“The Moral Imperative of Health Care Reform”
By Rev. Dr. James Kubal-Komoto
Saltwater Unitarian Universalist Church
Des Moines, Washington
August 30, 2009

             I could tell you hundreds of stories, but here is one about a young man named Sam…

            He was 21 years old. He was from a hard-working family. In July, he began to have stomach pains, but he thought they just the results of the flu, and he didn’t have health insurance, so he didn’t go to a doctor. The pains got worse, but he still didn’t have health insurance, so he still didn’t go to a doctor. The pains got even worse, so he finally went to an emergency room.

            Within 48 hours, he began to experience total organ failure.

            His cause of death was acute pancreatic and undiagnosed diabetes.

            His family, of course, is devastated.

            If he had had health insurance, he most likely would have sought medical treatment sooner. If he had had health insurance, he would most likely be alive today.[i]

            This morning I would like us to join in the conversation that is happening across our nation, and I would like to talk with you about health care reform.

            But I’m a minister, not a policy wonk. So I don’t want to take you on a guided tour of the ins and outs of legislation currently before the U.S. Congress - - House Resolution 3200, otherwise known as “America’s Affordable Health Choices Act of 2009.”

            Instead, I want to try to offer you a religious perspective, especially a liberal religious perspective on this issue.

            When a lot of politicians talk about our health care system, including President Obama, they say it’s “broken,” and “broken” is a good word to describe some of the problems with our health care system - - for example, those problems that make the cost of health care in this country the most expensive in the world without making the quality of health care any better.

            How much money do we spend on health care in this country?

            Try something with me. Open up your purse or your wallet. Look inside and see how much money you have. You will most likely spend one out of every six of those dollars on health care.[ii]

            If you lived in any other country, you’d spend less.

            I figured out that in my own family, health insurance costs us $9,916.56 every year. The church, as my employer, pays my share of the premiums, but I pay for Hiromi and Kai’s share. Still, this makes health insurance the second highest item in our family’s budget, after our mortgage.

            Many of you probably spend even more.

            Yet, Hiromi, Kai, and I, and all of you who have adequate health insurance are really among the lucky ones, because as many of us already know, there are 46 million other men, women, and children in this country without any health insurance at all - - roughly one in six of us - - and millions more who are underinsured, whose deductibles and co-pays are so high that they can’t afford to seek medical care unless they’re in a medical crisis.

            As a result of this lack of access to affordable health care, it is estimated that about 18,000 people die unnecessarily every year, people like Sam, whose story I told you as I began my words this morning.[iii] 

            Millions of others suffer unnecessarily from untreated health problems, and can you imagine what that must be like? A few weeks ago I had an painful earache. I went to the Virginia Mason Clinic in Federal Way. I paid my $20 co-pay to see a doctor and $40 for some prescription eardrops - - best $60 I ever spent. Without insurance, the doctor’s visit would have cost nearly $100 and the prescription eardrops $140 - - at total of nearly $240. I wonder how many people without insurance - - especially those working low-wage jobs who can barely afford rent and groceries - - would have just decided to suffer through it?

             To say a healthcare system that lets 18,000 people a year die unnecessarily and millions of others suffer unnecessarily is merely “broken” doesn’t seem quite adequate.

            I think stronger language is necessary.

            If we came across a situation where there were six people, and five of them were drinking water while the sixth was thirsty, dehydrated, or even dying of thirst, I think most of us would be morally shocked, or even morally outraged.

            If we came across a situation where there were six people, and five of them were eating a wonderful meal while the sixth was hungry, malnourished, or even dying of hunger, I think most of us would be morally shocked, or even morally outraged.

            But those situations are not so different from our current health care system, in which one in six people in this country doesn’t have access to affordable medical care.

            So I don’t think it’s enough to call our current health care system “broken.”

            I think it is more accurate to say that there are aspects of our current health care system that are immoral.

            I think it is even more accurate to say that there are aspects of our current health care system that are evil.

            “Evil” is not a word that religious liberals use often.

            I’ll even admit that it feels a little silly to say. “Evil.” “Evil.” “Evil.” I feel a little like a right-wing televangelist talking about Hollywood.  

            It’s also not a word I use lightly, because if you plop the word “evil” into any kind of conversation, it has an instantly polarizing effect.

            It’s also a dangerous word to use because it encourages us to demonize our enemies and overlook our own wrong doing.

            Yet there are some situations that are so immoral, that so offend our sense of compassion and justice, that “evil” seems like the only right word to describe them, and if we fail to ever use the word evil, I think we will sometimes underestimate the problem we are facing.

            But how can aspects of a healthcare system be evil?

            Too often, when we think of evil, we think of individual acts of evil and we think of destructive evil. For example, we think of the terrorist attacks of September 11, 2001, or we think of one of many shooting rampages that have made the news in recent years.

            However, I think the worst kinds of evil in human society aren’t the results of individual acts of destructive evil. To do real evil to a large number of people you need a system, and systemic evil can be destructive - - as in war - - but more often, it is what the Unitarian Universalist theologian Henry Nelson Wieman called “obstructive” - - evil that obstructs human beings, either as individuals or as communities from reaching their full potential and living as richly, fully, deeply, and abundantly as is possible for them.

            Slavery was an obstructive evil. Poverty is an obstructive evil. All the isms - - classism, sexism, heterosexism, racism, ableism, and ageism - - are obstructive evils. And for people like Sam and so many others, our current health care system - - which truly kept them from living as richly, fully, deeply, and abundantly as was possible for them - - was an obstructive evil.

            What’s at the root of this evil?

            I went to a town hall meeting in Lakewood on Tuesday night this past week. The meeting was hosted by Congressman Adam Smith, who represents Washington State’s Ninth Congressional District, where many, but not all of us, live.

            There were about 2,500 hundred people at this meeting, including about a dozen people from this church, whom I was very glad to see. The crowd seemed to be about evenly split between those in favor of health care reform and those opposed to it. As one NPR commentator says, the latter’s motto seems to be, “Give me liberty, and give me death.”

            Let me tell you, there is nothing like sitting and listening to some of your fellow citizens speak to make you wonder whether democracy is truly the best form of government.

            There were a few individuals who had well-informed, well-reasoned opposition to the current legislation now before Congress, and I truly appreciated hearing their perspectives. However, for the most part, I have to say that I haven’t heard so much ignorance, so much distortion, so many half-truths and outright lies since, well, the debate over whether the United States should invade Iraq to rid it of its non-existent weapons of mass destruction.

            Stephen Colbert once said, “In order to maintain an untenable position, you have to be actively ignorant,” and there were many very active citizens at Tuesday night’s town hall.

            There were some women sitting in front of me carrying signs in opposition to health care reform, and so I asked them some questions about why they were opposed. I honestly wanted to hear what they had to say.

            I sat and listened to one woman, as calmly and as coolly as I could, resisting that urge within me to reach out and shake her until she promised to stop relying on the Fox News Channel as her sole source of information. What I heard behind her words and the words of so many others who spoke that evening was not so much suspicion of a government-run plan or indifference to those without health care, but fear.

            Though these were not anybody’s exact words, it was as if so many of them were saying, “If we give health insurance to 46 million more Americans, there’s not going to be enough for me and my family, and that makes me afraid.”

            As I was listening to them speak, I couldn’t help thinking of one of the scenes at the end of the movie Titanic. Some people had made it into the lifeboats, and some people were treading water or holding onto debris in the cold ocean water, but the people who had made it into the lifeboats were afraid to let anybody else into their lifeboat out of fear that one more person might sink them all.

            That was the kind of fearful mentality of those opposed to healthcare reform.

            And that fear - - that fear that life in this country is a zero-sum game, so me getting mine might mean you not getting yours - - that fear that there’s not enough room at the welcome table for all of us - - that fear which stands in the way of understanding that in this ever-more interconnected and interdependent world in which we live, we’re all in this together, what helps  my neighbor and his family helps me and my family, and that we truly are one another’s keepers - - that fear has certainly played a role in maintaining certain immoral, evil aspects of a health care system that leads to the unnecessary deaths of 18,000 people a year and the unnecessary suffering of millions more.

            However, my friends, what I want to suggest for your consideration this morning, is that fear is not the root of the immorality and evil present in our current health care system.

            Think about this.

            According to Fortune Magazine, the health insurance/managed care industry was the 24^th most profitable industry in the United States in 2008.[iv] United Health Group, the most profitable of health insurance/managed care corporations made $4.6 billion in 2008.[v]

            As Wendell Potter has said, “A lot of money in this country is made off sick people.”

            But let me stop here and ask how many of you have ever heard of Wendell Potter?

            Well until last year, he was head of Public Relations for Cigna, the fifth biggest health insurance corporation in this country. In other words, he was their Number 1 P.R. flack. For example, he was responsible for trying to discredit Michael Moore’s documentary Sicko in the mainstream media, though he now says the film “hit the nail on the head.” About a year or so ago, however, Potter had an awakening of conscience of sorts began to question the practices of the industry for which he had worked for most of his career.

            He recently testified before congress and has begun speaking out publicly, criticizing the health insurance industry. If you haven’t seen it already, I highly recommend watching Bill Moyer’s interview with Potter on PBS, which is available online.[vi]

            During the interview, Potter speaks about the insurance industry’s efforts to deny as many requests for expensive medical procedures as possible as well as their despicable efforts at something called rescission - - canceling an individual’s policy, even after the person has paid all their premiums on time for years, because of a minor technicality or an unintentional mistake on an application form - - just when that person gets a diagnosis for a disease that will expensive to treat, all in order to increase corporate profits.  

            But most of all, Potter talks about the health insurance industry’s efforts - - his own past efforts during the early 1990s- - to make sure that any kind of health care reform is unsuccessful because any kind of health care reform, especially one that included a public option for health insurance, which would mean additional competition for any health insurance corporation, would affect what the health insurance industry cares about most - - its own profits.

            The CEOS and other executives of health insurance corporations know their own lavish compensation and benefits depends on their corporation’s stock price on Wall Street, which in turn depends on how profitable their companies are, which depends on not only denying as many claims as possible but also making sure there’s no public option to compete with, and if that means 18,000 people die unnecessarily every year and millions of other unnecessarily suffer, well, that seems to be a price they’re willing to pay as a cost of doing business.

            And so Potter says, the health insurance industry is willing to say or do almost anything, including pouring millions of dollars into lobbying and advertising filled with distortions and outright lies to make people afraid and to defeat health care reform.

            Before I asked what is at the root of the evil and immorality present in our current health care system.

            My answer is that at the root of the evil and immorality present in our current health care system are a simple pair of sins - - the sins of greed and lying. The CEOS and other executives of health insurance companies are willing to put their own love of money over the well-being and even the lives of other people, and they are willing to tell any fear-mongering lie necessary to be able to continue to do so.

            Have I overly simplified things? Have I overly simplified the enormously complex issue of health care reform into a black-and-white battle of good against evil, or is it really that simple?           If so, what should our response be, as individuals and as a religious community committed to creating a world that is more compassionate and more just?

            As many of you know, my favorite reading in the hymnal, is the one by the 19^th-century Unitarian minister Edward Everett Hale:

I am only one

But still I am one.

I cannot do everything,

But still I can do something.

And because I cannot do everything

I will not refuse to do the something that I can do.

            Within the next few months, the U.S. Congress will be making a decision on health care reform will affect our own lives, the lives of our children, and the lives of millions of others for decades to come, and so this morning, I would like to ask each of you, each and every one of you to do something to make sure that legislation is passed that will lead to universal health care coverage.

            At the very least, I ask each of you to contact your elected representatives about this legislation. As of now, Representative Smith and Senators Maria Cantwell and Patty Murray are all leaning toward legislation which includes a public option, which I believe is the best politically viable hope for universal coverage. However, that could easily change if they hear from enough people who oppose it, so it’s important they hear from enough people who support it.

            I’m also asking as many of you as possible to write a letter to the editor. I’m going to do this. Will all of them be published? Certainly not, but many will be, and I believe it’s important that we say that we’re tired of the greed and lying of the health insurance industry, that our values of compassion and justice call us to make sure that every person and family in this country has affordable health care, that we’re all in this together, that the forces of fear will not win, and that there is enough room at the welcome table for us all.

            After the service today, we’re also going to have a discussion here in the sanctuary about other actions we might take as individuals or as a congregation, and I hope many of you will join that discussion.

             Do we have any chance of succeeding against opposition that is so powerful, that has defeated efforts at health care reform so many times before?

            Let me finish this morning by telling you about a video I saw recently on YouTube. The video was taken at Kruger National Park in South Africa.

            A herd of water buffalo was approaching a watering hole, but as they did, a pride of lions attacked. Most of the water buffalo escaped, but lions, like all predators, quickly focused their attention on the weakest member of the herd, a young calf standing near the edge of the water.

            The lions surrounded the young calf, for some reason not killing it immediately, but as they did, a crocodile emerged out of the water and begin pulling the calf into the water by its hind legs. The lions then began pulling the calf back toward the land and eventually wrenched the calf away from the jaws of the crocodile.

            Then something even more amazing happened. The other water buffalo realized that one of their young, one of the weakest members of their herd, was being attacked by the hungry predators. Individually, none of the water buffalo could have rescued the calf. Individually, none of them would have been a match for the powerful lions. However, together, the water buffalo moved in a giant huddled mass toward the lions and drove them away from the calf, who was not unscathed but was able to walk away alive.

            In figuring out whether we will succeed or not, I suppose a good question to ask is whether we are as smart as water buffalo!

            When people stand together and move together, we too have the ability to defeat even very powerful enemies.

            My friends, may we have the wisdom to stand and move together.

            So may it be. Amen.

Learning More

·         For a good overview of healthcare reform, visit http://www.sojo.net/healthcare. This overview is created by Sojourners, a politically progressive evangelical Christian organization. Though many Unitarian Universalists may not share the same theology as the creators of this overview, it is, nevertheless, a very good resource.