Thursday, September 17, 2009


Comprehensive health care reform should not rely on charity medical initiatives

I am convinced that charitable efforts, while graciously compassionate and sometimes heroic, have not, do not, and will not adequately address the health care needs of uninsured citizens.  The limits of charity is one reason I advocate for reforms that offer fair, affordable health insurance and quality, accessible health care for all American citizens.

As an urban pastor and social service director in Indianapolis for over twenty years, I have witnessed incredible charity in medical care.  From community health fairs and free clinics to street medical teams and physicians who sometimes wave fees for uninsured neighbors, inspiring charitable efforts abound.  There is no way to underestimate the value of these often-overlooked initiatives.

Many charitable medical efforts have developed to respond to uninsured and under-served neighbors—individuals and households the current health care system is neglecting.  Without them, the health conditions of our region’s uninsured working poor and the measure of our collective response to these neighbors would be vastly diminished, if not disastrous.

I believe the heart of most Hoosiers is compassionate.  Folks frequently give freely of their time and financial resources to relieve the needs of people they don’t even know.  Time and again, we’ve demonstrated our readiness to respond and make a difference for our neighbors in crises.  And many are responding again as more Central Indiana households are facing the unpayable bills and mounting debt that occurs when health insurance is canceled or unaffordable.

I profoundly disagree, however, with those who are suggesting or inferring that charity should be a significant part of a permanent solution to the current health care and insurance crisis.  The impression that charitable health initiatives can adequately respond to the estimated 46 million citizens without insurance is both na├»ve and unrealistic.

Most free clinics are already underfunded, understaffed and overwhelmed.  Charitable health initiatives are often narrowly focused.  Many are disconnected from professional networks that provide a continuity of care leading to stability and wellness.  Some charitable health care initiatives may be models worthy of moving to scale in national health care reform, but few, if any, are prepared to vastly expand their capacity.  Taken together, charitable medical efforts are no match for the need.

National research recently estimated that if every church, synagogue and mosque in the nation were together to pay for the costs of our nation’s uninsured citizens, every local religious body would be bankrupt within two months.  While many faith communities are already responding compassionately to their constituencies and are ready to be part of a long-term solution, they are in no way prepared to responsibly accept the burden some opinion leaders would place on them.

When it comes to comprehensive health care for our nation’s citizens, charity is not the answer.  I pray we will always be able to count on our friends, neighbors, and charitable organizations to help us through occasional crises.  I count it a privilege to be part of that dimension of a community-wide response.  But instead of hoping for charitable interventions, every American deserves to know that the best possible medical care is readily available, accessible and affordable.

I call on the fellow citizens who have been elected to represent and lead us to do their best to ensure that this fundamental of security is addressed in a manner that reflects the best practices and comprehensive care capacity of America’s healing community.

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