Friday, December 07, 2007

A Prayer for Health Care

By Dan Beauchamp

It seems to me, as we plunge deeper and deeper into our presidential election season, we never talk about issues with the seriousness they deserve. Instead we talk about haircuts, adultery in the Hamptons, or favorite Bible verses.

Then, after everything is over, we quail in the presence of the most recent winner.

Even when we do talk about important problems, the policy wonks drown us with technical details.

Nothing important ever gets discussed in terms of the deep, invisible questions that need airing.

Take health care reform, for example.

I believe that one of the reasons we constantly drop the ball on health care reform is because we don't see how profoundly this issue challenges our ideas of membership in a democratic community and the meaning of our life together, and, indeed, the meaning of life itself.

Yes, I am saying that I believe that at bottom health care reform is about how we view life---how we view life itself underneath it all and what this means for membership in the body politic.

Ultimately, this is a spiritual question, where 'spiritual' means our views on what we mean by life, life itself, to whom and what we belong, and what it is that we possess and own to dispose of as we choose.

Spiritual writers like the Franciscan Richard Rohr, in his book Adam's Return, boil down the answers to these fundamental questions with the insight that, "Your life is not about you; you are about life."

Rohr is actually giving a spiritual twist to a deeply ecological idea of life and our membership in a biotic realm, an understanding that is at once utterly realistic and spiritual, reflecting the mutuality and interdependence of all of life, human and all else.

To say that we belong to life is to say that "life" is something that we find ourselves in the midst of, in our birth and in our lives together, and in our deaths. Life itself is something that we do not possess or control; life itself possess us.

This is our original blessing.

To say that we belong to life is to reflect a deep ecological reverence for our place in the large and intricately interconnected processes of life. We are mutually connected and mutually dependent on air, water, the earth, and the sun, as well as on the prudence and judgment of those billions of fellow inhabitants of our planet called human beings.

Life itself then, is a gift, an enormous gift. Whether this is a gift from God or the universe I will leave to others to proclaim. The ecological point is the same; we are part of an ecological totality where the greatest sin is that of hubris, the arrogance of self-sufficiency and pride.

Despite our horrific destruction of the processes of life on this planet, I think we are gradually coming to embrace an ecological ethic.

As someone who has written a good deal about community and the idea of advancing our health together I am constantly reminded of how little I have said compared to what could be said, and it strikes me that "Our lives are not about us; we are about life" is utterly the point of our health together, of healthier together, of epidemiology, of sound health policy, and much else.

At the personal level, to remind ourselves that we are about life is to bestow on ourselves a huge gift, and of course that is a funny and upside down way of putting it, because the gift is already ours if only we are willing to receive it.

This is the point made by Wendell Berry in "Health is Membership," in his book of essays, Another Turn of the Crank. Berry argues that health is a communal and ecological concept, referring to our membership and participation in communities, both civic and ecological.

The ecological confession that that we first belong to life only increases individual responsibility.

The discovery decades ago that smoking is a dire threat to our health has led to increased individual responsibility for quitting smoking and for the health of those around us at the same time that it has led to higher tobacco taxes, health warning labels, proscriptions on smoking at work or other public places, and bans on tobacco advertising.

Seeking the common good of highway traffic safety or cleaner air and water only increases our individual responsibility for health and safety in these areas.

We can run, but we can't hide from the task of health care reform. As the Nobel Laureate, Joshua Lederberg says, (of the threat of resurgent epidemics), “there is nowhere in the world from which we are remote and no one from whom we are disconnected.”

But this is true of health care reform also. The confession that our health is about our health together, is about the interdependence of health in all its dimensions, teaches us that we cannot pursue more insurance, or controlling costs, or defending quality as separate goals, because what we do here affects what we do there.

In ecology, in global health, and in health care, everything is connected to everything else.

Who is talking about health care reform in this way?

Not many. Still, plans that contain the elements of the ecological confession of the interdependence of all of life together are plans that make health insurance uniform, that forbid refusing coverage to the sick, that promote health care costs control and that evaluate new health care technology, and that also build upon the success of our existing universal health care program, Medicare, all at the same time.

These are the plans that admit that everything is connected to everything else and our life together must reflect this interdependence.

Most of the Democratic proposals point in the direction of the ecological confession. Whether the Democrats stick to their guns, we shall see.

The Republican candidates promote plans that do little more than stand for their Johnny-One-Note theme of individual responsibility for health, embrace the hubris of "We're on our own" in this world.

Parker Palmer, in To Know as We are Known, says about prayer:

One one side, prayer is our capacity to enter into that vast community of life in which self and other, human and nonhuman, visible and invisible, are intricately intertwined. While my senses discriminate and my mind dissects, my prayer acknowledges and recreates the unity of life. In prayer, I no longer set myself apart from others and the world, manipulating them to suit my needs.

It is this kind of prayer that we need for health care reform, a prayer that our leaders and we ourselves, as citizens, will acknowledge the unity and interconnectedness of life itself.

Dan Beauchamp is a former Washington representative, university professor, health official, and small-town mayor. He is working on a memoir about meeting yourself again, for the first time, again and again. His blog, on politics, spirituality and other matters, can be found at

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