mal’s statement to Jayne which I’ve quoted above, which is strikingly reminiscent of the words of Jesus in Matthew 25:40 (though Jayne did evil instead of good). The point is of course different, since Mal isn’t (and doesn’t claim to be) God—but it’s related. From Mal’s point of view, it isn’t enough to show loyalty to him alone: you have to be loyal as well to all those to whom he’s committed himself. Any violation of loyalty to any of them—any betrayal of the crew bond—is a betrayal which he takes personally, and which therefore brings inevitable judgment.The other is what saves Jayne: repentance, as evidenced by the stirring of shame. Jayne’s not much of one to be ashamed of anything—if you don’t count his reaction at the end of “Jaynestown,” the show’s seventh episode, this might be the first time in his life he’s felt shame—so this is a significant moment; and at that sign that Jayne is truly repentant, Mal spares his life (though he doesn’t let him out of the airlock right away—perhaps to encourage further self-examination on Jayne’s part). In the face of repentance, mercy triumphs over judgment.