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Filtering by Category: Healthcare

Creeping around the Edges (Mark 5:21-43)

Rev. Derek Penwell's sermon for 7/1/2012

 


 

In the recent debate over healthcare reform one focus of the argument centers on whether the government or the private sector can better provide healthcare service at a manageable cost. Distilled to its essence, the debate seems to me to focus on which bureaucracy is less bureaucratic.

Private insurance providers claim that the free market is more efficient, because competition drives prices down—which, given the metastatic growth in healthcare costs, is a dubious claim at best. Public healthcare advocates say that the profit incentive in private healthcare makes the job of insurance companies center around figuring out how to deny coverage. Whatever your position, though, the main argument revolves around how to get more healthcare for less money.

Our society spends a great deal of time doing cost-benefit analysis. That is to say, we're socialized to ask, “Does the benefit I derive from a thing exceed the cost I lay out?”

I love cherries, for instance. But whereas I will pay $2.99 a pound for them, $4.99 a pound strikes me as unreasonably high.

Advertising is the practice of convincing you that the prices we're charging for toilet brushes are worth the investment. This makes a certain amount of sense in a market based economy. The problem, though, is that we don't just apply cost/benefit analysis to stuff—we also apply it to one another.

John Stuart Mill wrote in the middle of the nineteenth century that ethics is a matter of “maximizing utility.” Maximizing utility means doing that which leads to the greatest happiness.

According to Mill, if I have to make a choice about whether to save one person or to save ten, I make that choice based on the greatest benefit I can achieve by my action. The sacrifice of one person to save ten is good utilitarian math—though it may not necessarily be good Christian math.

But utilitarianism in Western calculations concerns not only thorny ethical dilemmas, but also the investment of energy. Does it make more sense to teach one special needs child to read or ten average kids? We only have so many resources. We need to get the biggest bang for our buck, right? You see the problem.

But it's one thing to have to figure out how to divide up food for six among seven people on a life boat; it's an entirely different thing to apply utilitarian calculations to our everyday social arrangements. Under this kind of cost/benefit analysis, people can be judged to “cost” more than they're “worth.”

How do we deal with the mentally handicapped, with alzheimer's patients, with people in a persistent vegetative state? What do we do with people who've gotten in over their heads with mortgages they can't afford, or who've had to buy groceries with credit cards? What kind of return on our investment can we expect from them? These are tough questions.

We much prefer to deal with the easy ones: should Jr. go to Harvard or Yale? Can we really afford private Zamboni lessons for our sweet little girl? Do we want our child to date the doctor or the lawyer? Does it make more sense to be a Cubs or Yankees fan?

By and large, people want their kids to be voted “most likely to succeed,” not “best body piercing.” That's the way our society operates. The pressure is to move forward and upward—and to associate ourselves with those who do.

If you have any experience on Facebook, you know that one of the moments of pleasure it can bring is when someone you've sent a friend request to responds by accepting you as a Facebook friend. On the other hand, it can be a little unnerving to send out a friend request to somebody, and never have them respond.

You start thinking, “Did he get it? Is he ignoring me? Did I do something to insult him at some point? Does he think his other friends will think less of him if they see I'm also his friend? Am I

goofier than I thought? That can't be right, because I hung out with way cooler people in school than he did?”

It becomes a sort of endless social calculation of worth—who's more important? Who's worth my time? Do other people think I'm not worth their time?

Of course, these endless calculations of worth aren't unique to us. People throughout history have been doing these sorts of things. Even Jesus isn't completely removed from the social pressures of figuring out who's worth his time and energy.

In our Gospel, Jesus has just calmed the storm and exorcised the demons from the Gerasene demoniac. He crosses back over the sea he's just calmed, where he is approached by an important man, a leader of the synagogue named, Jairus. Up to this point in Mark, Jesus is getting a bad reputation for hanging out with the wrong sort of folks. He's paying attention to all the wrong people. Healing lepers and paralytics and the demon possessed.

Back in chapter two he does some leadership recruitment—not at the finest business schools—but at a “tax booth,” where he calls Levi. Then, he adds insult to injury by going to Levi's house to eat with a bunch of “tax collectors and sinners.” People are starting to talk. You have to be a bit more discerning about the company you keep. Jesus is getting a bad reputation.

So, when Jairus prevails upon Jesus to come see about Jairus's sick little girl, everyone’s relieved. Jairus is the kind of ally Jesus is supposed to cultivate. He's head of the Men's Morning Breakfast down at the synagogue, president of the local Lion's club; he's got contacts. He can help Jesus network.

The disciples must have been thinking, “Finally. Now, we're getting somewhere.” Do a favor for this guy, and no telling the kind of political capital Jesus can start building.

On the way to Jairus's house, though, something happens. It shouldn't have been a big thing. Jesus probably should have just kept going. When you've got a big one on the hook like Jairus, you don't

want to lose your concentration, don't want to get distracted. But Jesus stops anyway. Somebody's yanking on his shirttail. “Who touched my clothes?” he wants to know.

The disciples look at each other, their eyebrows knitted. “What do you mean, 'who touched my clothes?' You're in a crowd, for Pete’s sake.”

A woman approaches. She's owns up to grabbing onto his cloak.

If Jesus is going to turn over a new social leaf, quit hanging out with the wrong crowd, this is the perfect time to start. Women weren't supposed to touch men who were not their husbands. Jesus could make a real statement about how he's willing to play ball in the current political environment by giving this woman what-for.

Moreover, not only is she a woman, she's an unclean woman. She has, what the King James called, an issue of blood. She's been bleeding for 12 years, which is a nice way of saying she's had female problems—not just monthly, but daily . . . for 12 years.

A menstruating woman was considered unclean—which is to say, untouchable. She wasn't supposed to touch anyone, let alone a strange man.

Jesus could really signal his willingness to play by the rules by doing the right thing, the thing that would grease the social gears, the thing that would maximize utility, making the largest number of people happy. He could humiliate her, should humiliate her. But he doesn't.

He tells her that her faith has healed her. “So what?” you ask.

The outrage is that he gives tacit approval to the woman's actions. She’s a drain on society. You can’t encourage that kind of behavior. We know how people are, they’ll take advantage of you every time if they think they can get something for free—especially healthcare.

But rather than do the socially and politically expedient thing, Jesus walks the margins again in search of those folks who are creeping around the edges.

Soon, he and Jairus make it to where the sick little girl is. But by the time they get there, she's already died.

Oh well, nice try, Jesus. Thanks for coming. We appreciate you taking the time, but all that's left to us now is to start preparing her body for burial.

Jesus says, “I'd like to see her anyway. She's really only sleeping.”

Mark says that everybody laughed at Jesus for saying this. They've seen dead people before. They know what dead people look like.

Jesus persists, though. As far as Jairus is concerned, Jesus has done all that could be asked of him. Now that she's dead, Jesus will only make himself unclean by going to see her to hold her lifeless hand.

He never learns, this Jesus. What's the public relations upside here? You've got to think about how this stuff is going to play on cable news.

Not Jesus. Ignoring the cost/benefit analysis, Jesus goes to her, takes her hand, and tells her to get up, and together they walked the margins hand in hand.

What I find interesting about these two intertwined stories is the issue of how short-sighted they make Jesus appear on the front end. In both cases, Jesus participates in activity guaranteed to marginalize him in everyone’s eyes. In both cases, he risks the social and political costs of being unclean by touching those who are unclean. A true test of your convictions is what you’re prepared to look like a complete idiot for.

But the great shock of the story, however, is that once Jesus touches them, they are healed, made alive—and not only is Jesus not unclean as a result of the this encounter, neither any longer are they.

In touching these two in an unclean state, Jesus has not only healed them physically, he’s restored them to the social world in which purity is boss. In other words, he’s given them back their lives . . . in more ways than one.

When Jesus walks the margins looking for those who creep around the edges, he redefines the edges, so that the margins are set in the center; and it's the folks who usually occupy the center who risk finding themselves on the margins.

Once again, Jesus turns the world on its head. The last shall be first, and the first shall be last. The one who wants to find life, must first lose it. Love your enemies and pray for those who persecute you. The one who wants to gain the world, must forfeit everything.

But Jesus, that doesn't make sense; it's just not good math. You need to put your money on a winner, get a good return on your investment, ride the middle of the road. And Jesus says, “Life's much more interesting out here with those folks on the edges.”

Ask them. Ask those folks who, because society’s told them repeatedly that they’re not worth the effort, what it means for Jesus to go out of his way to reach out a hand, to risk the bad opinion of those bigwigs who occupy center. Ask them whether somebody finally willing to go looking for them means anything.

Walk the margins with Jesus, go looking for those folks creeping around the edges, and sooner or later your cost/benefit analysis is going to get really goofed up.

I promise you.

-Amen. 

Sermon Podcast: Wanting What You've Got (Matthew 20:1–6)

This sermon begins with Louis C.K. and ends with the promise that "in the reign of God, we’re valuable not based on our production, not based on how much we’re worth.  We’re valuable because, by the grace of God, God says we’re valuable."

Here's the video Rev. Penwell references of Louis C.K.:



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"Wanting What You've Got" by Rev. Derek Penwell

Healthcare and a Prescription for Faithfulness

Luke tells us in chapter six that Jesus went up to a mountain to pray—that he prayed all night to God. That’s a pretty long time to spend in prayer. Must have been important. The very first thing he does as soon as he finishes praying is call all his disciples together and choose twelve from among them to be apostles, that is, those who will be sent out on his behalf. Those twelve are going to be the foundation upon which the church is built once Jesus is gone, which makes it understandable why Jesus would have struggled all night over whom to call. So, when Jesus finally addresses the twelve who’ve been chosen, we expect that he will say something important. His first address to them after he calls them will be the vision speech, the one where he lays out what’s at the heart of the ministry he has in mind, the ministry for which twelve of them have just been called. Luke tells us that while all the disciples are still gathered around him, Jesus begins to clarify the principles of this new endeavor, which are only highlighted by this latest major personnel move. What’s at the center? What does Jesus indicate will animate his ministry, and therefore, the ministry of his followers? What’s the first thing out of his mouth when laying out the grand plan?

“Blessed are you who are poor, for yours is the kingdom of God. Blessed are you who are hungry now, for you will be filled. Blessed are you who weep now, for you will laugh . . . But woe to you who are rich, for you have received your consolation. Woe to you who are full now, for you will be hungry. Woe to you who are laughing now, for you will mourn and weep”(Luke 6:20b-21, 24-25).

Now, I want to say right off that I’m not happy about this. By just about any accounting done on a macro level, I’m pretty sure to be lumped in with the latter rather than the former. When the truth is told, though I sometimes struggle to make ends meet, the ends I have to make meet are quite a bit nicer than most of the rest of the world, and the means with which I have at my disposal to meet those ends would surely evoke envy among all but those in the highest percentiles when it comes to the world’s wealth. So, my ox is being gored too as Jesus trots out the core values for the new business model. Unlike most successful ventures, Jesus has the powerful in his sights as the problem and not the solution.
Taking that into consideration, a story I heard last week about someone I know has gotten me to thinking about the relationship between those with power and those without. A young woman I know who had a baby just over a month ago, in the midst of all the adjustments the family has to make to accommodate a new arrival, received a bill from the insurance company enumerating costs and covered benefits. One of the things that the bill said, much to her surprise (and chagrin), was that the insurance company considered an epidural an elective procedure for a vaginal birth. When I told my wife about the position the insurance company had taken, she said, “Some man made that decision.” Over the next few days, almost everyone to whom I told that story said exactly the same thing. One African-American minister from a church on the West Side to whom I relayed the story said, “This talk about the Public Option taking away choice is funny to people in my congregation.”
“Why?” I said.
“Because the only people who’ve ever had any choice about healthcare is rich people. The only healthcare choice poor people have is which emergency room to take your kid to.”
All of which got me to thinking . . .
Although the healthcare system we have now is excellent in many ways, one of its fatal flaws is that powerful people make decisions for others based not on the best interests of the patient, but on the interests of keeping costs low and profits high. That’s just part of it. The rich making decisions about what the poor ought to do because they’ve committed the unpardonable sin of poverty, white folks making decisions for everyone about nearly everything down to which drinking fountain black folks could use, men making decisions for women about everything down to what women should be able to endure in childbirth are only symptomatic of power arrangements that have been in place for as long as anyone can remember. And the church, of course, has often been a major player in underwriting those power arrangements. What struck me was that from the outset Jesus identified inequitable power arrangements (of which, admittedly, many of us have been the beneficiaries) as the problem. He could have started with any number of things at the beginning of his ministry, but he started out with the poor and the powerless.
Those disciples who are called two thousand years later to share in that same ministry probably ought to take note.