Health Insurance for All?

As the Supreme Court of the U. S. hears arguments this week about the constitutionality of the Obama Administration's health care reform legislation, Fareed Zakaria offers up an insightful analysis of the nation's need for comprehensive health care approaches and reform. 

See what you think of his point of view.

Zakaria: Health insurance is for everyone

By Fareed Zakaria, TIME.com

Two years ago, Barack Obama signed into law the most comprehensive reform of American health care since Medicare. Most of its provisions haven’t been implemented yet. But the debate about it rages on at every level. Twenty-six states have filed legal challenges to it. And this month the Supreme Court will hear arguments about its constitutionality.

The centerpiece of the case against Obamacare is the requirement that everyone buy some kind of health insurance or face stiff penalties - the so-called individual mandate. It is a way of moving toward universal coverage without a government-run or single-payer system. It might surprise Americans to learn that another advanced industrial country, one with a totally private health care system, made precisely the same choice nearly 20 years ago: Switzerland. The lessons from Switzerland and other countries can’t resolve the constitutional issues, but they suggest the inevitability of some version of Obamacare.

Switzerland is not your typical European welfare-state society. It is extremely business-friendly and has always gone its own way, shunning the euro and charting its own course on health care. The country ranks higher than the U.S. on the Heritage Foundation’s Index of Economic Freedom.

Twenty years ago, Switzerland had a system very similar to America’s - private insurers, private providers - with very similar problems. People didn’t buy insurance but ended up in emergency rooms, insurers screened out people with pre-existing conditions, and costs were rising fast. The country came to the conclusion that to make health care work, everyone had to buy insurance. So the Swiss passed an individual mandate and reformed their system along lines very similar to Obamacare. The reform law passed by referendum, narrowly.

The result two decades later: quality of care remains very high, everyone has access, and costs have moderated. Switzerland spends 11% of its GDP on health care, compared with 17% in the U.S. Its 8 million people have health care that is not tied to their employers, they can choose among many plans, and they can switch plans every year. Overall satisfaction with the system is high.

When Taiwan - another country with a strong free-market economy - decided to create a new health care system in the mid-1990s, it studied every existing model. It too chose a model of universal access and universal insurance but decided against having several private insurers, as Switzerland and the U.S. do. Instead it created a single insurer, basically a version of Medicare. The result: universal access and high-quality care at stunningly low costs. Taiwan spends only 7% of its GDP on health care.

The most striking aspect of America’s medical system remains how much of an outlier it is in the advanced industrial world. No other nation spends more than 12% of its total economy on health care. We do worse than most other countries on almost every measure of health outcomes: healthy-life expectancy, infant mortality and - crucially - patient satisfaction. Put simply, we have the most expensive, least efficient system of any rich country on the planet. Costs remain high on every level. Recently, the International Federation of Health Plans released a report comparing the prices in various countries of 23 medical services, from a routine checkup to an MRI to a dose of Lipitor. The U.S. had the highest costs in 22 of the 23 cases. An MRI costs $1,080 here; it costs $281 in France....

The Swiss and Taiwanese found that if you’re going to have an insurance model, you need a general one in which everyone is covered. Otherwise, healthy people don’t buy insurance and sick ones get gamed out of it. Catastrophic insurance - covering trauma and serious illnesses - isn’t a solution, because it’s chronically ill patients, just 5% of the total, who account for 50% of American health care costs....

The Obama bill expands access to 30 million Americans. That’s good economics and also the right thing to do. But it does little in the way of controlling costs. Medicare’s costs have stopped rising as fast as in the past. But for broader costs to decline, there is no alternative to having some kind of board that decides what is covered by insurance and what is not - as exists in every other advanced country. This has been demagogued as creating “death panels” when it is really the only sensible way to make the system work.

When listening to the debate about American health care, I find that many of the most fervent critics of government involvement argue almost entirely from abstract theoretical propositions about free markets. One can and should reason from principles. But one must also reason from reality, from facts on the ground. And the fact is that about 20 foreign countries provide health care for their citizens in some way or other. All of them - including free-market havens like Switzerland and Taiwan - have found that they need to use an insurance or government-sponsored model. All of them provide universal health care at much, much lower costs than we do and with better results....

Asking the Right Question. . .

My friend, Dr. John Siburt, serves the Richardson East Church of Christ as its Senior Minister.  John is an extremely bright, creative leader.  He's a person to watch as an important emerging leader for our entire community. 

On Sunday, August 15, John delivered a message entitled "Asking the Right Question."  To listen to his sermon click here.  It's worth your time.

I'd love to hear your reactions.

Education and black men

African American men commenting on education and its importance to all of our communities and our future.

Teach for America provides the platform for this important conversation.

My friend, Rev. Gerald Britt asks the important question of us all, "Are you willing to invest in the education of my children so that they can grow up and compete on an even playing field with your children?" 

Possibly that is the fundamental question. 

What do you think?

You, stand there!

One of the nicer things to happen to me was the recent notification that I had been selected as the 2010 recipient of the Robert O. Cooper Peace and Justice Fellowship at Southern Methodist University.  Frankly, I wouldn't have mentioned it here but for my profound respect for Bob Cooper, our past experiences reaching back well over two decades in the struggle for peace and justice in Dallas and the request of my board chair, Dave Shipley asking me to post my speech. 

Bob Cooper served the Southern Methodist University family for years as one of the university chaplains.  He also led students into deeper understandings of the place of ecumenism and the pursuit of peace and justice in any viable life of faith and authentic spirituality.  I'm tempted to start telling stories here of some of our common experiences, but I will resist! 

Bob Cooper has been a loyal advocate for truth, real community and fairness for his entire career.  I was most honored to receive the fellowship and to present the lecture that follows here.

“You stand there. . .”

The Robert O. Cooper Peace & Justice Fellowship Lecture
Sunday, April 18, 2010
Southern Methodist University

 I have regarded Bob Cooper as one of the most important leaders in our community for a very long time. His unflagging commitment to the work of establishing justice and realizing peace here and beyond have inspired us all  across a generation. 

So, I regard this award as an extremely high honor and I accept it with humility on behalf of all of our neighbors who still long for the realization of justice and the experience of peace in their own lives tonight.

It was suggested that I spend this time talking about my work at Central Dallas Ministries, and I expect I’ll do a bit of that before I’m done.  But I want to broaden, focus and personalize our conversation this evening, if that is possible, to face some discomforting realities about our society, most of our faith communities and the manner in which we “do life” as a people today.

I’ve had the “advantage” of having spent most of my 60 years living in Dallas. This is a city and a state I believe that I know and know well.

I also know the faith community here in Dallas. I first met many of you while serving an embarrassingly short stint as Executive Director of the Greater Dallas Community of Churches back in 1998.

I grew up in Richardson where I attended a very conservative congregation that was part of a fundamentalist denomination, a denomination locked in deep denial about its actually being a denomination.  But, that is a subject we need not unpack tonight.

It is worth noting tonight that I thought and experienced my way out of fundamentalism thanks largely to observations I made and experiences I had relative to issues of justice and peace inside the little church where I grew up.  Mostly my current views on faith and society grew up as a reaction formation to the experience I had in that church.  I grew up in the 1960s and came to realize that inside that little Sunday morning box no word was ever uttered about how our nation was on fire literally or how a senseless war of fire waged halfway around the world stood against our best values and traditions as a people, to say nothing of our faith.  I came to realize that my church was strangely, hauntingly irrelevant and disengaged from the real world.

I know that many, if not most of you, had a much more expansive view of faith relative to those revolutionary years, I’m grateful for that for you. 

Yet, forty years later we find ourselves in Dallas facing some of the very same issues, especially those issues related to peace and justice. If anything, in many ways, we’ve moved backward, especially in regard to economic justice in our society.

As I said, I grew up schooled in a rather repressive brand of fundamentalism which meant that I read the Bible again and again. Now, I soon noticed that the people who attended our little church on Abrams Road were reading the Bible also, but not all of it and not with equal regard for all that it contained. It seemed that our hermeneutic could best be characterized as a "pick and choose" process.  Pick what we understood, or what we were comfortable with or what had always been our patterns and tradition.  Choose those requirements that justified our actions, choices and lifestyles, and leave the rest aside.

For example, I remember particularly that we spent a great deal of time in the Epistle of James.  Evidently written by the brother of Jesus, this short letter addressed Christians in Judea and Jerusalem in some of the earliest communities devoted to following the Messiah.  We were correct in valuing this message, but actually we never really got it because of our methodology and our presuppositions. 

To be sure, in one short section of the letter we found a stated emphasis on the place of “works” versus “faith.”  We used this tension in our debates with our Baptist friends and neighbors, as well as any other group that emphasized grace and faith.  Of course, with this interpretive frame we missed the sort of “works” that James actually had in mind:

"What good is it, my brothers and sisters, if you say you have faith but do not have works? Can faith save you? If a brother or sister is naked and lacks daily food, and one of you says to them, "Go in peace; keep warm and eat your fill," and yet you do not supply their bodily needs, what is the good of that? So faith by itself, if it has no works, is dead."  (James 2:14-17)

What I discovered about the epistle of James is the simple and rather obvious fact that it was an economic justice tract from start to finish.  To set James over against Paul is to misunderstand both thinkers.

For James, suffering is seen as an opportunity to grow (1:2-4):  how often have I heard this rationale among Dallas’ urban poor?  His advice is set against a backdrop of harsh economic injustice that affects the lives of the vast majority of those who first read and/or heard the words of his letter.  The economic system that the poor members of these early Christian communities faced were established, championed and maintained by the wealthy and the powerful.  The result for the poor of the day, the people of the land, was suffering and grave difficulty. 

For James, like Jesus (see Luke 1:53-55), the structural reality and power nexus at work within the reign of God is characterized by a grand reversal of fortune among poor and rich (1:9-12).  The poor should take pride in the high position they occupy in God's scheme of things, while the rich should take pride in their lowly position. Quite a reversal indeed. 

James singles out the affluent, the wealthy as oppressors who create economic systems that produce the suffering that is clearly in mind throughout the letter.  Hear these strong words:

"Come now, you rich people, weep and wail for the miseries that are coming to you. Your riches have rotted, and your clothes are moth-eaten. Your gold and silver have rusted, and their rust will be evidence against you, and it will eat your flesh like fire. You have laid up treasure for the last days. Listen! The wages of the laborers who mowed your fields, which you kept back by fraud, cry out, and the cries of the harvesters have reached the ears of the Lord of hosts. You have lived on the earth in luxury and in pleasure; you have fattened your hearts in a day of slaughter. You have condemned and murdered the righteous one, who does not resist you."  (James 5:1-6)

In my view today, most of our faith communities have been co-opted by our culture of the "consumer, financial industrial complex." 

[To be sure, the military industrial complex is still very much alive and well.  Have you noticed?  We never really review the Department of Defense budget, no matter how large the federal deficit grows; and we always seem to be able to find some enemy to engage in protracted battle that costs billions we could use at home and around the world, not to mention the catastrophic loss of life on both sides of the battle lines and among civilian populations.]

But, the poor seem to be doing worse and worse and their numbers continue to grow, as does the amazing gap between those at the top and those at the bottom of our economy.  It is also interesting that this continuing, worsening trend occurs at a time when the nation’s churches are in decline, but the American Civil Religion seems to be on the ascendency. 

So, indulge me one more text from James, but allow me to broaden its application to the nation and our national response to the poor beyond the comfortable confines of the church.

"My brothers and sisters, do you with your acts of favoritism really believe in our glorious Lord Jesus Christ? For if a person with gold rings and in fine clothes comes into your assembly, and if a poor person in dirty clothes also comes in, and if you take notice of the one wearing the fine clothes and say, 'Have a seat here, please,' while to the one who is poor you say, 'Stand there,' or, 'Sit at my feet,' have you not made distinctions among yourselves, and become judges with evil thoughts? Listen, my beloved brothers and sisters. Has not God chosen the poor in the world to be rich in faith and to be heirs of the kingdom that he has promised to those who love him? But you have dishonored the poor. Is it not the rich who oppress you? Is it not they who drag you into court? Is it not they who blaspheme the excellent name that was invoked over you?"  (James 2:1-7)

 And, it is true, isn't it? 

As a nation and as citizens, over and over again, we say to our neighbors who find themselves trapped in poverty, “You stand there. . .”  While at the same time we honor the rich, the successful from among whom we can identify the very ones responsible for creating and maintaining the systemic injustices that consign the poor and their children to lives of limitation, misery and despair for generations.

"You, stand there!" while your babies cry with hunger.

"You, stand there!" while your schools remain substandard and unlike anything we would allow to continue.

"You, stand there!" while your housing forms a slum due to absentee owners who get rich from your misery.

"You, stand there!" while we trim the housing, health and human services and education budgets annually.

"You, stand there!" in the Emergency Room waiting for hours to see a doctor because you have no health coverage and not access to public benefits.

"You, stand there!" to collect your pay check that reflects a pay scale far below living wage and is attached with no benefits.

"You, stand there!" in the pay day loan line with no banking services you can access, forcing you to pay outrageous interest rates.

"You, stand there!" in the line to get  into the night shelter or stranded outside in the cold, propped up against a back alley wall or curled up in your broke down, old car. 

"You, stand there!" in the soup line or at the food pantry front door because there are not options for you that the community can provide. 

"You, stand there!"  No greeting for a life crafted in God's image, but the only directive you've come to expect from your fellows who control the current rules of the game of life.

"You, stand there!" nameless and problematic.  Like Lazarus, invisible to the rest of us, the ultimate insult.

If you doubt my assessment, consider the findings of a study conducted by that liberal local rag, The Dallas Morning News in an editorial report on life in Texas for the poor and marginalized:

• Every 7 minutes a child is born in poverty.
• 25% of Texas children are born in poverty.
• 49th in the number of working poor (that is, Texas is second in the number of people who work and remain poor).
• $14,700--the average annual income of the poorest 20% of Texas families.
• $203,200--average annual income of the richest 5% of Texas families (13.8 times as high as the poorest 20%).
• 16% of Texans live with hunger or in fear of starvation, just ahead of New Mexico and Mississippi.
• 48th in the nation in state and local government expenditures for public welfare--$808 per capita.
• Second highest Gross Domestic Product in the U. S.
• Number 1 in cancerous emissions into the air and toxic chemicals into the water.
• Ranks 50th in the number of insured people in the nation--5.5 million Texans are not covered by health insurance or 24% of the population (compared to 15.7% for the U. S.).
• 1st in the U. S. in executions since the death penalty was reinstated in 1976.
• 2nd highest incarceration rate.
• 34% of Texas high school students drop out--8th highest in the U. S.
• 49th in verbal SAT scores and 46th in math.
• Texas ranks 41st in per capita spending on students in public schools, compared to 25th in 1999.
• 8th largest GDP in the world--$1.1 trillion in 2006.
• 1st in number of shopping malls in the nation.
• 12th in church or synagogue attendance in the U. S

Here's how the editorial board of the local newspaper summed up their report:

"Hidden among Texas' great abundance--the booming businesses and mega-malls--are statistics that all of us would just as soon ignore. But the state can't afford to forget the faces behind those numbers. . . . No liberal blog or legislator is spinning these numbers. In fact, they aren't even new. They are simply compiled from statistics published by sources including the Texas state comptroller's office, the U. S. Census Bureau and other government agencies. . . . Looking at the statistics, it's almost impossible to comprehend how a state with such a healthy bottom line has crashed to the bottom in so many social areas. How many lives must be ruined before we get the picture?"

So, what do we do? 

I'll offer a few suggestions for your consideration.

First,  we must learn to partner with the poor as we seek change.  The days of neo-colonial, one down, charitable approaches are long gone.  We must move from charity to partnerships with poor folks taking positions as leaders and experts.  We believe that people closest to the problems know and understand most about those problems.  We believe that people can solve their own problems if given the opportunity and resources. 

I've learned a long time ago that people don't need me.  They need equity, justice, equal access and opportunity. 

Second, we must speak the truth we know from our experiences in the community against forces that would blunt our message.  Remember:  the revolution will not be funded, nor will it be popular among the powerful.  The arrival of new decision makers and influencers will create tension, a healthy tension that is long overdue.

Third, we must find partners in our sector and in the communities of distress who “aren’t playin’” and  we must determine to work with and support them.

Fourth, we must recognize that we are in this together and, therefore, we must learn to work across the lines and categories that have been cleverly deployed and used to divide us in the past by those who wield unreasonable power and influence over public and private systems and resources. .

Fifth, we must energize, organize, mobilize and criticize to achieve the change we know will save us all.

Finally, we must commit to hold one another, our community and every public and private institution accountable for performance on these matters of life and decline.

Saying to a poor neighbor, “You, stand there!” is not an option for people seeking justice and peace.

Rather, the time has come for us to say to one another, “Let’s stand together for a just and peaceful society. Let’s sit down together at the table of fellowship and strategy to celebrate our progress and plan our next steps together.”

The sin of Sodom and the New York Times

So now comes Nicholas D. Kristof, columnist for The New York Times, to instruct us all on the values of the Kingdom of God as over against those who often spouted by religious types from pulpits and across electronic media airwaves. 

Tell me what you think.

Learning From the Sin of Sodom
Published: February 27, 2010
Nicholas D. Kristof

For most of the last century, save-the-worlders were primarily Democrats and liberals. In contrast, many Republicans and religious conservatives denounced government aid programs, with Senator Jesse Helms calling them “money down a rat hole.”

Over the last decade, however, that divide has dissolved, in ways that many Americans haven’t noticed or appreciated. Evangelicals have become the new internationalists, pushing successfully for new American programs against AIDS and malaria, and doing superb work on issues from human trafficking in India to mass rape in Congo.

A pop quiz: What’s the largest U.S.-based international relief and development organization?

It’s not Save the Children, and it’s not CARE — both terrific secular organizations. Rather, it’s World Vision, a Seattle-based Christian organization (with strong evangelical roots) whose budget has roughly tripled over the last decade.

World Vision now has 40,000 staff members in nearly 100 countries. That’s more staff members than CARE, Save the Children and the worldwide operations of the United States Agency for International Development — combined.

A growing number of conservative Christians are explicitly and self-critically acknowledging that to be “pro-life” must mean more than opposing abortion. The head of World Vision in the United States, Richard Stearns, begins his fascinating book, “The Hole in Our Gospel,” with an account of a visit a decade ago to Uganda, where he met a 13-year-old AIDS orphan who was raising his younger brothers by himself.

“What sickened me most was this question: where was the Church?” he writes. “Where were the followers of Jesus Christ in the midst of perhaps the greatest humanitarian crisis of our time? Surely the Church should have been caring for these ‘orphans and widows in their distress.’ (James 1:27). Shouldn’t the pulpits across America have flamed with exhortations to rush to the front lines of compassion?

“How have we missed it so tragically, when even rock stars and Hollywood actors seem to understand?”

To read the entire essay and to get to the part about Sodom click here.

Health care reform: a study of one

The current national debate on health care reform stirs up emotions while provoking heated argument even among friends.  Just listen at about any water cooler in offices around town.  Or, bring up the topic during coffee time before Sunday School next week and see what breaks out! 

Most of us enjoy the luxury of debate, hopefully friendly. 

For some individuals and their families the debate is anything but theoretical or abstract.  Think for a moment.  I expect you have a story or know someone with a story that moves quickly toward the harsh realities associated with no easy access to health care when most needed.  Often we hear horror stories about how we'll all be forced to wait for treatement if health care reform passes the Congress.  The fact is, millions wait today thanks to our current system that leaves almost 50 million Americans without access to comprehensive care. 

A few days ago, Dallas Morning News' columnist, Steve Blow reported the tragic story of  Xavier Ramirez.  I'm grateful to Blow for bringing reality into our theoretical arguments.  For me, Xavier's story settles the issue and ends the debate.  We need reform and we need reform now. 

I've published the entire story below.  Take a moment to read it and let me know what you think.

Fort Worth tragedy underscores dire health care situation
January 3, 2010
STEVE BLOW

In all the talk of politics and policy, we sometimes forget why a health-care overhaul is needed in the first place.

But Xavier Ramirez should remind us.

The morning after Christmas, the 17-year-old student's body was found on the running track at his Fort Worth high school.

He had been doing his family's wash at a nearby coin laundry. While the clothing washed, he apparently went for a jog on the track, collapsed and died.

News stories mostly focused on the outpouring of young grief for the well-liked, much-admired young man.

But there's another angle that deserved more attention.

It may be too strong to say that Xavier died from lack of health insurance. But it's certainly why he never got the heart exams he needed.

In the fifth game of his high school football season, near the end of the third quarter, Xavier asked to come out of the game.

Paschal High School coach Matt Cook said that was highly unusual. Xavier was one of the most dedicated, hardworking players on the team.

"He said he had taken a hit in the chest and was having a hard time catching his breath," Cook recalled.

Xavier's heart was racing even when the game ended. A trainer insisted they go to the hospital emergency room to check it out.

Doctors at John Peter Smith Hospital performed a few tests on Xavier. They discharged him that night with instructions to get follow-up cardiac testing.

And that's when Maria Martinez discovered that she had no health insurance on her son.

He had been covered under the state's Children's Health Insurance Program. But Martinez learned that she no longer qualified. Her income was just dollars over the limit.

Martinez works at a company that manufactures plastic bags. When she tried to get Xavier on the insurance there, she was told he couldn't join outside the enrollment period.

It's possible the pre-existing heart condition wouldn't have qualified for coverage anyway.

Martinez worried endlessly about her son's heart. She was desperate to get the tests done.

Xavier, on the other hand, was sure he was healthy. He wanted the medical tests just to clear him for a return to sports.

Trying to satisfy both mother and son, Coach Cook began looking for a solution.

The local children's hospital said it would begin the tests if the family could pay $3,000 in cash up front.

It might as well have been $1 million. Martinez is a single mother. Both Xavier and his older brother worked after-school jobs to support the family.

On the advice of a doctor friend, Cook was helping the family write a letter of appeal for free care at the county hospital.

They were still working on that when Xavier's heart apparently failed as he circled the track.

For those of us blessed with good health and good insurance, it's easy to be cynical about health-care legislation.

The need is more apparent to others. Like the mother who can barely speak through her weeping. And the coach who lost a model student and athlete.

"I'm really upset that he didn't get the care he needed," Cook said.

Xavier's family couldn't come up with $3,000 for the needed tests. But in the wake of his death, friends quickly raised $8,500 for his funeral.

And somehow, for Cook, that makes it even worse.

"It's mind-boggling that we can raise $8,500 to put somebody in the ground, but coming up with $3,000 to save somebody's life ..."

He paused, searching for words.

"I'm sick to my stomach," Cook said.

[For a direct link to Steve Blow's story click here.]

Captured faith

Here's a strong and, some would say I'm sure, controversial word from my friend Dr. Joerg Rieger, professor of theology at Perkins School of Theology at SMU.  After  you read it, let me know what you think.

. . .we need to face the forces that constantly threaten to hold captive our thinking about Christ. Theologies and Christologies that do not dare to confront their assimilation and bondage to empire stand little chance to push through to new versions of liberation (p. 315).

Other truths are still hidden and covered up, especially the question: Who ultimately benefits from the current structures of empire? Why else would so many common people vote for the interests of the wealthiest and most powerful members of society – for instance by endorsing tax cuts for the rich and for limits to the social and ecological accountability of monied interests – and against their own interests, that might better be served by a strong social security net that includes health care for all and a well-funded educational system? (p. 316).

The problem here is not so much an intentional cover-up or a conscious lie (although lies and cover-ups are part of the repertoire). The problem is with the fact that the most basic truth about empire is often invisible, to be found between the lines… The American empire… took shape… in a state of denial that did not allow reflection or debate. (pp. 317 & 318).

Awareness of a powerful alternative reality that cannot be captured by empire inspires fresh action and generates new energy… (Continue in my word: - John 8:31). Why not think about “continuing in [Jesus’] word” in terms of participating in Jesus’ alternative reality, which includes the realities of the kinds of people on the margins with whom he developed

from Joerg Rieger, Christ and Empire:  From Paul to Postcolonial Times (Fortress Press, 2007).

Dramatic rise in elderly seeking food assistance

Found the following report in The Huffington Post.  The trend reported here is one we've noticed in Dallas at our Resource Center.

ALBANY, N.Y. — Older Americans who were raised on stories of the Great Depression and acquired lifelong habits of thrift now find themselves crowding soup kitchens and food pantries in greater numbers for the first time after seeing retirement funds, second jobs and nest eggs wiped out by recession.

"What we see in line is lots of gray hair, lots of walkers," said Marti Forman, CEO of The Cooperative Feeding Program in Fort Lauderdale, Fla.

The help is crucial for many fixed-income seniors, who can't always keep up with rising food prices.

"It's a lifeline. It just means that you can function," said Ronald Shewchuk of Ithaca, N.Y. "Otherwise we would have to sell our house. I don't know what we would do. Go to an old age home."

The number of seniors living alone who seek help from food pantries in the U.S. increased 81 percent to 408,000 in 2008, compared to 225,000 in 2006, according to the U.S. Department of Agriculture. Overall, 4.7 million households used American food pantries in 2008, compared to about 3.7 million in 2006.

"Seniors thought they were OK, but they're not OK," said Virginia Skinner, director of Development at The Association of Arizona Food Banks in Phoenix, citing the downturn in the area's housing market.

Catholic Charities USA, which has 170 agencies across the country helping the needy, issued a 2009 third-quarter report that found a 54 percent increase in requests for food and services from seniors nationwide compared to the same period last year.

Despite the increased need, it can be difficult for some older people to come forward and seek help.

To read more click here.

Hunger: We Must Do More and Better

Editorial: Texas must fight hunger all year

04:00 PM CST on Monday, November 23, 2009

While millions of Texas households prepare to celebrate Thanksgiving with a hearty family meal, millions of their fellow Texans aren't sure when or how they'll get their next meal.

"Texans should be shocked that a state as prosperous as Texas is doing so poorly," says the state's agriculture commissioner, Republican Todd Staples.

According to federal statistics released last week, 16.3 percent of Texas households lack regular access to adequate nutrition or face hunger nightly. The percentage of so-called "food insecure" households in Texas is more than 4 points higher than the national average of 12.2 percent, ranking Texas ahead of only Mississippi. In these households, people regularly skip meals, eat cheaper and less nutritious foods, depend on government aid like food stamps or seek help from food pantries.

The recession can be blamed for only part of Texas' misery; it rated an abysmal 15.2 percent of "food insecure" households a decade ago, when its economy was booming. Now, says Jan Pruitt, executive director of the North Texas Food Bank, member agencies are seeing about 36 percent more new food recipients and distributing 50 percent more food each week.

The food bank readily accepts contributions in food and money all year, but Pruitt says eradicating hunger also requires such comprehensive strategies as making sure the needy, especially those with children, receive food stamps and other assistance.

Texans can confront hunger in small and large ways. A few hopeful signs emerged at a hunger summit in Waco last week. Led by the Texas Hunger Initiative, a coalition of federal, state and local agencies agreed to campaign to make sure Texas schoolchildren don't go hungry during the summer when subsidized breakfasts and lunches are less accessible. Churches, youth organizations and school districts will be asked next month to help get food to the 2.5 million school-age children eligible for summer feeding programs. Likewise, Staples will issue a similar anti-hunger challenge to mayors across Texas.

Hunger has been with us forever and will stay with us until enough people insist that it will not continue. It's good to hear more voices shouting this message.

People don't choose to be hungry, which is why prosperous Texans shouldn't ignore others' suffering when the holiday season ends. It's honorable to volunteer at food banks or to write a check to provide food for the needy, but eventually Texans must come to grips with the reality that this state's dismal record on combating hunger is getting worse.

Fighting Texas hunger

•Donate food and cash to the North Texas Food Bank or its member agencies. For contribution details, go to www.ntfb.org or call (214) 330-1396. Or visit http://www.centraldallasministries.org/ and donate online.

•Urge Texas legislators to support efforts to provide food stamps and other programs to needy families, especially those with children. Only a small portion of eligible recipients in Texas currently participate in food stamp and summer feeding programs. For contact info go to http://www.legis.state.tx.us/

•Contact the Texas Hunger Initiative and ask how you can help. For more information, go to www.baylor.edu/texashunger/ or call 254-710-3704.

What's The Big Story? Find out at dallasnews.com/opinion

My young friends and "health insurance"

On Thursday, October 15, my young friend, David Null appeared before a U. S. House of Representatives committee considering health care reform.  David, Sherry and little Tatum experienced the failure of our current system of caring for one another's health as a people.  I decided to post David's comments in their entirety. 

United States House of Representatives
Committee on Energy and Commerce
Subcommittee on Oversight and Investigations

Testimony of David Null

My name is David Null and my family’s insurance story begins in 1999. My best friend and I finally came to realize what we considered the American dream; we started our own company together. Our baby, Tatum, was now two and my wonderful wife, Sherry, quit her job teaching so we could raise our family at home.

We employed 12 and had group health coverage sponsored by the company. We were doing well, life was good. But like many Americans, 9/11/2001 hit our company hard. Contracts got cancelled, our business plummeted and we were forced to discontinue our group coverage within 6 months. That’s when we had toswitch to the individual policy market. Business was bad but we knew the value of insurance and didn’t want to go without, although sometimes we did. Three times in 5 years we were unable to continue coverage without lapse because of decreased business in the 9/11 aftermath. We’d lose coverage for a few months and then we’d get a good contract and get a new policy.

January of 2005 I found myself shopping for health insurance again. We had been without insurance for about 3 months when our youngest daughter, Hannah, fell in the bathtub and split her chin. A quick trip to the ER for a liquid bandage cost us almost $800. It served as an excellent but costly reminder for the need to be insured. So I began the search for another policy.

Sherry and I spoke at length to an insurance agent at our dining room table. I explained an event in detail to the agent when my mother had become deathly ill suddenly. Her intensive care had cost nearly $200,000. I explained to the gent, “I don’t mind paying for the doctor’s visit for the head cold. We can handle that out of pocket. It’s the big “Oh, no!” like what happened to my mother that I need to protect my family from financially. Something like that could bankrupt us.” The agent told us, “You’re a very savvy shopper and this is the policy for you. By the time you factor our negotiated rates and what the policy pays out, you’ll hardly have to pay anything.” The way he explained it, it sounded like we were getting what we asked for, protection from being bankrupted by the $200,000 example I gave him. Our premiums were affordable at $320 a month, about $100 less than what we paid just before for insurance. I was under the impression my savings were due to not having significant office visit coverage like I asked. We felt relieved to be protected again.

March of 2005, just three months later. We started out for Sea World for Tatum’s first spring break, she was seven. Tatum had been sick to her stomach a little but we left thinking she’d be better the next day. She was a quick healer and always the picture of health. We had been in the hotel only hours when she looked at us with canary yellow eyes. We knew something was very wrong and immediately headed home to see the doctor the next morning. We didn’t realize until we arrived home that Tatum’s condition had deteriorated so much that her peaceful sleep in the truck was actually her slipping into a coma. We rushed her to the hospital and before the sunset that day we were told she would require a liver transplant within days to possibly save her life, if they can keep her alive that long.

Tatum laid in the ICU clinging to life. Her brain swelling from the poisons accumulating that her liver normally removes. The doctors told us she was the sickest kid in the hospital and they struggled constantly just to keep her alive. She had only days at best to live. In the midst of all this, the transplant department administrator came to me and said we needed to talk about insurance and walked me to a council room. As we walked I thought to myself, “Aren’t I glad we picked up that policy when we did. Wonder what he wants to talk about”. We sat down and he proceeded to explain that my insurance had a 25,000 max and Tatum had reached that after the first night. She had no more insurance from this point forward and its hospital policy to collect a $200,000 deposit to proceed. I couldn’t believe this was happening. Could this be true? Surely it’s a mistake because this is the big oh no I was buying protection from. Now my precious child lies just down the hall struggling for her life. Suddenly, not only were we facing the possible death of our child but now the financial death of our family at the same time. How could this be happening to us when we have insurance for this?

Thankfully, the hospital CEO agreed to proceed without any guarantee of payment. Tatum’s life is most important to the hospital and we’re grateful for that humanity. Miraculously, within two days a donor had been located. A loving family, who lost their daughter Angela, graciously donated her liver to Tatum so she could keep living. Tatum received her transplant with probably less than 48 hours to live.

Once Tatum was stabilized, the hospital helped me apply for Medicaid and we were narrowly approved. The coverage was retro active so they covered the entire transplant. Tatum’s bill for the first stay of 21 days approached $600,000 and our so-called hospitalization policy only covered about 1/10th of that cost.

Even with insurance, this left a balance we could never bear to payback, it would have bankrupted us. Our insurance had failed us. We were clearly relieved that Medicaid covered the entire cost. Tatum and our finances both had near death experiences. Although, we didn’t know at the time what going on Medicaid was going to mean to our family. Our daughter had been on total life support for a week and now our finances would be going on life support for the next two years.

Post transplant is also medically expensive. Her blood labs were $4,000- 6,000 a month. Her medicine over $1,000. CT scans and liver biopsies were the norm. The first sign of rejection was cause for 3 days inpatient for IV treatment. Nine months post she developed a complication of the anti-rejection medicine and developed a cancerous like infection. That required 7 weeks in the hospital with IV treatments daily. That treatment caused her to need another monthly IV treatment that was several thousand dollars for each bag. We never knew what the next day would bring but we knew for sure we can’t afford even one day without insurance.

We began to look for insurance that would help cover her post transplant expenses so we could get off Medicaid. We thought Medicaid was there to help people who couldn’t afford insurance or their medical bills. Then I was told by insurance agents to “not waste the time, paper or ink filling out an application with Tatum on it because they won’t even accept it.” We were learning Tatum was blacklisted from individual policies. Getting a corporate sales job for group coverage didn’t seem like an option for me. I’d make too much during the waiting period for company insurance and we’d get dropped by Medicaid, leaving a gap we couldn’t cover. Sherry is a teacher and schools do most their hiring just once a year. Additionally, our family was instructed by the hospital to self quarantine from public for infectious reasons. Teaching is a sure way to bring home a virus that could put Tatum’s life at risk due to high immuno-suppression. We now had no where to turn. We were somehow stuck on Medicaid. Not because we couldn’t afford insurance, we thought we had insurance when this started. It was simply that the insurance industry would not make a policy available to us in the individual market.

So, in order to keep receiving health care for Tatum we had to voluntarily drop our income to near poverty to satisfy Medicaid requirements. The allowed monthly income limit on Medicaid was a shocking $1,613 a month for a family of 4. This barely allowed us to cover our mortgage, most utilities and some food bills. That’s under $20,000 a year. This meant I would frequently have to pass on work because I’d make too much for Medicaid. It was even suggested that we might fair better financially if we got a divorce.

Those were tough times and we found ourselves in the red every month. Many expenses went on credit waiting for a day when we could afford to make the money to pay it back. Interestingly, with Medicaid we never incurred any cost for her healthcare. We’re very lucky; we actually have no debt related directly to medical bills. The high cost of staying on Medicaid is on the backside, trying to survive financially on less than $20K a year. We took on tremendous debt, eliminated our savings and retirement and put our growth on hold trying to survive while she got the healthcare she needed. All because we didn’t get the insurance coverage we specifically asked to have.

After two years Tatum began to reclaim her new normal life. Her immune system and new liver were getting along much better and she was on a bare minimum of immuno-suppression. There were now more good days than bad so her mother could return to teaching, group health coverage and an entirely different insurance experience.

I found it interesting when we transitioned to group coverage; Tatum was accepted with open arms and without question. They wouldn’t give us the individual application and yet on the group application, all we had to do different was check a couple ‘yes’ boxes and write ‘liver transplant’ in a blank. Next thing we knew we had insurance cards in hand. The insurance cost deducted from Sherry’s paycheck is actually reasonable and identical to other co-teachers. Our rates have remained that way for three years now. Under group coverage we’re treated like we don’t have a preexisting. It would appear individual policies and group policies exist in completely different universes.

Her mother and I are thankful Tatum’s physical recovery is quicker than our finances. She’s growing, thriving and giving back. She regularly appears on behalf of Children’s Medical Center, the Southwest Transplant Alliance and is active in supporting her favorite charity, Make-A-Wish. Her life has been a joy and inspiration to many. We’d do it again for her sake. We’re thankful Medicaid was there for us to provide the protection that nobody else would. We’re equally thankful to be off Medicaid.

We do hope our testimony illustrates for you how the Hospitalization and Surgical policy in question here today was obviously worthless at actually protecting anyone from financial disaster with its ridiculously low maximum caps. Through all this, we’ve learned the languages of policies and agents can be confusing. In spite of both being college educated, we didn’t recognize or understand at the time that $25,000 maximum for “Misc Hospital Expenses” meant the total of the medical bill. We thought it literally meant misc hospital expenses. Even today we still find the wording a little counter-intuitive and misleading.

While policy language can be confusing, we asked in very simple terms, for a policy that would protect us from the big “Oh, no!” We ended up with a policy that would do no such thing. We trusted the agent was matching our needs to his product. He was not. His policy was saving us only 25% compared to our last policy but the $25,000 cap was 1/40th the coverage ($1million). No college degree is needed to see that’s not a good deal. Obviously not a policy with the consumer in mind.

While our testimony should be labeled “Grossly Under-insured”, we’ve since learned that even traditional $1 million policies are sometimes no challenge for long-term life threatening illnesses. Maybe 10 years ago it was sufficient. Today it’s very possible that $1 million will still leave you under-insured. They estimate that transplants, nationally, average somewhere in the ¾ million dollar range, plus post transplant expenses. Had we started our experience with a million dollar policy, we’d be close to maxing it out now, if not already. If that ever happens, my wife will be forced to move to another school district with a different insurance
provider or I must give up self-employment and take a corporate job. Only time will tell.

Most importantly, we’ve learned that being under-insured really is the same as being uninsured. They both lead to the same end. Unfortunately, we’ve learned that if your American dream is to be self-employed, the insurance companies can make it your nightmare. Under-insurance certainly impacted our lives. God has carried us through and we trust He will continue to do so, and we’re glad. We’ve certainly learned from this experience and are trying to move on.

It would seem like the story ends here but it’s actually just the beginning for Tatum.

Under-insurance isn’t the biggest tragedy of our story if you ask me. Tatum’s story encompasses another shortcoming of the health care system that you need to do something about so people like Tatum can be truly free. Without health care reform from Capitol Hill there will be more challenges for a grown up Tatum and those like her.

What will continue to sadden Sherry and me is the issue of blacklisting on the individual market, for life. That carries a lot of ramification behind it that most of us never consider. We’re lucky because Sherry’s dream has always been to teach and with that career choice we have access to group coverage. But that’s not every bodies dream. Does this mean Tatum and those like her, will be required to dream of corporate work for group coverage or marry into it. What if they get laid off? Small companies will certainly find reason to not hire her, or her husband, if they find out she’s transplanted because it will torpedo their insurance rates. Will
Tatum and her husband be forced into the Medicaid trap too, not because of finances but because of policy unavailability? Her career options to access affordable health care in the future are tremendously effected simply because the industry has designed it. Is that really fair? Is that American?

Consider this. When Tatum was four, she and her mother went to New York City. Tatum visited Ellis Island and stood transfixed on Lady Liberty, our American symbol of freedom and beacon to the world. Tatum even got herself a Lady Liberty costume. She was told Lady Liberty stands and invites the world to come to the land of opportunity, where anyone can follow their dreams. And yet Tatum, a born and bred American citizen, might not get to share in this dream through no fault of her own. Simply because the insurance industry has developed a system that won’t allow it. Our Tatum has so much potential, but for now, she doesn’t have full access to Lady Liberty’s promise to pursue her dreams. She can’t pursue little girl dreams to be an artist, or have a dress shop, a restaurant or self-employed in any fashion that requires individual coverage.

When she asks me what she should be when she grows up, I can’t tell her the same thing you probably told your kids. Right now I can’t tell her she can be anything she wants and you need to fix that. Do I tell her Lady Liberty does not stand for her too because the insurance industry has made it so with underinsurance and preexistings? Do I tell her the government before her today, a government for the people, by the people, refuses to take the steps to also protect her rights to life, liberty and the pursuit of happiness?

What do we tell her? Tomorrow our family plans to see with our very own eyes our Declaration, Constitution and Bill of Rights. A true privilege and honor as an American. These documents were bought and upheld with the blood of men for all of us. What do we tell about her place in those? What do we tell her?

In closing, while my purpose today is to testify and answer your questions as an American citizen, I also come to pose just one question to the very distinguished committee as a father. Which of you, will commit yourself today to be able to look Tatum in the eyes and tell her, that you will be helping lead the way and you will see to it that when she grows up she’ll have affordable access to adequate healthcare, regardless of her occupation, and that today she too can start pursuing all her American Dreams?

We sincerely pray that God bless you and guide you. And God bless America.
Thank you.

To read a story on David and Tatum's powerfrul testimony click here.
.

Embracing Community Health

Interesting comments from Dr. Oz on health care reform.

Reactions?
.

The Future of Downtown Dallas

>Here's an important note of interest to folks living in Dallas. Why not show up and have a say?

Arguments

To hear a thoughtful sermon by Dr. John Fiedler on the benefits of civil argument and the downside of the uncivil variety, click here and then select "What Are We Arguing About?"

Once you are there you can fast forward to 30:14 to the start of the message.

Very useful resource on impact of health care reform

If you would like to evaluate the impact of Congressional bill, H.R. 3200, America's Affordable Health Choices Act of 2009, on a congressional district-by-district basis click
here.

The imformation that you'll find is amazing!

Here's what I found about U. S. Congressional District 5 represented by Jeb Hensarling (R-TX).

America’s Affordable Health Choices Act would provide significant benefits in the 5th Congressional District of Texas: up to 13,400 small businesses could receive tax credits to provide coverage to their employees; 8,600 seniors would avoid the donut hole in Medicare Part D; 700 families could escape bankruptcy each year due to unaffordable health care costs; health care providers would receive payment for $84 million in uncompensated care each year; and 167,000 uninsured individuals would gain access to high-quality, affordable health insurance.

• Help for small businesses. Under the legislation, small businesses with 25 employees or less and average wages of less than $40,000 qualify for tax credits of up to 50% of the costs of providing health insurance. There are up to 13,400 small businesses in the district that could qualify for these credits.

• Help for seniors with drug costs in the Part D donut hole. Each year, 8,600 seniors in the district hit the donut hole and are forced to pay their full drug costs, despite having Part D drug coverage. The legislation would provide them with immediate relief, cutting brand name drug costs in the donut hole by 50%, and ultimately eliminate the donut hole.

• Health care and financial security. There were 700 health care-related bankruptcies in the district in 2008, caused primarily by the health care costs not covered by insurance. The bill provides health insurance for almost every American and caps annual out-of-pocket costs at $10,000 per year, ensuring that no citizen will have to face financial ruin because of high health care costs.

• Relieving the burden of uncompensated care for hospitals and health care providers. In 2008, health care providers in the district provided $84 million worth of uncompensated care, care that was provided to individuals who lacked insurance coverage and were unable to pay their bills. Under the legislation, these costs of uncompensated care would be virtually eliminated.

• Coverage of the uninsured. There are 188,000 uninsured individuals in the district, 27% of the district. The Congressional Budget Office estimates that nationwide, 97% of all Americans will have insurance coverage when the bill takes effect. If this benchmark is reached in the district, 167,000 people who currently do not have health insurance will receive coverage.

• No deficit spending. The cost of health care reform under the legislation is fully paid for: half through making the Medicare and Medicaid program more efficient and half through a surtax on the income of the wealthiest individuals. This surtax would affect only 1,990 households in the district. The surtax would not affect 99.3% of taxpayers in the district.

Visit the website and check out the impact of this comprehensive plan for health care on your own congressional district. Let us hear your reactions. There is so much misinformation and fear out there. We need more factual analysis.