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.
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.
188.8.131.52. He may contribute to a family member’s account with government matching funds
184.108.40.206. 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.
7.3.1. 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.
7.4.1. 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.
220.127.116.11. 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.
18.104.22.168. All doctors should be required to face their accuser.
22.214.171.124. 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.
126.96.36.199. 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
188.8.131.52. Prices need to reflect what real people can realistically be expected to pay out of pocket or out or a medical savings account.
184.108.40.206. Then they need to approach billing in a way that expects everyone to pay, not just insurance companies and a few suckers.
220.127.116.11. 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.