Tag Archives: Hospital

Medical Part Seven

Proposed Solutions
Review
Part One – God is the source of Life, Health and Healing
Part Two – All illness is the result of sin
Part Three – The Church (Christians) is the only group properly equipped to minister God’s healing and deal with the issue of sin. Christians must lead the way.
Part Four – Medical care must be primarily a ministry not a business
Part Five – The hierarchy of responsibility and care must follow this pattern: the individual, the family, friends and community, the Church, and finally Government
Part Six – Medical care and payments for care must be handled at the personal level where responsibility is at its highest and the economic laws of supply and demand are most effective
The Skimmer Version
There really can’t be a skimmer version. Obama care is 17,000 pages long. My proposal is only about 7 pages. It is in outline form. If you don’t want to read the whole thing now, the just read through a few sections and come back to read the others later.
This is not a complete, comprehensive program but I think it establishes a strong base on which we can build. Our current system is heading in the wrong direction. As we continue down this path we move further and further away from God’s ideal. My goal is to get us turned around and headed in the right direction, but we will still have a long way to go. Let’s get started.
The Outline
1. Churches must
1.1. Teach that God is the source of Life, Health and Healing
1.2. Teach personal responsibility to care for our bodies as the temple of God
1.3. Teach Old Testament practices which God promised that if obeyed would rid a nation of disease
1.4. Teach the Body/Spirit relationship and struggle and the need for physical disciplines as part of spiritual growth
1.5. Teach about the problem of sin and the need for righteous living (not just forgiveness)
2. Christian Colleges must
2.1. Train Doctors, Nurses, Medical Practitioners and others medical professionals to be ministers of God’s healing for the whole person
2.2. Train nutritionist and others to be ministers of God’s healing for the whole person
2.3. Teach about the American economic system, and God’s economic system. Teach the need to create an economic system that reinforces the principles taught in the Old and New Testaments.
3. Christian leaders in health care must step up and begin to promote Biblical principles of heath care.
3.1. They must be communicated in articles in medical journals, and health magazines. If they are censored then Christian journalist must aspire to positions of leadership in the magazines, or create new journals. (Reform or Replace)
3.2. They must aspire to leadership in key medical organizations like the AMA. These organizations have gradually become advocates for many of the key problems in our healthcare system and the movement away from Christian values. They must be reformed or replaced. (The same problem exists in key Psychiatric and Psychological organizations).
3.3. They must reverse the trend toward institutionalization of medicine and return the family physician to a position of prominence. One way is to reduce the financial incentive to specialization.
3.4. They must learn to practice Christian medicine/ministry and set an example for others to follow. Christian doctors must bring newly graduated doctors under their wing and teach them Christian medical/ministry.
Note: Many doctors carry large malpractice insurance policies. Much of this litigation would go away if we practiced Christian medical/ministry. Christian medical/ministry attempts to truly love and care for the person as Christ would. Persons sue doctors because they believe that the doctor didn’t care about them to the point of being negligent. Persons don’t sue if they believe the doctor truly cared and did everything they reasonably could. That is not to say that families, that don’t know the doctor well, will not sue. This makes the case for family doctors rather than every family member having their own doctor.
4. Christians in general need to
4.1. Place their faith in God rather than doctors and drugs
4.2. Get a proper perspective on life, health, healing and death. We need to stop seeking immortality through medicine.
4.3. Drugs are not the answer. God did not make most people over 50 with a chemical imbalance to be treated by drugs.
4.4. Take personal responsibility for our health and our life styles
4.5. Live righteously
5. Christians in government need to
5.1. Understand this issue from a Christian world view and begin to apply biblical principles to government policy and teach their colleagues.
5.2. Stand firm against policy which undermine Christian principles, the Church, families, righteous living, or God’s hierarchy of care.
6. Churches, Christian leaders or other Christians
6.1. Need to organize to once again form hospitals or medical clinics that offer services at free or greatly reduced prices.
6.1.1. Christian Colleges could do this as a teaching hospital
6.1.2. The government must support this effort by shielding medical caregiver volunteers at these facilities from liability. It is one thing to volunteer but they cannot subject themselves to being attacked when they are trying to help. To protect those who are serving the poor is a proper Biblical role for government.
6.2. Need to provide supplemental training for health care professionals on how to provide Christian medical ministry. Medical schools currently do not give this training and someone needs to fill the gap.
6.3. Need to train, deploy and financially support Christian Chaplains for service in hospitals, clinic and medical treatment facilities.
7. Specific recommendations for government policies to improve medical care and reduce the costs
7.1. Personal Medical Savings Account
The key element is to have the person receiving the treatment make the payment. This is done best when they have set aside money for medical emergencies. So far the best system has been a tax free medical savings account. The major flaw with this approach is that it favors those who are in a high tax bracket and provides little or no incentive for those who are in the lower tax brackets. It is these poorer persons who are currently unable to pay for their healthcare.
I propose a system that benefits all Americans equally; a matching contribution system. For every dollar saved by an individual the government would match it with a 25 cent contribution.
Note that at its root there is no reason the government should be subsidizing healthcare. Everyone needs healthcare and everyone should pay for their own healthcare. The medical industry is a wealthy industry and does not need government subsidies. In fact, government subsidies drive up the overall cost of healthcare. The only reason I am recommending a subsidy at all is that American people do not have the current mindset that they need to save for their own emergency healthcare and they need an incentive. Matching funds may provide that incentive.
Ideally at some point in the future the government would drop the subsidies and people would continue to save.
7.1.1. The account must belong to the individual. In my current system the money belongs to my company once it is deposited and at the end of the year they get any unused portion.
7.1.2. The account must be allowed to accumulate year after year
7.1.3. Once money is in the account it can only be used for specified medical expenses
Note goods and services which may be purchased using these accounts will be an area of constant debate. Lobbyist will be pressuring the government to include their product or service. There must be constant vigilance to keep these categories narrow.
7.1.4. Individual Medical Savings Accounts monies may not be used to pay for health insurance premiums. Insurance is not health care and there is no reason to indirectly subsidize the insurance industry.
7.1.5. The owner must be issued an account debit card for easy payment of bills. We do not want to complicate the system with paperwork and claim forms
7.1.6. Approved services must be checked automatically at the time of billing transaction
7.1.7. Companies should be required to offered automatic payroll deductions (after taxes) to individual Medical Savings Accounts
7.1.8. Companies should be offered tax incentives to contribute additional matching funds to individual’s medical savings accounts
7.1.9. A maximum total accumulated savings shall be established, probably around $500,000 (this number may be adjusted in the future based on changing healthcare costs).Once an individual’s medical savings account reaches the maximum dollar amount that person is considered self-insured and is no longer eligible for matching contributions to his account. Other options are open to him at this time.
7.1.9.1. He may contribute to a family member’s account with government matching funds
7.1.9.2. He may continue to save to the account on an after tax bases. Any funds beyond maximum dollar amount may be used to pay another person’s medical bills and considered on taxes as a charitable contribution
7.1.10. Upon death the balance remaining in a Medical Savings Account shall be passed on to his beneficiaries as dictated in his will or according to rules of probate. The distribution is limited to contributions to their Medical Savings Accounts. These distributions shall not be subject to any taxes.
7.1.11. The available balance in a person’s Medical Savings Account must be kept private. Unfortunately unscrupulous individuals and institutions will provide unneeded services and procedures and drain an account if they know there are a lot of reserves.
7.1.12. Monies from Medical Savings Accounts may be used to pay for a persons own medical expenses or those of a spouse or dependent child through the age of 25.
7.2. Health Insurance
One of the differences in my proposal compared to our current system is the reduction in the role of health insurance. With the growth of Medical Savings Accounts the need for health insurance should diminish.
7.2.1. As an individual’s Medical Savings Account balances rise he should be able to afford a larger and larger deductible; eventually only carrying catastrophic coverage.
7.2.2. Companies which provide health insurance for their employees must allow the employee to select his own deductible.
7.2.3. Companies must offer “health benefits” which include both a matching contribution to Medical Savings Accounts of at least 25 cents per dollar and health insurance. Each employee must receive the same dollar benefit and decide how much will be spent on insurance and how much will go to matching funds.
7.2.4. Dependent coverage insurance shall cover spouses and dependent children through the age of 25.
7.2.5. When selling individual or group policies, health factors such as weight, blood pressure and age may be considered. Life style issues such as smoking may also be considered. Other factors such as region of the country may also be considered if there is a statically correlation between location and healthcare costs. These are all factors over which the individual has some control. Pre-existing conditions such as cancer, diabetes, or chronic disease may not be considered.
7.3. Hospitals
7.3.1. Hospitals must be non-profit corporations. In order for healthcare to be more of a ministry than a business, at the very least hospitals must be non-profit.
7.4. Pharmaceuticals
7.4.1. If a particular drug is shown to be truly lifesaving (which is seldom the case) the government should be permitted to declare “eminent domain”; compensate the drug company with a fair market value and release the drug for generic production. Drug companies should not be able to withhold lifesaving drugs in order to extract outrageous profits
7.4.2. Persons should be able to purchase drugs from overseas providers in order to obtain the best price.
7.4.3. Maintenance drugs such as inulin, or blood pressure medications should have automatic renewals for a longer period.
7.4.4. Doctors should be encouraged to present non-drug alternatives to their patients. Such as exercising and losing weight rather than blood pressure medication, or let the disease run its course, “you should be over it in 10 days”, rather than prescribing antibiotics. The current mindset is that if you didn’t get a drug prescription then you didn’t get treatment.
7.5. Medical Records
7.5.1. Our medical system should allow for medical records to be easily shared between medical professionals.
Note that this is not the ideal system. The ideal system is a family doctor who you have dealt with for a long period of time and knows you well and knows your medical history and directs your medical care rather than handing off responsibility to specialists who only know you through your medical records.
7.5.2. Medical records should be freely shared with immediate family members. Unless specific directions have been given to not share information. The current legal climate placing “the right to privacy” above all other rights. No one cares for a person more than their family and no one is affected by a medical issue more than the family. The family has a right to know. Our government policies should be strengthening families not dividing them with the government as the gatekeeper between family members.
Note, there is very little basis for a “right to privacy” anywhere in America’s founding documents. The only hint of a right to privacy is that Americans have a right to protect their homes and personal property from invasion by the government. The idea of the government being the guardians of our privacy is totally contrary to the Constitution.
7.5.3. Key facts from medical records should be shared with those who may be impacted by them. This is most notable in the area of life-threatening sexually transmitted diseases such as AIDS. Contract tracing should be mandatory. Informing of a spouse of sexual partner should be mandatory.
7.6. Litigation and Malpractice Insurance
7.6.1. We must revise our current system of legal extortion. This is where a patient and lawyer team up to extort money from an insurance company. They develop a case that just may win if brought before a sympathetic jury. They sue with the intention of settling out of court for a much smaller amount. This is extortion and it is totally contrary to what a justice system should be. The idea of justice does not enter into the negotiation. It is simply a numbers game; a calculation of potential profit or loss and probability. Most insurance companies have a price they will pay rather than take a case to court and lawyers aim for that price.
7.6.2. Any malpractice case should lead to an investigation by the appropriate licensing board. Information gathered during the investigation should be submitted as evidence in the case. All evidence should be public record.
7.6.2.1. Doctors with repeated problems or horrendous offences should lose their licenses to practice. Too many doctors are getting off because the patients are being paid off and the offences never become public record.
7.6.3. No cases should be settled out of court. If the case is good enough to make a suit it is good enough to make a trial.
7.6.3.1. All doctors should be required to face their accuser.
7.6.3.2. All accusers should be required to face the person they are suing.
7.6.4. A cap must be placed a malpractice suits. I will not address how much that should be. Texas instituted a cap and suits dropped significantly as did healthcare costs. The focus should be on compensation for loss.
7.6.5. There should not be any monetary punitive damages. A punishment paid by an insurance company or an institution has no effect. If there is cause for punishment then it should be the suspension of a license or the right to practice a particular procedure. A truly criminal offence should result in jail time. The goal is to prevent future problems.
7.6.6. The amount of malpractice insurance carried by a doctor should not be made available to the public. Any suit brought should be based on the merits of the case and should be brought against a doctor. It should not be based on an insurance company with a lot of money available to pay out.
7.6.7. There is a special issue with Christians and litigation
Jesus teaches that if a man sues you for your coat then give him your shirt also. In 2 Corinthians, Paul teaches that Christians should not be suing each other. At the very least they should be able to judge among themselves what is just without taking the issue before a secular court. These teachings only work well between individuals. Our current system is set up to involve suits between individuals and institutions, companies, or insurance companies. The individuals involved are replaced by lawyers arguing on their behalf.
Let me give you a hypothetical situation. Something went wrong during a medical procedure and the patient ended up being partially disabled. The Christian doctor in charge feels partially responsible for the damage done to his Christian friend. He would like to make amends, but he can’t. Any money he would have had for that purpose has been given to an insurance company for a malpractice policy. His insurance company will not allow him to pay out any money. If the incident should ever go to court then any actions to help the injured man would be judged as an admission of guilt. The insurance company will not pay out any money without a law suit being filed. So in order for the injured man to receive any type of compensation he must sue his Christian brother (an act that is prohibited in scripture). If he does go ahead with the suit then the insurance company will attempt to pay out as little money as possible (this also is contrary to the direction of Jesus, “If a man sues you for your coat give him your shirt also.”). In the end the case between two Christians will be decided in a secular court or before a secular arbitrator (Once again in direct opposition to the teaching of scripture). The cases will likely be argued by lawyers instead of the men involved. Nothing will be accomplished to truly mend an injured relationship; in fact this process will likely make the situation much worse.
Any law or system which allows evil to happen is a bad system, but any law or system which prevents good from happening should not be allowed.
7.6.7.1. My only suggestion for resolving this dilemma is to create a malpractice insurance system similar to the one I am recommending for health insurance; where the doctor can save money in a “discretionary compensation account” and use it as he sees fit. In addition he would carry a malpractice insurance policy with a high deductible.
7.7. Products and services
Auto mechanics are required to give a written estimate before they begin work. In most cases when a person is admitted into a hospital they must sign the equivalent of a blank check. The document typically says that the person agrees to pay any and all costs which are not paid by the insurance company. This needs to change.
7.7.1. Doctors, hospitals, and other medical care givers must give an estimate of costs for procedures, services and drugs before they are administered.
7.7.2. Alternative procedures, services and drugs must be offered.
7.7.3. A discussion of range of reasonable outcomes must be discussed.
My brother, Dave, related a story where his doctor was going to schedule some blood tests to determine what type of infection he had. Dave asked, “What is the difference in treatment?” The doctor said, “The treatments are the same.” So Dave said, “Skip the tests and just treat me.”
7.8. What about people who have not saved their money and do not have insurance?
Christ said you will always have the poor. No matter what we do to encourage people to be responsible for themselves there we be those can’t or won’t. In our current system hospitals emergency rooms are required to treat anyone who comes in with an emergency. I think that is a necessary and compassionate thing to do. The question is who will pay? Right now the options are: sign the person up for Medicare or some other government program, send the person to a government hospital or health clinic, send them to a private charitable clinic, let the hospital absorb the cost by overcharging the paying patients, or try to extract the money from the poor person by turning it over to a collections department and badgering the person for the next 2 years.
Obama care solves this by trying to force them to buy insurance, and fining them if they don’t. I have no confidence that this will work, especially for those who are truly poor. Hitting someone with a fine when they are sick and already unable to pay their bill just seems unrealistic not to mention uncompassionate.
Any way you look at it the paying people will pick of the slack for the non-paying persons. It will either be through higher medical costs or through taxes. That is just the way it is.
The biggest problem here is that our current system does this through companies and institutions. There is no personal contact. The sense of responsibility to pay is diminished. So people who really could pay just decide not to and little can be done about it.
When people receive charity it comes through the government or through institutions. They don’t see it as charity, a gift of compassion; instead they receive it with a sense of entitlement. There is no gratitude. There is no movement towards a life of greater responsibility.
I don’t know how to fully fix this problem. Hospital related medical costs have become so outrageous that no one without insurance is truly expected to pay these bills. A few people will be intimidated into making some payments. Some may raid the kid’s college fund or the retirement account and pay the bill, but most will just blow it off.
7.8.1. The first step is for hospitals to readjust their pricing structure and billing procedures
7.8.1.1. Prices need to reflect what real people can realistically be expected to pay out of pocket or out or a medical savings account.
7.8.1.2. Then they need to approach billing in a way that expects everyone to pay, not just insurance companies and a few suckers.
7.8.1.3. They need to collect their own bills and not be able to sell of the bills to collection agencies.
Note: The shift away from insurance and toward medical savings accounts should already begin to bring prices down to a more realistic level.
7.8.2. Just as the farmer in the Old Testament didn’t harvest the corners of his field but left it for the destitute, doctors and hospitals should designate a portion of their services for the poor.
7.8.3. Individuals who are unable to pay immediately will be able to work out a payment schedule. Doctors and hospitals should extend this credit interest free. No loan should extend more than 6 years (based on the Old Testament system).
7.8.4. Once the prices have dropped to a reasonable level individuals who are unable to pay can appeal to their family, friends, charitable persons in the community and the Church for assistance. (In that order).
7.8.5. Christians should establish networks to connect those in need with individuals who are willing and able to help. They should also provide mentoring connections so people can begin to be trained to take responsibility for themselves.
7.8.6. In all cases these charitable gifts should be given from individual to individual in person whenever possible.
7.8.7. Only as a last resort, should the government give assistance. When the government steps in everyone else steps out.
So this concludes my suggested solutions to our current healthcare system. If you didn’t read the earlier articles then you really should go back and read them. It is not good enough to just throw out solutions. The solutions must be based on solid reasoning. We need to not only focus on the mechanics of medicine we need to always keep in mind why we do medicine.
I would really love to hear your thoughts. Please leave a comment.

Medical Part Six

Personal Responsibility verses Group Responsibility
Skimmer Version—Just the main points for those who won’t take the time to read the full article
• In general individuals will not knowingly harm or take from other individuals.
• Persons easily rationalize harming or taking from groups of people when they are in the form of companies, institutions or the government.
• Persons also rationalize harming or taking from individuals as long as they are acting through a group, company, institution or the government and are detached from the person being harmed.
• A little harm done to a lot of persons or major harm done to one person is still the same amount of harm. The detachment felt by the group makes it easier to rationalize.
• Group responsibility means no responsibility. IF EVERYONE IS RESPONSIBLE, THEN NO ONE IS RESPONSIBLE.
• Our current medical system works through groups rather than individuals, especially in the area of billing. There is waste, overcharging and fraud and no one cares because these actions are taken against groups rather than individuals.

The Full Article
Years ago I was driving and I needed to stop for gas. I pulled into a rather large and busy, self-serve, gas station. In those days you could pump your gas first and then go up to the window to pay. So I filled up my tank and walked up toward the window. There was another customer in front of me. He looked into the attendant’s booth. Then he shaded his eyes with his hand to see in better. He turned around, looked at me with a puzzled expression and said, “There’s no one in there”. Then he walked back to his car. I walked up to the window and sure enough, no one was there. I tried to see in the building but there was no sign of an attendant. I walked a little way down the front of the building to see if the attendant was in another section. People behind me were walking up to the window and then back to their cars and driving away. As I made it in front of the garage section I heard a voice yelling for help. I called back. It was the attendant. He said, he had been robbed and locked in the bathroom, but he was alright. He asked me to find the emergency shut-off switch and shut down the pumps. By this time news of the unattended gas station had made its way to the pump islands. People were no longer coming to the window. They were just filling up their tanks and driving away. I found the switch and shut down the pumps.
My guess is that a hand full of people got to work and told the story about the unattended gas station where they filled up for free. I don’t know if the report of the robbery made in on the news or into the newspaper the next day; but my guess is that the same people who were happy at their good fortune to get free gas were horrified that some low-life would rob a gas station at gun point.
How is it that we can condemn someone for robbery and yet justify our own actions of stealing a tank full of gas? You see one action is violent and directed toward an individual. The other is detached, almost unintentional and directed toward a company. Somehow we have little problem rationalizing negative actions against a group or an institution. It is easy to say “Exxon is this huge company. They make tons of money—huge profits. They won’t miss a tank of gas. That’s not going to hurt them.”
Exxon is a company, but that company is made up of thousands of people. Individuals that have families and responsibilities and bills, just like everyone else. What if Exxon took the losses that they experienced that day and said, “Rather than spreading the loss across the whole company, we will deduct it all from one person’s pay check.” Suddenly that gives it a different perspective. For some reason we think it is OK to hurt a lot of people just a little bit, but it is not OK to hurt one person a lot. Funny, it is the same amount of hurt; just one is distributed and one is concentrated.
What about when it is the other way around? Will a group of people combine their efforts to do major harm to an individual and not feel personally responsible? Of course they can and do. This is the basis of a firing squad. One man can execute another, but when he does, he often feels great guilt and personal responsibility. So the solution is to have a firing squad. In this way the execution will be quicker. We don’t have to watch the person suffer. No one bullet or person killed him. The responsibility is distributed among multiple people. It becomes easier for a person to justify or rationalize their action. “I didn’t kill him. I was just following orders. Someone else convicted him; they are responsible for his death.” I am not against executions or firing squads. I am just using it to illustrate in a dramatic way how we rationalize our individual actions when we act in a group.
By this time you should be asking yourself, “What does this have to do with medicine?” It has a lot to do with our current medical system. Notice that we no longer talk about health care in terms of doctors and patients; it is now the “health care industry” or our “medical system”. In Medical Part Four I talked about how medicine has moved from being a ministry to being a business. It has also moved from individuals dealing with each other to, groups, institutions, and companies dealing with each other and with individuals.
Let me give a few examples.
When dealing with a family physician, the exam is done face to face after you talk to the receptionist, filled out paper, been weighed and vital signs taken. When it is all over the billing is between institutions. The doctor’s billing department contacts the insurance company for payment.
If you belong to an HMO, you go to the office and you may see your doctor or another doctor on the schedule. I had a doctor for about 8 years that I never met. The routine is much the same as seeing a family doctor, but much less personal. You move from line to line and room to room receiving and returning forms until you see the doctor. Once again the billing is handled by institutions and departments.
Hospitals are even worse. Now when you go to a hospital you may be assigned to a team of doctors. So who is really responsible for you? The hospitals have realized that this is a problem. They understand that if everyone is responsible then in reality, no one is responsible. Now they will designate someone on the medical team as the responsible physician. In some cases a hospital will assign a patient advocate. This is an additional person, paid by the hospital, to assist the patient in navigating through all of the complex hospital procedures and personnel. It gives the patient one person that they can deal with and is responsible to see that the patient gets proper care.
The big problem here is:
IF EVERYONE IS RESPONSIBLE, THEN NO ONE IS RESPONSIBLE
If I go to my HMO and see a doctor, then later go back and see another doctor, and he sends me to a specialist, who is responsible for my healthcare? The answer is everyone and no one. If I would die the chances are that my primary care physician would never know. He would only see that I was dropped from his list.
What about billing? If the doctor or hospital over bills, who will hold them accountable? I most likely will not check the bill closely. Even if I do, I have little recourse to have it corrected. Besides what do I care? If I have it corrected then I get no benefit. The insurance company is the one that saves money. That will never trickle down to me.
This concept is so obvious. Everyone knows it and experiences it in their daily lives. Are you more careful when spending your own money or someone else’s money? I think most of us, if we are honest, would say we are more careful when spending our own money.
Normally when I buy my lunch I try to average about $5 a meal. On a rare occasion I go on a business trip. They give me an expense account that may allow me to spend up to $25 per meal. I will feel free to spend it all. Why? Because the money comes from a group, a company, not an individual.
My brother, Dave, related to me a personal experience as to how this plays out in the world of medicine. He was without medical insurance but he did have a medical savings account. A situation came up where he needed to have an MRI. He called the place referred by his doctor. They quoted him a price somewhere around $3000. That seemed rather expensive so he decided to shop around. He called another place and received a price of about $1,200. After calling some more places and he found one that would do it for only $800. That was quite a savings. As he was talking to the receptionist, to book the appointment, he related to her his experience calling various places. He told her that he needed a good price because he didn’t have insurance and would be paying for it out of his medical savings account. Her reaction was “Oh I didn’t know you would be paying for this yourself. In that case it is a different price, only $385, we save a lot by not needing to bill an insurance company.”
There was a price range from $3,000 to $385. How can that be? There are really three factors coming into play here. One of them is what she mentioned, billing an insurance company. Many times insurance companies will delay payments as much as 120 days. That means repeated billings, which cost. They will also negotiate the price based on their own rules. Sometimes companies will borrow money from a bank based on accounts payable resulting in more paper work and interest payments. All of this adds up. With a simple cash payment from an individual all of this goes away.
The second factor is that dealing with an individual allows the market economy to function. Dave shopped around for the best price and they know if they want to get Dave’s business they are going to need to provide reasonably good service at the best price. That is not so with our current medical system. Often the patient gets to decide where he will get the best service base on a doctor’s recommendation. Then the insurance company must pay for it. Sometimes the insurance company will set limits on what they will pay or they will negotiate the price after the fact. A related market factor is supply and demand. People will pay more for a product if they have a lot of money available. Dave had limited funds available; whereas the insurance company has very deep pockets.
The final factor, and I think the most significant, is the aspect of dealing with a company rather than an individual. The woman that Dave was dealing with realized that to charge him even the $800 would create a financial hardship for him and she offered him the $400 price. That doesn’t happen when dealing with insurance companies. Rather they are viewed as cold institutions loaded with money. The game of business come into play. Now it is a strategic contest to see how to move as much money as possible from their company to ours. Individuals and the impact on their lives is no longer a factor.
In order to fix our current medical system we need to move the payment system back to the individual as much as is reasonably possible. Medicine happens with individual doctors and surgeons treating individual patients. The payments for such services should happen in the same way. We will explore some ideas on how to make that happen in next week’s article, Medical Part Seven.

Medical Part Five

Personal Responsibility, Family, Friends and the Church
There is a hierarchy of care in the Bible.
First Level
The first level of responsibility falls on the individual. We are each responsible for our own behavior before God and each other. 2 Thessalonians says that each person is responsible to provide for his own needs.
2 Thessalonians 3:10 (NKJV)
For even when we were with you, we commanded you this: If anyone will not work, neither shall he eat.
Second Level
The second level of responsibility falls to the family. If a person is not able to take care of himself then his family is to step up and assist him. In this way the family unit is strengthened.
1 Timothy 5:8 (NKJV)
But if anyone does not provide for his own, and especially for those of his household, he has denied the faith and is worse than an unbeliever.
Third Level
The third level goes to individuals in the community. Note that I said individuals. Each person has a responsibility before God to pay alms. That is giving to the poor not giving to institutions that give to the poor. God wants us to be personally involved and aware of the needy around us. The book of Ruth is a great example of this system performing at its best. Old Testament Law required that individuals leave a portion of their harvest for the poor.
Leviticus 23:22 (NKJV)
When you reap the harvest of your land, you shall not wholly reap the corners of your field when you reap, nor shall you gather any gleaning from your harvest. You shall leave them for the poor and for the stranger: I am the LORD your God.’”
Old Testament Law also taught that individuals were to freely loan to the poor without charging interest. Giving of alms was an expected common practice of all Jews.
Deuteronomy 15 (NKJV)
7 “If there is among you a poor man of your brethren, within any of the gates in your land which the LORD your God is giving you, you shall not harden your heart nor shut your hand from your poor brother, 8 but you shall open your hand wide to him and willingly lend him sufficient for his need, whatever he needs.
Forth Level
The forth level of care falls quickly behind the third. The forth level is the church. In the Old Testament one reason for the Tithe was so that there would be food in God’s house. Some of that food was for the Levites, but it appears it was also for the needy and for national emergencies.
Malachi 3:10 (NKJV)
10 Bring all the tithes into the storehouse,
That there may be food in My house,
And try Me now in this,”
Says the LORD of hosts,
“If I will not open for you the windows of heaven
And pour out for you such blessing
That there will not be room enough to receive it.
Part of the Tithe was not to be sent to the Temple in Jerusalem, instead it was to be stored locally for the Levite, widow, fatherless and stranger.
Deuteronomy 14:28-29 (NKJV)
28 “At the end of every third year you shall bring out the tithe of your produce of that year and store it up within your gates. 29 And the Levite, because he has no portion nor inheritance with you, and the stranger and the fatherless and the widow who are within your gates, may come and eat and be satisfied, that the LORD your God may bless you in all the work of your hand which you do.
In the New Testament, one of the first issues faced by the early Church was the daily feeding of widows. Overseers were established to make sure the food distribution was equitable (see Acts Chapter 6).
Fifth Level
The fifth level of care comes from the Government. I have searched the scriptures looking for some place where God commanded the king or the Government to feed or take care of the needs of the poor. I was unable to find any (If you have found one I would love to see it). The role of the Government is to provide justice for the poor. The Government is to prevent people from cheating, abusing or taking advantage of the poor. The Government should create an environment where the poor are safe and protected and allowed fair opportunity.
The system that God set up started with the area of greatest care, personal reward and accountability and then work out from there. No one cares about a person more than himself. Next in line would be his immediate family. They have the most to gain or lose regarding an individual in the family. Friends in the community would be next. Then the Church and finally the Government.
Also note that as you move down the hierarchy you move from obligation to charity, mercy and grace. Charity, mercy and grace are attributes of individuals not institutions.
By this time you should be asking, “What does this have to do with healthcare?” Well who cares about your healthcare more than you? No one! You have the most to gain or lose by being healthy. It would follow that you should take the greatest responsibility for your personal healthcare, both in terms of caring for our bodies and paying for medical care. Once a person realizes that their lifestyle is damaging them and they will pay both by poor health and by high personal, out of pocket, medical bills, they become highly motivated to correct their unhealthy lifestyle. Personal responsibility produces better behavior.
The same goes for their family. If a person becomes seriously ill it impacts the whole family. If the family is responsible for the persons health care and expenses they are highly motivated to encourage healthy living. Knowing that you may need your family in a medical emergency forces you to attempt to be on good relations with them. The Biblical structure works to strengthen the family unit.
A person’s friends are also impacted, but not nearly as much as the family. The same could be said of the Church. You will also want to maintain your friendships and your Church relationships because you may need their help in times of need. This strengthens friendships, communities and Churches. All of these work to build up and encourage the individual.
Government has the least personal influence on an individual, it has the least to gain or lose.
Our current medical system is exactly the opposite of God’s design. In our system we don’t take personal responsibility for our health care and our healthcare expenses. Instead we pool our resources through a disinterested third party, insurance companies, hospitals, or the Government. This method leads to the lowest level of accountability. It creates the greatest opportunity for abuse and fraud. Worst of all it undermines personal responsibility, family unity and the position of the Church.
This is a strong statement, but I believe that Satan has been working quietly, behind the seines, for decades within our insurance and healthcare system to get us to this point. His goal is to undermine these three foundational aspects of our society: personal responsibility, family unity and the Church.

Medical Part Three

The Role of the Church in Healthcare

The Skimmer Version—Just the highlights—for those who won’t take the time to read the full article

  • Leading question: “Should the Church be involved in healthcare?”
  • Answer:
    If God is the source of Life, Health and Healing (see Medical Part One) and
    If all illness is the result of sin (see Medical Part Two) and
    If humans are body and spirit, rather than just animated bodies (see Medical Part Two)
    Then the Church is the only group properly equipped to deal with all aspects of human health
  • Historically the Church has been deeply involved in health care by training doctors, nurses and medical missionaries. We have also been responsible for building and running hospitals and medical clinics throughout the world.  It is only recently that the Church has withdrawn from medicine.
  • Warnings:
    The Church providing healthcare must supplement our overall goal of making disciples rather than detract from it.
    The Church must provide health care for the whole person physically and spiritually. We must not provide secular healthcare with a Christian name attached.

The Full Article

Should Churches be involved in health care?

The answer is quite simply—YES. If God is the source of Life, Health and Healing  (Medical Part One), and All illness is the Result of Sin (Medical Part Two), and humans are both body and spirit, then it follows that the Church should be at the center of health care. Not only should the Church be involved; we must be involved. No one else in all the world is equipped to deal with the whole person, body soul and spirit. No one else is equipped to deal with sin and extend forgiveness. No one else is a proper channel for the power of God’s healing. No one else is equipped to train people to be disciples of Christ and to live lives which honor Him, avoid sin and its consequences.

Not only should the Church be involved in health care, we have been, up until recently. Healing has been a part of what God does from way back. We can trace it back at least to the time that Moses fashioned a brazen serpent and placed it on a pole in the wilderness so the Children of Israel could look at it and be healed from poisonous snake bites. Later Jesus referred to that as a symbol of His death on the cross. Now it has become the symbol of the American Medical Association. Throughout the Old Testament prophets of God healed people. Men like Elijah and Elisha. In the New Testament Jesus healed the people before He preached the Gospel. He also showed the need to heal the whole man by calling people to repentance, forgiving their sin and healing their diseases.

Nursing traces back to Florence Nightingale.

The missionary movement of the 1800s often brought medical care and healing, hand in hand with the Gospel; and that trend continues all the way up to the present.

In my area of the San Gabriel Valley in Southern California there are a large number of hospitals. There is the Presbyterian Hospital in Glendora, the Methodist Hospital in Arcadia, Queen of the Valley Hospital, founded by the Catholics, in West Covina. In fact if you look into the founding of the hospitals in the area you will find that nearly all of them were founded by Christian denominations or small groups of Christian Doctors.

It was understood that healing was part of the work of Christ and that the Church should continue to caring on that work. We understood that heath care is a Christian ministry to the community.

There were a number of things that reversed this trend. One is the deterioration of denominations. This happened in two ways. Many, not all, of the large denomination wandered from the truth and became much more liberal in their theology. This led them to deny the power of Christ and turn to secular means to solve community problems. The distinction between Christian medicine and secular medicine was lost. A second way that denominations deteriorated it that key churches cut their ties with the denominations. The denomination was viewed as dragging down the larger churches. The churches would contribute money to the denomination but they saw little benefit. Denominations began to break-up and the hospital and medical clinics went too. Without large amounts of money pooled together through the denomination the hospitals could not function. They were sold off.

Of course there were a number of other factors, businesses moving in to medicine, Doctors looking for new ways to make money, health insurance coming in and driving up the cost of medical services, lawyers deciding that they can make money by targeting doctors and hospitals with malpractice law suits, the development of expensive diagnostic equipment, and pharmaceutical companies developing new high price drug treatments. Everyone recognized the medicine was a growing field, full of new opportunities. The business of greed took over. The Church unknowingly surrendered to business.

Healthcare is primarily a ministry, not a business. Business cannot do something that only the Church is equipped to do. Healthcare will only continue to deteriorate unless the Church provides clear direction and leadership to fix the problem.

A Word of Warning

The Church has only one mandate; “To go into all the world and make disciples”. We are not called to create hospitals or to run medical clinics. That is not the goal of the Church. It is true that the Church being involved in healthcare could lead us away from our primary objective and that must be guarded against. Another danger is that we would provide healthcare according to the popular naturalistic secular model, instead of following a Biblical approach to healthcare. We have been away from the Biblical approach for so long that we need to learn it all over again.

We are called to make disciples. All too often that statement is simplified down to mean “make converts”. A disciple is much more than a convert. A disciple is a fully devoted follower of Christ. A disciple wants to emulate Christ in all he does. He studies God’s word and knows how to apply it to all of life’s issues. If the Church is making true disciples wouldn’t we see it in how Christian doctors do medicine? Wouldn’t we see it in how Christian hospital administrators do their work? Wouldn’t we seek to minister to the whole person rather than just their body? Wouldn’t we deal with the problem of sin? Wouldn’t we demonstrate to the world God’s plan for life, health, and healing?

We, the Church, have become very small in our thinking. God has the answers to all of life’s issues. It is time we learn the answers and apply them to everything we touch. Those areas that we have surrendered we need to retake. Medicine is one of those areas.

Medical Part One

God is the source of Life, Health and Healing

Skimmer Version–Just the main points for those of you who won’t take the time to read the whole article.

• God is the source of Life, Health and Healing. A simple word study of scripture using Biblegateway.com will show this to be true
• We have adopted a naturalistic world view that sees illness and health in terms of physiology and germs.
• Doctors not God have become the go to solution for health problems
• We must adopt a Christian World View that puts God back in the center.
• Future articles on this subject will give a deeper understanding.

The Full Article

I have been sick for the last couple of weeks. It has been a strange illness consisting of a slight fever and extreme fatigue along with a half dozen of other random symptoms. Last week at church people came up to me and asked two questions in this order. “How are you feeling?” To which I respond, “I am doing better, but I am still extremely tired.” Their next question was always, “Have you been to the doctor?”
I find it funny that as Christians we think that doctors heal us. It is clear from scripture that God gives life health and healing. In the Old Testament persons went to the Temple for various medical examinations. In Deuteronomy the Children of Israel are promised that if they follow God’s Law they will not experience any of the diseases that they had in Egypt. In the Gospels people flocked to Jesus to be healed. Later in the Book of Acts sick people lined the streets in hopes that Peter’s shadow would fall on them and they would be healed.
I understand that these were miraculous healings and were given as evidence that Jesus and the Apostles were messengers of God. These types of healings are the exception and should not necessarily be seen as God’s normal way of dealing with us. But still the basic understanding is that God heals. In James the instruction is that if you are ill call for the elders, confess your sins and they will pray for you and you will be healed.
Of course there were doctors in the Bible and there are many subtle references to medicines, oils, balms and other healing agents, but those are all secondary to God.

What has happened to us? It seems that after the advent of germ theory that we have increasingly viewed illness in purely biological terms. That is not the Biblical view. In the Bible illness or health is primarily a spiritual condition with physical manifestations. In a Christian World View  Germs are not the cause of disease, rather germs are part of a complex set of physical mechanism  which affect health. If we were only physical beings then the physiological chemistry would be the whole story. But we are not just physical beings. We are much more. We are body and spirit, or body, soul and spirit. The physical is only one part.

What has happened is that we have taken on a naturalistic world view. We view medicine in terms of body chemistry and we go to doctors to give us a chemical solution. Doctors have replaced God. We don’t expect God to heal. We have no faith that God can or will heal us. I am as guilty as anyone. I make a superficial prayer that God will heal me. I have faith that God can heal me, but I have no expectation that He actually will. I fully expect my illness to run its natural course as if I live in a naturalistic world, without God’s intervention. Isn’t that the way we approach illness. We take a purely naturalistic view point. Illness is the effect of germs or chemical imbalances. If we take the right types of medications they will kill the germs and we will return to normal health. Or we need some other medications to bring our bodies back into normal balance. We place all of our faith in doctors and medicine.
We have turned everything on its head. The process goes like this. We get some small symptoms of an illness. At first we may see if it gets worse, but more often we run to the drug store to try to get an over the counter medication to head off the illness. Maybe if I take some Echinacea, Airborne or some other remedy. If that doesn’t work then we go to the doctor. He/she will prescribe some drugs and usually in a week or two we are back to normal. If it is a more serious illness we go through extensive treatments. If the treatments fail and the doctors are running out of options, then we call for the Church Elders.
When all else fails—PRAY.
Isn’t that the opposite of what we should do? We should begin with prayer. We should have some expectation of healing, supernatural or natural. We should examine ourselves to see it there is some sin in our lives. We should examine our spiritual state to see if there is something out of balance there that is affecting us physically. These are the things that need to be dealt with first in the same way that Jesus said to the paralytic, “Your sins are forgiven you.” Before He said to him, “Rise up and walk.” Of course sometimes it is as simple as the environment and germs. God designed our bodies to heal themselves. Often we just need to let our bodies do what they were designed to do.
I am not suggesting that we stop going to doctors. I am suggesting that we get our perspective straight. No doctor has ever healed anyone, only God heals. We need to turn to God first. We need to acknowledge Him as the giver of life, health and healing. We need to place our faith in Him. We need to acknowledge doctors for what they are, agents of God, who occasionally assist in God’s healing process. I wonder how your doctor would respond if you told him that. We need to stop attributing god like qualities to doctors and medicines. Doctors do not preform wonders. There are no miracle drugs. Miracles are the realm of God and no one else.
What do you think? If Americans really had faith in God would we stop being so worried about our health? If we saw God as the key to our healing would we be so worried about our healthcare system? I think our obsession with health care is a clear indication that we have turned away from God and have placed our faith elsewhere.