A retired State Senator remembers being appalled as she listened to older retired constituents contemplate whether to buy food or medicine. An Episcopal deacon recalls helping young Steven with his disability insurance before Steven died from AIDS. A National Concerns Committee member expresses shock at the extremely long time a seriously ill friend waited in an emergency-care unit because so many patients with minor illnesses requiring attention had filled the hospital’s rooms.
Talk to anyone anywhere in the nation and the consensus is that America’s health-care system is in crisis and needs immediate attention.
The crisis runs the gamut from inaccessibility to basic care and pharmaceuticals to uneven care quality, rapid increases in insurance premiums and the high number of uninsured people. “The bottom line from a social and economic standpoint is that the health-care system is utterly broken and absolutely must be fixed,” says John Johnson, domestic policy analyst of the Episcopal Church’s Office of Government Relations in Washington, D.C.
According to a 2002 report by the U.S. Census Bureau, 44 million people -- 15.2 percent of the American population -- are uninsured. Of those, 78 percent are full-time workers or dependents of full-time workers. Approximately 40 million more people are considered under-insured. And every year, working families see insurance costs rise.
“The greatest challenge,” Johnson says, “is recognizing that all these areas are not mutually exclusive and addressing just one area does not solve the problem. It has to be done from a wholistic approach.”
The church tackles health care
Today, the Episcopal Church practices a wholistic approach in various ways. Many churches heavily emphasize parish nursing programs; dioceses initiate health ministries; church-related organizations advocate for the disabled, elderly and poor; conferences raise awareness about health issues; church representatives network with national health-care coalitions on behalf of members to help bring about health-care reform.
Faith In Action in Winston Salem, N.C., an organization strongly supported by the Robert Wood Johnson Foundation, receives grants from the Episcopal Church. It advocates for uninsured poor, elderly and disabled people. “Our team [which includes volunteers] works to get disability insurance approved for many in the community so that prescriptions can be filled, individuals will have regular hospital visits, doctors appointments and also access to mental-health care,” says the Rev. Kermit Bailey, an Episcopal priest who leads this ministry.
One of the organization’s initial mandate was to find disabled citizens and help get their disability benefits approved. “Over a period of five years, 2,000 people were located,” Bailey says. Locating people in the pews who need help caring for themselves is the goal of the National Episcopal Health Ministries. A grassroots organization begun in 1996, NEHM supports more than 250 congregations that focus primarily on parish nursing and health-care promotion.
NEHM’s mission is to promote health ministry, helping congregations reclaim the gospel imperative of wholeness, says the director, the Rev. Jean Denton. “We seek to call local congregations to ministry in not only preaching and teaching, but also in healing,” she says. “We believe that this work is needed at the grassroots, congregational level and cannot be relegated to health-care institutions.”
NEHM provides resources to congregations, dioceses and provinces; leads workshops and seminars; teaches courses to prepare and equip parish nurses and health ministers; and collaborates with other faith communities, institutions and health organizations.
The Rev. Frances Clark is a vocational deacon and health-care nurse serving in an upper- to middle-class suburban area in Medford, N.J. With a 650-member congregation at St. Peter’s Episcopal Church, Clark says she strongly believes that health care must be brought back into the churches. “We were the first in the business of health care,” says Clark. “And then we got out. The saints are out of it, and the government has moved in.”
She calls her ministry simple yet effective. “Taking people’s blood pressure on Sundays after service once per month is an example. What we have found is that two folks have avoided strokes, and one gentleman found his blood pressure to be up so high he went ahead and lost 10 pounds.”
Other programs include providing hospice care or accessibility to a grief counselor; showing a film on how to visit a patient in the hospital; offering lay Eucharistic ministry; giving pointers on how to meditate; and outlining proper diets. Health ministry also can take place through a church institution, such as St. Luke’s Hospital, Kansas City.
The hospital works continually to improve its care system for patients, their loved ones and the staff, says the Rev. John Swift, director of spiritual wellness. “The fact that we are a faith-based hospital is felt at every level, and the commitment to quality care comes out of our faith commitment that God wants us to do our very best.”
With seven staff chaplains, six resident chaplains and six interns, the hospital chaplaincy’s primary focus is 24-hour in-house coverage for emergencies – chaplains are called upon automatically at every death, cardiac arrest or traumatic incident.
Advocating for complete medical care
Although the work at the parish level is “superb,” more must be done, says Cynthia Cohen, a member of the Standing Commission on National Concerns and senior research fellow at the Kennedy Institute of Ethics at Georgetown University, Washington, D.C. “It’s like putting a finger in a hole in a dike, because they can just do things that help people in small ways. They don’t have the ability to give individuals the access to the kind of complete medical care that they need.”
In 1990, an average family medical plan cost approximately $3,800; in 2003, it rose to more than $14,000; by 2006, family health-insurance premiums will exceed $14,500, according to the National Coalition on Health Care, Washington, D.C.
“This [increase] takes away from our ability to pay for education, to give to charities, to support other economic developments important to our community and the overall ability to support and take care of the poor,” says Johnson. According to the Census Bureau, U.S. health-care spending in 2001 was $1.4 trillion, up 8.7 percent from 2000. That’s more than other industrialized countries spend.
Small dioceses suffer huge challenges with the rising cost of health-care premiums. Skyrocketing health expenses are pitting employer versus employee, so the whole system is starting to collapse, says Bishop James Kelsey of the Diocese of Northern Michigan.
His diocese has a ministry-development strategy “by which smaller congregations pool their money and the diocese contributes to that pool to make possible a team of missioners who serve multiple congregations,” says Kelsey. “The result is that our diocesan budget supports the compensated clergy to a high degree. So when there is an increase in health-insurance premiums of around 24 percent per year over several years, it devastates our budget.”
Several small dioceses formed an advocacy group to work with the New York-based church’s Medical Trust, which supports active clergy and lay employees, Kelsey says. Through consultations, the dioceses’ bishops will help identify specific needs for small dioceses.
To secure the retirement needs for clergy, the Church Pension Fund increased its assistance with post-retirement medical costs even though the road ahead is fraught with uncertainty, says President Alan Blanchard. “I believe the level of assistance provided to long-service clergy is higher than many other ‘employers’ in the United States.”
Educating church leaders
In 2003, a conference sponsored by the Office of the Bishop Suffragan for Chaplaincies at the Episcopal Church Center met in response to a 2000 General Convention resolution calling for Episcopalians to advocate for a system providing “decent and appropriate primary health care for all citizens.”
The goal, Johnson says, was to establish a core group of health-care advocates in the Episcopal Church who understood the crisis from both national and local perspectives. The participants were then exposed to policy makers and national experts to help them to understand more fully how the U.S. system needs to be repaired. They were asked to return to their communities and educate others about opportunities to advocate for health-care reform.
Johnson stresses the importance of meeting and networking with Congress but says individuals can be just as effective within communities. “There are more opportunities for contact with policy makers at home.”
A General Convention 2003 resolution called for a Standing Commission on Health and a staff position in health care at the church center.
Because of budget constraints, the staff position will not be established, although a commission will be appointed, says the Rev. Rosemari Sullivan, executive officer of the General Convention Office. “While the position is unfunded, the work that has been emphasized by this resolution and by the convention and the church is part of the ongoing work of several offices.”
The church must be vigilant in calling for health-care access for all, Johnson concludes. “It needs to continue to meet with corporate, government, union and other interests in ensuring that health care in the U.S. serves the least among us by providing health care to clergy, staff, sexton, so that our ability to be a witness to Christ in society is impacted by the basic human right of health care.”