Health Care Insurance
On the first business day of the new year, I received an automated telephone message telling me that a preauthorization for medical care had been denied and I would receive paperwork later to explain.
This is the first message I’ve had from a new insurance policy that we were required to purchase after the General Council on Finance and Administration (GCFA), the treasury arm of The United Methodist Church, for which I worked, dropped our retiree insurance policy.
Without explaining why, but promising we would have more choices and perhaps lower costs, we were thrown into the health insurance marketplace. In order to get coverage we were required to deal with a health care marketing firm whose function is to sell policies for select insurance companies.
Descent into Hell
After four days and at least 10 1/2 hours on the telephone and online doing research for a policy, Sharon and I stopped counting the time we were investing.
We gave up the search and enrolled in a policy that isn’t as good as the one we’ve had for the past several years. It’s less flexible, we had to give up one physician who has helped me through two surgeries for an on-going condition, and it’s not clear whether we will pay more or less money.
But, unlike 4 million other U.S. citizens, we’re insured.
In lieu of contributing the employer’s share of a premium, the GCFA is contributing to a health reimbursement account amounting to $4,100 per year for a couple.
As insurance and drug costs rise, no doubt the reimbursement will stay the same, so retirees on fixed incomes will absorb the increase.
I won’t list everything that went wrong. I don’t have enough space and I don’t want to try your patience because the list would be long.
The description one of my friends gave as he went through the process should suffice. “It was a descent into Hell,” he said.
Instead, I want to discuss a larger issue that looms over this decision.
Institutional Failure
The decision made by my employer was an institutional shift away from an understanding of deep ties of mutual obligation rooted in community to far weaker ties based on market choices by individuals engaged in a transaction.
There is a growing body of analysis that traditional institutions in Western liberal democracies are failing. They are being replaced by market-based capitalism.
Health Care as a Commodity
In virtually every country in the developed world, health care is a basic right, and a service. However, in the U.S. we buy access to health care through insurance as if health care is a commodity.
We have turned it into a retail transaction. Thus, insurers, health providers, device makers, and Big Pharma all are given a piece of the action, all of which is funded from the pocketbooks of everyday workers, retirees, employers (if they offer it), and the uninsured.
This is a system that gives competing forces of predatory capitalism the ability to profit from the potential and actual suffering of people, otherwise known as consumers.
I contend my relationship with my doctors is more than a retail transaction and I am more than a consumer.
Together, we make decisions about my life that affect me and my loved ones. These decisions are about how I live a meaningful, purposeful life. I’m not buying a product, I’m seeking well-being.
The consequence of my employer’s decision to place one of its most vulnerable, powerless and voiceless constituencies into this transactional marketplace illustrates the problem. It’s a direct rejection of this religious community’s theological claim to a preferential option for the poor and the vulnerable as an expression of social holiness.
Where the Power Resides
As we listened to the insurance brokers read scripts written to protect the corporation and remind us “this conversation is being recorded,” it was clear where the power resides in this transaction. Not with us.
As we surveyed which policies included or excluded our physicians, hospital and certain drugs, it was also clear our choices were determined not by our needs but by the commercial relationships large corporate interests have made for their own benefit.
We had to make judgments from a range of choices dictated by corporate bottom lines that would confound the most astute mind.
We are subjected to the vagaries of the market without voice, vote or right to appeal.
This is hardly an authentic expression of our theological teaching about caring for one another as Jesus taught in Matthew 25.
The Church as Community
In the past, as the CEO of one of the global church agencies, I encouraged staff to view themselves as an extension of our larger community of believers, and their work as a form of ministry on behalf of the community as well as service to the community.
We were not individuals pursuing our self-interests, we were part of a collective, multi-layered, interwoven community that ultimately extended from our workplace to congregations to global connections.
It is true that we were in a workplace, but it was a workplace within a context of shared values, common identity, mutual interactions, obligations and shared purpose.
We were deeply rooted, connected and responsible for a common good.
These are the qualities that mark a traditional institution. And this is what is being lost as the marketplace and predatory capitalism subsume the place of these institutions.
If the church does not preserve this understanding of community and commitment in a market-driven, consumerist society, we will continue to leave those without leverage in this predatory system unprotected and vulnerable to principalities and powers far stronger than any one of us can influence alone.
Our Evaluative Outlook on the World
Matthew B. Crawford, writing in The World Beyond Your Head: On Becoming an Individual in an Age of Distraction says, “commercial forces step into the void of cultural authority and assume a growing role in shaping our evaluative outlook on the world.”
This is the crux of my concern about the decision my institution made—it transfers responsibility for a common good to a transactional, market-based culture. It further diminishes the role of the church in the culture. It fundamentally changes our evaluative outlook on how we view this piece of our world.
Death by a Thousand Cuts
Economic sociologist Wolfgang Streeck says that the great contribution of traditional institutions is that they provide us the means to resist forces of predation: commercialism, secularization of values, economic exploitation and the depletion of the natural world.
Traditional institutions won’t suddenly disappear, Streeck says. They die by a thousand cuts, conceding responsibility, or being shut out of power, in small, almost imperceptible ways.
Imperceptible that is, until they realize they have no power to resist. They become subordinated to the dominant values of a secular, commercialized, market-dominated dynamic, that is by definition predatory.
That’s why a decision like this has larger implications than recognized on the surface.
The Most Perfect Christianity – to Seek the Common Good
An early church father, John Chrysostom (c. 347–407), once wrote: “This is the rule of most perfect Christianity, its most exact definition, its highest point, namely, the seeking of the common good . . . for nothing can so make a person an imitator of Christ as caring for his neighbors.”
When it functions as it should, the church provides us moral instruction, and functions as a moral compass, to blunt, if not challenge, the destructive effects of rampant and unrestrained materialism promoted by predatory capitalism.
It offers us an evaluative outlook on our world.
But today that challenge requires adjustment to a new world of technology, information, and economics unlike humans have known in the past.
New Forms for a New Day
It requires new forms of institutions, constituted to address the powers and principalities of the 21st Century.
It requires imagination and creativity.
Thus, the institutional church should be seeking new ways of being in community in a diverse and complicated world. It must resist the pressure to move toward a society governed by materialistic transactions and offer creative, innovative alternatives.
I believe this involves leaders in the global church giving deep thought and action to conceive new policies—pubic and private—that support a moral economy.
Re-imagining a Place in the World
To be specific, it means imagining how to provide health care to everyone as a basic human right.
In frontier America, the church did this by creating hospitals that became the backbone of the health care system that exists today.
At this writing, in Africa religious organizations provide 40% of health care in the same spirit of public concern.
Nothing less than bold, creative effort is needed in the U.S., and the church should be leading in this effort, not merely reacting to (admittedly) powerful market forces.
It is not enough for our church’s administrative arm to hand-off its retirees’ health care to a transactional marketplace as if they are little more than an economic liability to be written off.
As we hurtle toward an over-heated world whose resources are being depleted beyond the capacity to sustain us, market-based transactions will not save us, they will only hasten the downward spiral.
If the institutions that inform and protect our highest values and ideals abrogate their responsibility for the common good and don’t help us prevent that downward spiral, we all lose.
Larry Hollon
Rev. Larry Hollon
The Rev. Larry Hollon served as the top executive of United Methodist Communications. This post is republished with permission from his blog, Faith, Media and Culture.