By Dennis Gruending

President Barack Obama attempted in a September 10 television appearance to recover lost ground in the debate over his proposed health care reform. In a 46-minute speech to Congress, Obama insisted that he was determined to proceed. “I am not the first president to take up this cause,” he said, “but I am determined to be the last.” He said that many Americans who have health care coverage find when they get sick that their insurance companies exclude them from benefits. He said that the American health care system is the most expensive in the industrialized world but that it leaves 47 million people without insurance. He said that he will see to it that every American will have health insurance. Anyone who is now covered will be free to keep their existing insurance but if they do not have it, they will have to get it.

Obama said that he will not pursue a single payer system similar to that in Canada because he that would be too dramatic a change for Americans to absorb. He did leave open the possibility of having the government provide some coverage, as one among a variety of insurers. This option, in reality, seems increasingly remote given the Big Brother hysteria being generated by the Republicans and vested interests. Obama also promised to make it illegal for insurance companies to drop people from coverage when they become ill, often on the premise that they had a “pre-existing” medical condition. He said his plan will cost $900 billion over 10 years, less than it would cost to maintain the status quo, less than the wars in Iraq and Afghanistan, and less than the Bush administration spent on tax reductions to wealthy Americans in its first term of office.

Canadians are spectators in the American health care debate but we have found a small niche. On July 27, I reported on Pulpit and Politics that some major religious organizations in the U.S. were opposing the president on health care reform. I focused upon the United States Conference of Catholic Bishops, the National Association of Evangelicals and the 16-million-member Southern Baptist Convention. All are prepared to oppose broadly based health care reform based on fears that the plan may provide money for therapeutic abortions.

In my July 27 posting, I contrasted this behaviour by mainstream American religious groups to the role that Canadian churches have played in this country — including their support for public health care. Two weeks later, on August 10, Rev. Dr. Karen Hamilton, general secretary of the Canadian Council of Churches (CCC), wrote a polite letter to two of the three American religious organizations that I had cited. She also sent the letter to National Council of Churches USA. Rev. Hamilton’s comments to her various American coreligionists were polite but pointed. “We have no wish to advocate specific positions on the various public policy options being proposed by politicians in your country,” she wrote. She did make it clear, however, that the CCC believes the principles embedded in public health care are good theology. “Medicare can be the Good Samaritan parable writ large,” she said in her letter.

I was curious to know what happened after she sent the letter, so I sent an
e-mail query to Rev. Hamilton. She replied, saying that the CCC letter has generated significant interest. “I heard from the General Secretary of the NCC that they were glad indeed that we had sent the letter. There has been much enthusiasm here in Canada for the fact it was sent – a sense of thankfulness, I think, that we have experience we can share. Also a sense of how well done our work on health care is in Canada.”

Christianity Today, a Canadian church-based newspaper, carried a brief story regarding the CCC’s letter. The Winnipeg Free Press reported that Rev. Hamilton believes her letter led to an invitation to listen in on a conference call involving President Obama and representatives from a variety of American faith groups on August 19. An estimated 140,000 people were on the call and web cast organized by a supportive faith coalition.

The Washington Post also carried a story. The Post’s religion writer Davie Waters made the connection between popular American actor Kiefer Sutherland and his grandfather Tommy Douglas – whose CCF government pioneered medicare in the province of Saskatchewan. Waters provided an update on where major American churches stood on health care reform as of August 29. Referring to a story in the New York Times, he wrote that a “growing number of Catholic bishops” are speaking out against some details in Obama’s plan, despite the fact the bishops have been lobbying for decades for the federal government to provide universal health insurance. The New York Times quoted Bishop R. Walker Nickless of Sioux City, Iowa, as saying in a recent pastoral letter that: “The Church will not accept any legislation that mandates coverage, public or private, for abortion, euthanasia, or embryonic stem-cell research . . . No health care reform is better than the wrong sort of health care reform.”

Waters reported that the National Association of Evangelicals released an August 19 opposing Obama’s plan on the basis concerns over abortion funding. But Waters the NAE statement was equally concerned about government involvement: “We also call on the President and members of Congress,” the NAE said in its statement, “to establish health care provisions that will maximize the creativity of the private sector while minimizing governmental control.”

The National Council of Churches, Waters wrote, “doesn’t seem to be sweating the details at all.”  In an August 14 letter the NCC urged its members to support health-care reform, without mentioning the legislative details.

It will be instructive to see how these organizations respond to Obama’s September 10 address. He promised that state funds would not be used to pay for abortions under a reformed health plan. He wants to keep a public insurance option on the table, but says it would likely not apply to more than five to 10 per cent of the population – hardly the “government takeover” of health care that he has been accused of plotting. We know how the Republicans will respond. Their spokesperson, Senator Joe Wilson of South Carolina, in what can hardly pass for profundity, said that Obama is trying to “put lipstick on a pig” and that the Republicans will continue to oppose. What about the bishops, now that abortion funding appears to be off the table? What about the evangelicals, now that both Obama says abortion funding and significant government involvement in health insurance will not occur?

The Washington Post now reports that the health care debate, and opposition to Obama, has breathed new life into the Christian right, which had been discredited by its unwavering support for George W. Bush and demoralized by the Republican defeat. The Post says that as Obama was preparing to speak on September 10, conservative Christian leaders were “ rallying their troops to oppose him, with online town hall meetings, church gatherings, fundraising appeals, and e-mail and social networking campaigns.”

If the president’s opponents are invigorated, many of his supporters are becoming demoralized. They believe that, after announcing his intentions on health care reform, he waited far too long to come forward with his own detailed ideas. One television commentator said that when the Republicans drew their line in the sand over the summer, Obama was not even on the beach. A perceptive commentary in Harper’s magazine said that Obama might resemble former President Herbert Hoover (an intelligent and ethical man who was unable to overcome his own caution) when what America needs is a Franklin Delano Roosevelt, who had the courage to stare down his opponents on the issues that mattered.

By Dennis Gruending

The Canadian Council of Churches (CCC) has written to three large American religious groups offering positive comments on the value of a publicly financed and administered health care system. Rev. Dr. Karen Hamilton, the CCC’s general secretary, sent a letter on August 10 to the National Council of Churches, the United States Conference of Catholic Bishops, and the National Association of Evangelicals. (The CCC has not yet posted the letter on its website at the time of this writing). I had reported on Pulpit and Politics on July 27 that some prominent American religious groups, including the powerful Southern Baptist Convention, were altogether opposed to significant health care reform, while others including the Catholic bishops and the American Evangelical Association were not prepared to support any plan that might include paying for abortion as a medical procedure. Rev. Hamilton’s low-key intervention comes at a time when American special interest groups are orchestrating a campaign of fear and misinformation about health care reform. Some angry Americans are showing up at town hall meetings on health care carrying handguns, rifles, and even automatic weapons – claiming that it is their constitutional right to do so in the United States of America. This is a chilling development that really does cross the line, and it is more in keeping with Germany in the 1930s or with experiences in recently-failed states than it is with a healthy, functioning democracy.

Rev. Hamilton’s letter

“Canadians are aware that certain lobby groups and media outlets in the United States regularly use critical references to Canada’s health care system and interviews with Canadian citizens to support their arguments,” Rev. Hamilton writes. “By means of this letter and its enclosures, we simply wish to inform you of our Christian reflection on health care in Canada, the implications of this reflection in our ministries, and the action we have taken to discern an appropriate role for Canadian Christians in terms of health care and health care advocacy.”

Hamilton tells her American coreligionists that prior to 1966 Canada had a health care system that failed to provide over 30% of the population with medical insurance. That situation, she says, “created enormous human suffering and ethical problems for those who believed with Paul in 1 Corinthians 12:26, ‘If one member suffers, all suffer together with it…’” She adds, “With varying degrees of fervour, Canadian churches publicly began to advocate for the establishment of Medicare. Canadian churches wanted health care for all.” Hamilton then provides a brief description of this country’s Medical Care Act and describes it as “one of Canada’s hallmark policies towards social inclusion and the alleviation of suffering related to poverty.”  The CCC in recent years, she says, has continued to urge that Canada’s public health system be strengthened.

Expensive health care

The Democrats are not proposing a publicly-administered, single-payer health care system such as we have in Canada, but rather a patchwork of private and public insurance that would assure coverage to everyone, including those 47 million Americans who lack it entirely. President Obama believes that having government as one of the insurers would bring some discipline to a system whose costs are out of control. They are bloated by competing health care insurance companies that are expected to turn a handsome profit for shareholders, and by the provision, for those who can afford it, of rampantly costly high technology medicine. Arnold Reilman, professor emeritus of medicine at Harvard University, writes, “The entire system behaves like a profit driven industry.” He adds, “In most advanced countries with universal coverage, the government determines how medical expenses are reimbursed, and the income of health care providers from technical services is therefore more modest.”

The U.S. spends more on health care than other industrialized country — 17 per cent of the gross domestic product in 2008. By comparison, health care spending accounted for 9.7 per cent of GDP in Canada in the same year. Obama says that the U.S. cannot afford to keep spending so much, even as millions of people are excluded from the service. He has proposed to increase taxes modestly on high-income earners to pay for the extended coverage, and he claims that new efficiencies can be found to reduce the rising cost of care in the future. Any mention of higher taxes is anathema to the rich in the U.S., as is any hint of state involvement, no matter how minor. Obama has now begun to back away from having the government involved at all and is talking about having health cooperatives in some cases, but a continuation of private plans in most others.

Rumours and lies

Nonetheless, the Democrats have been attacked relentlessly in an air war (on television), a ground war (at town hall and other meetings), and a digital war that is spreading like a viral flu on the web. They are fighting back as best they can. I received a message recently referring me to a site called Setting the Record Straight. “It seems like a new lies about health insurance reform crop up each day,” the site says. “These lies create fear and anger – and we’re seeing the results around the country. It’s time to work together to set the record straight and expose the special interests and partisan attack groups who deliberately spread these rumours and lies in a desperate attempt to preserve the status quo.”

What are some of those rumours and lies? Perhaps the most disgusting among them came from Sarah Palin, the former Alaska governor and Republican vice-presidential candidate in the 2008 election. She posted a note on her official Facebook page claiming that the Democratic plan would ration care and that “my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care.” Needless to say, no such panel exists or has been proposed in any version of the health care bills in Congress.

Canadian comparisons

There is some similarity between what is occurring in the U.S. today and what happened when Saskatchewan’s social democratic government introduced medicare in July 1962. That decision triggered an ugly 23-day doctors’ strike. In a biography that I published in 1990 about former Saskatchewan Premier Allan Blakeney, I describe how someone painted the word “commie” on the wall of then-Premier Woodrow Lloyd’s home. That prompted police to provide him with around-the-clock protection. The Canadian (and the American) Medical Association and the private medical insurance companies were instrumental in financing opposition to medicare and were joined in their project by the Liberal opposition party of the day – much as the Republicans are now part of the corporate campaign against health care reform. There was also a religious dimension to the dispute in 1962, as there is in the U.S. today. Some Canadian Protestant churches had been among those advocating on behalf of medicare for years, but Catholics were mostly opposed. I was in grade eight at the time and recall the religious sisters who taught in our school telling us that medicare was communist-inspired and the beginning of a slippery slope that would rob us of our democratic and religious freedoms. And yes, we were told that under medicare the government would choose our doctors, our treatment, who would live and who would die.

Father Athol Murray, a well known priest who founded Notre Dame College at Wilcox, Saskatchewan, was one of the featured speakers in a series of Keep Our Doctors rallies held throughout the province and broadcast by an obliging radio network. At one rally, Father Murray was quoted as saying: “This thing may break out in violence and bloodshed any day now, and God help us if it doesn’t.” Murray’s bishop was not amused and sent him out of province on an unscheduled holiday. But there were other, countervailing religious voices as well. The Prairie Messenger, a Saskatchewan newspaper published by Benedictine monks, assessed the issues and became one of only two newspapers in all of Saskatchewan to support medicare.

Good Samaritans

In her letter of August 10, Rev. Karen Hamilton is deferential to her American counterparts. “We have no wish to advocate specific positions on the various public policy options being proposed by politicians in your country,” she writes. But, gently, she does make it clear that the principles embedded in public health care are good theology. Quoting from a former CCC general secretary, Hamilton writes, “Medicare can be the Good Samaritan parable writ large.”

The churches had a choice to make in Saskatchewan in 1962 and they have one today in the much grander theatre of American politics. The religious voices of reason and compassion now appear almost entirely absent from the American debate.

By Dennis Gruending

President Barack Obama appeared on national television recently to promote his plan for reforming his country’s health care system. He is involved in a high stakes contest against the massive American health insurance lobby and its political friends among Republicans, but also some so-called  “Blue Dog” Democrats who are opposed to reform. Obama is not proposing a publicly-administered, single-payer system such as we have in Canada (which, it appears would be too much for Americans to accept) but rather a patchwork of private and public insurance that would assure coverage to everyone, including those 47 million American who lack it entirely. The provision of health care to citizens is an ethical as well as a political issue and one would expect that churches and religious organizations would have something to say about it.

The Catholic bishops’ conference in the U.S. has long favoured health care reform but is now focusing on its fears that the plan might provide money for therapeutic abortions, which are legal in the U.S. even if access is restricted in many states. The National Association of Evangelicals is focusing upon abortion as well, and the 16-million-member Southern Baptist Convention appears to be lining up with Obama’s opponents. Richard Land, president of the SBC’s Ethics & Religious Liberty Commission, said this: “They’re going to take money from our pockets and force us to take part in health insurance programs that will subsidize and underwrite the baby-killing industry.” The Episcopal Church is on record as supporting universal access to health care (and supports choice) but its priorities appear to be tilted more toward race relations and gender equality than health.

This debate occurs in a context where health care is exclusionary and increasingly expensive. Most Americans with health insurance receive it through their employers. Those whose employers do not offer it or who are unemployed must either buy costly insurance or pay medical bills out of pocket. The elderly and indigent receive coverage from the government and 47 million Americans have no coverage at all.

The Washington-based National Coalition of Health Care reports that the U.S. spends more on health care than other industrialized nation. Total health spending in 2007 was $2.4 trillion, representing an expenditure of $7900 per person. In 2008, the annual premium for an employer health plan covering an individual worker averaged over $4,700. For a family of four that premium averaged nearly $12,700.

American health care spending in 2008 represented 17 per cent of the gross domestic product and it is rising by nearly 7 per cent a year, well above the rate of inflation. By comparison, health care spending accounted for 10.9 per cent of the GDP in Switzerland, 10.7 per cent in Germany, 9.7 per cent in Canada and 9.5 per cent in France, according to the Organization for Economic Cooperation and Development.

What do Americans get for that vast expenditure? The rich get a designer service while the poor may get little or no service, and as Michael Moore pointed out in his documentary Sicko even those who have an insurance plan are regularly excluded from benefits through shady dealing by their insurance companies. The National Coalition of Health Care concludes: “Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, and inappropriate care, waste and fraud. These problems significantly increase the cost of medical care and health insurance for employers and workers and affect the security of families.”

It is that situation that Obama wants to tackle and he is investing his popularity to do so. If he cannot achieve health care reforms early in his presidency, the opportunity may be lost for another generation. An earlier attempt by the Clinton administration to reform the system was opposed by the powerful health lobby and it went down in flames.

With the U.S. spending almost twice per capita what Canada does on health care, it is interesting to say the least, that the American health lobby and Republican politicians are using Canada’s “socialist” health care system as a bogeyman to instil fear into their own population. Canada’s system has its problems but on balance it is superior to that of the U.S. in providing a good quality of service to every one of its citizens – whether or not they have a fat wallet.

Churches have been involved in the Canadian debate from the beginning. Saskatchewan’s premier Tommy Douglas, a Baptist minister, promised in the 1960 election campaign to introduce public health care if his CCF was re-elected. He was opposed strenuously in that election by the Canadian medical establishment and the American Medical Association. Later, when the Saskatchewan government introduced the continent’s first public health insurance plan in 1962, it triggered a 23-day strike by doctors. The CCF government of the day faced a situation similar to the one that President Obama faces today — an attempt to introduce a basic health care reform in the face of powerful opposition. Obama’s of course, is a much larger theatre.

The Saskatchewan government won the battle in 1962 and the action then shifted to the national scene. Prime Minister John Diefenbaker appointed Supreme Court Justice Emmett Hall to lead a royal commission into health care. Hall weighed the evidence in a most judicial way and concluded that publicly insured health care was the way to go. He found that Canada’s existing patchwork of private health care insurance was highly inefficient and that it failed to cover 30 per cent of the population, something eerily reminiscent of the situation in the U.S. today.

Hall took the view in his report that a commitment to improved health services for the common good took precedence over the self-interest of individuals. Hall was a devout Catholic and to buttress his point made reference to a papal encyclical of Pope John XXIII. In 1966, the Liberal government of Lester Pearson accepted Hall’s recommendations and Canada introduced publicly financed health care modeled on what the CCF had done in Saskatchewan.

Fast forward to 2007, when the Canadian Council of Churches (CCC) released a book called A Health Care Covenant, which described the involvement by churches in Canada’s various debates about health care, including their appearance before the Hall Commission in the 1960s to support medicare. The churches also appeared before a recent royal commission in 2001-02 led by former Saskatchewan premier Roy Romanow. They asked him to reaffirm the public health care system and called for improvements to it, without the various, specific caveats demanded by religionists in the U.S.

One of the authors in the CCC’s book is Janet Sommerville. She writes that public health care not only makes good economic sense, but that the choice of systems is also a matter of what she calls applied ethics. “[The] principles guiding our health care system,” she says, “have an unmistakable affinity with the love of neighbour urged on us by God’s word in Scripture.”

Obama would be well served if he had more church spokespersons such as Sommerville on his side during the current health care debate.