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Health Care
Accesss Resolution, 2003
Mennonite Church USA
Prepared by the Anabaptist Center for Health Care Ethics
The Anabaptist Center for Health
Care Ethics has agreed on behalf of Mennonite Church USA Executive
Board, to facilitate the activities necessary to implement the
following resolutions. For this work, The Anabaptist Center for
Health Care Ethics will represent the collaborative efforts of
the following organizations: Mennonite Health Services, Mennonite
Mutual Aid, Mennonite Central Committee, Mennonite Chaplains
Association, Mennonite Medical Association, and Mennonite Nurses
Association.
Resolved:
1. That Mennonite Church USA
develop a new Resolution on Health Care in the United States,
taking into account the current problems of access to health
care along with the resolutions on record from the former General
Conference Mennonite Church (1992) and the Mennonite Church (1993).
Special instructions: The new resolution will be disseminated
in draft format to Assembly Delegates of record by no later than
July 2004, with the understanding that their feedback will be
received and integrated into a final statement for delegate action
at the 2005 Delegate Assembly.
2. That Mennonite Church USA
authorize the Access Initiative, a project to demonstrate our
commitment, as a community of faith, to universal access to health
care by developing models that focus on helping congregations
deal with problems of access to health care. These models will
incorporate the following principles:
- Access
to health care for all persons (The starting point in this project
will be Anabaptist congregations and the lives they touch.)
- Emphasis
on health promotion and prevention of illness
- An emphasis
on healing and caring rather than focusing only on curing
- Recognition
of our mortality and the limits required by stewardship of scarce
resources
Special
instructions:
The project team will explore the unique resources and talents
of Mennonite health care professionals and provider organizations.
They will collect, organize, and disseminate stories from providers
and church members, work with key stakeholders, and begin engaging
congregations interested in developing an access model in their
communities. A progress report will be provided for delegates
at the 2005 assembly.
The pages
that follow provide additional background, rationale, and vision
for this work.
A Prospectus on Health Care
Access for Atlanta 3003 Assembly Delegates
April 17, 2003
1. Why is access-to-care a high
priority at this time? The US health care system today is a system
nearing chaos.
The problems are numerous:
- Uninsured. Over 40 million
persons, or nearly 20% of all persons under age 65 in our country
do not have health insurance. Disproportionate numbers of these
persons are children and heads of single parent households. A
recent study showed there were 75 million people without health
insurance at some point during the past two years. Many of these
persons find their work in jobs paying a subsistence wage.
- Affordability. Health insurance
costs are exploding! During the past year employers experienced
average cost increases of 15% in their health insurance plans.
Employers, in an effort to manage this financial strain are passing
along more of their costs to employees. Persons who have insurance
are finding that the cost of insurance is increasing by substantial
amounts even as they are subject to ever-greater restrictions
in the services offered under their present coverage.
- Insurance
underwriting.
In order to provide competitive health insurance plans, insurers
are forced to screen new entrants, selecting wherever possible
the populations least likely to require high cost medical care
and excluding known illnesses from coverage for extended periods
of time.
- Consumer
behavior.
As consumers of medical care we must also own our complicity
in the problem. At its core, the crisis in health care involves
our misguided values and beliefs: our obsession with physical
health, our unrealistic expectations of the medical profession,
our fear of death, our faith in unlimited scientific progress,
and our individualism. Our appetite for expensive care and our
assumption that any available technology is ours for the asking
makes the prospect of controlling costs an unreachable dream.
In the interest of finding the best price or the lowest cost
insurance we make choices to support plans that discriminate
against the chronically ill who are most in need of care.
- Challenges
for institutions.
Mennonite health care organizations, senior care, behavioral
health, and disability service providers are trying to operate
in this context. They deal day-to-day with the growing challenges
of the uninsured, the under-insured, and declining reimbursement
from state and federal sources.
- Where
is community?
We place unreasonable expectations on MMA by expecting them to
provide health insurance for high-risk groups and then select
our coverage elsewhere in order to reduce our insurance expenses.
- Stewardship
of health.
We must accept the role that our life styles contribute to the
consumption of medical care. It is safe in our faith community
to speak of the excess costs related to the consumption of alcohol
or the use of tobacco and other drugs. It is also time that we
consider the price we are extracting from the health care system
by our sedentary life style and our dietary habits. We need to
adopt the language of stewardship when we speak of our health
or physical well-being. The God who cares about how we steward
our time, talents and money is also concerned about how we care
for our bodies. How well we care for our bodies has a direct
impact on our cost to the health care system.
2. What
have Anabaptists already said about access to health care?
In 1992 1993 the predecessor
denominations to Mennonite Church USA each adopted a Resolution
on Health Care. (See Exhibit 1 and Exhibit 2.) The resolutions identified four
foundational principles that should undergird a just health care
system. We said, the church is called to respond to this crisis
out of its biblical concern for both healing and social justice.
These concerns are evident in the message of Jesus: "The
Spirit of the Lord is on me, because he has anointed me to preach
the good news to the poor. He has sent me to proclaim freedom
for the prisoners and recovery of sight for the blind, to release
the oppressed, to proclaim the year of the Lord's favor"
(Luke 4:18-19). In response we called for a system that:
- Provides
access to health care for everybody everywhere in the U.S.;
- Places
emphasis on health promotion and prevention of illness;
- Emphasizes
the role of healing and caring rather than focusing only on curing;
- Recognizes
our mortality and the limits required by stewardship of scarce
resources.
We spoke
of our concern because of our belief in the sanctity and dignity
of persons created in God's image. This commitment to justice
calls us to free people from social structures which deny them
that dignity. Our concern for stewardship calls us to use our
limited resources wisely and in the promotion of justice.
We continue to believe all of
these were and are laudable goals and believe the intervening
years require that those resolutions be updated and strengthened.
We further believe that the conditions those resolutions addressed
have worsened since their approval. We confess that we have not
consistently sought the image of justice and responsibility these
aspirations call us to.
3. What do we, as Anabaptists,
have to offer in responding to the present access dilemma? As
Anabaptists, we are called to help shape the vision for a better
and more just health-care system. We should be demonstrating
by our actions that we are working to implement this vision.
We commend the following historical events as a challenge and
an encouragement to energize us to carry forward this agenda.
Civilian Public Service. Mennonite and Brethren Conscientious
Objectors in the Second World War and the Korean conflict were
instrumental in revolutionizing the treatment of the mentally
ill and those in prison. We believe this story demonstrating
the power of a small group of dedicated persons should give us
hope that our voice can carry weight beyond our numbers to foster
yet another social good for our society. As we spoke out for
the voiceless and the weak fifty years ago so should we demonstrate
our care for the voiceless and marginalized today. That history
has demonstrated for us the power of a small group speaking truth
into a larger system. We have lived out our beliefs in history.
By doing so now we will create a new history for our country
and our people.
Health Care Workers and
Organizations. By
the middle of the 19th century Mennonites were already developing
institutions of care for widows, children, and the homeless.
Today we have a large number of Mennonite-affiliated ministries
spread across the country caring for the mentally ill, the frail,
elderly, and those that are developmentally challenged. These
institutions are under stress today because of the pressures
on the health care system. Each such institution has the potential
to become part of the solution to the problem of access to care
as they, being part of the faith community, seek to be faithful
to their charge to minister to all people.
In addition, we have a higher
than average proportion of Mennonites in the caring professions.
These individuals care deeply about their work and believe that
their faith shapes their practice. They too struggle to know
what it means to be faithful in the context of a broken system.
They have important perspectives and resources to share within
the community of faith as we create new ways of caring.
Anabaptist Beliefs. As Anabaptists we understand that following
Jesus means a daily responsibility to practice what we believe.
We believe in justice and self-responsibility because we are
accountable for our actions.
We are a congregational and community
people. We value relationships within our families, our congregations,
and the wider church. We tell our stories of support and care
within the congregation. We tell them for all to hear and by
doing so we challenge all to be supportive of each other and
for the church by their actions. We respect and value the gifts
each person brings within our community.
We believe that being a good
steward of our health is not just seeking treatment for our acute
and chronic illnesses, but attending to our spiritual, mental,
emotional, and physical well- being. We believe in working together
to provide mutual support for each other, and to support community
needs beyond ourselves.
We believe in showing compassion
to those in need in our communities. We will commit ourselves
as a body to identifying with those who are cast aside by the
present system. We will begin by caring for those in our midst
who lack basic medical insurance. We will call our people to
sacrifice their own advantage for the purpose of enabling all
who are connected with the Anabaptist community to access health
care.
4. Organizing a response a proposal
for consideration.
Mennonite Church USA will authorize
and initiate a project to demonstrate our commitment, as a community
of faith, to universal access to health care by developing:
a. A new Resolution on Health
Care in the United States, and b. Models that focus on helping
congregations deal with the problems of access to health care
based on the guiding principles noted above.
We will call on our brothers
and sisters in the Anabaptist community to join in this effort
the Access Initiative.
The Anabaptist Center for Health
Care Ethics will be asked to facilitate the implementation of
this initiative. Sponsors joining in this effort will include
Mennonite Health Services, Mennonite Mutual Aid, Mennonite Central
Committee, Mennonite Chaplains Association, Mennonite Medical
Association, and Mennonite Nurses Association. They will assemble
a panel of church and business leaders who will bring visibility
to this effort as well as offer guidance and energy to the initiative.
They will make resources available for congregational and conference
leaders, including information and workshops on the subject.
Together we will gather with Anabaptists in all fields related
to health care delivery and usage to listen to their stories,
concerns, and suggestions. We will encourage exploration of alternative
systems of medical care delivery. We will seek to be an advocate
for all who are marginalized, and to stimulate congregational
dialogue with this issue. We will ask What does being a person
of faith living in community have to do with access to health
care?
Through the Access Initiative
we will solicit the creativity of many persons who will be able
to offer counsel about the values that should be in operation
for a truly just health care delivery system. Groups identified
include: physicians and other health care professionals, health
care administrators, pharmacists, government, insurers, employers,
attorneys, denominational leaders, and consumers. We will ask
these questions:
- What
will it look like if the household of faith got serious about
providing universal access to health care?
- What
will you be willing to contribute in order to provide universal
access to health care for all Anabaptists and the lives they
touch in a given geographic community?
While the ultimate goal from
our perspective of justice is to include all persons, everywhere
in the United States, the starting point for this project will
focus on interested Anabaptist congregations and their needs.
We will seek to publicize the
failure of justice and stewardship in health care delivery in
our country. We will endeavor to build this consensus first in
the Anabaptist community and will find opportunities to add our
influence to other groups who also seek justice and responsibility
in health care delivery. In so doing, we will become a part of
the grassroots initiative that will be required to bring about
the changes needed in our health care system.
5. Here is a vision for a new
order
We will insist that our committed
church leaders not have their health care insurance jeopardized
because of their health care history or by the financial hardship
that health care insurance has become.
Each congregation will be engaged
in health care advocacy and counsel for their members who desire
it.
Every person will have a home
for health care.
Our potlucks will no longer look
like an invitation to a heart attack.
We will find and publicize ways
to promote the stewardship of health through various means (exercise,
diet, stress reduction, etc.) leading to a greater sense of well-being.
We will promote wellness of the whole person, and create healing
environments which integrate treatment for the body, mind, emotions,
spirit, and soul.
We will tell stories about collaboration
within the congregation for the care of those who are ill or
dying. We will hold these up as examples of the best values of
community.
We will tell stories of heroes
of the faith who renounced health care options with the potential
of prolonging life for the short term in order to find time and
space to build and strengthen relationships during the dying
process.
We will hear of congregations
where members have covenanted to be accountable to each other
in choosing degrees of health care, trying to balance the right
for services with the expense to the community in choices related
to: infertility treatments, obesity options, cosmetic surgeries,
choice of prescriptions, etc.
We will hear of committees and
reference groups within congregations that are available to help
other members navigate the many decisions that must be dealt
with in the closing weeks of life.
We will hear testimonies of those
who have been challenged to live a life of meaning because of
the witness of one who died in Christ.
Exhibit
1
Resolution
on Health Care in the United States, 1993
Mennonite Church, 1993
Preamble
The U.S. health care system is
in crisis. It has become intolerably expensive, yet fails to
provide equitable access to care or achieve a better level of
health. Health care now consumes nearly 14 percent of our Gross
National Product, but more than 37 million people lack health
insurance.
However, the crisis in health
care involves more than politics and money. At its core, the
crisis reflects misguided values and beliefs: our obsession with
physical health, our unrealistic expectations of the medical
profession, our fear of death, our faith in unlimited scientific
progress, our individualism, and the pursuit of unfair profit.
Because of these difficult problems
and a change in national leadership, health care reform is a
priority on the national agenda. This climate has created a new
opportunity for the church to be involved in reforming the system.
The church is called to respond
to this crisis through its biblical concern for both healing
and social justice. The connection between these concerns is
evident in the message of Jesus.
The Spirit of the Lord is on
me, because he has anointed me to preach the good news to the
poor. He has sent me to proclaim freedom for the prisoners and
recovery of sight for the blind, to release the oppressed, to
proclaim the year of the Lord's favor. (Luke 4:18-19)
The concern for justice in health
care arises from our belief in the sanctity and dignity of persons
created in God's image and calls us to free people from social
structures which deny them that dignity. The rising cost of health
care widens the gap between the rich and the poor, between those
who have access to health care and those who do not.
As Mennonite Christians, we affirm
the following vision of a more effective and just health care
system and commit ourselves to specific actions to work toward
its realization.
- We call for a health
care system that
- provides access
to basic health care for everyone, everywhere in the United States. As a social good, basic health care
should be available to all regardless of ability to pay. While
the system cannot provide everyone with all the services they
might want or need, all people should have access to basic preventive,
curative, supportive, and emergency services.
- emphasizes health
promotion and prevention of illness. The health care system should encourage individual
responsibility for a healthy lifestyle and for appropriate use
of the system. It should emphasize health education, wellness
promotion, illness prevention, and primary care.
- places the curing
of individuals in the larger context of healing and caring for
one another. We must
replace our endless pursuit of curing with a broader vision of
healing which stresses the overall well-being of the person and
community. There can be cure without healing and healing without
cure. We must always care, though we cannot always cure.
- recognizes our mortality
and the limits of our financial resources. We must acknowledge death as an inevitable part
of life, and resist the temptation to fight it at all costs.
We must also recognize that financial resources are limited and
that excessive spending on health care reduces our ability to
meet other social needs such as education, housing, and transportation.
- is guided by a national
health care policy which controls cost while emphasizing quality
care. This comprehensive
policy should guide management of the health care system by addressing
issues of finance and administration, access to care, resource
allocation and planning, treatment and technology assessment,
medical education and research, and legal reform.
- As delegates we call on our
congregations, institutions, and members to
- reaffirm our biblical
beliefs about health and illness, life and death, and our hope
in the resurrection through Jesus Christ as the basis from which
we approach health care issues.
- We commit ourselves to completing
advance directives (e.g., living wills and proxies) as an affirmation
of our beliefs about life and death and as a symbol of our commitment
to stewardship and justice.
- We commit ourselves to living
self-controlled lifestyles, especially in the areas of diet,
exercise and stress reduction.
- strengthen the congregation
as a health promoting and heating community.
- We encourage the establishment
of congregational health ministries programs which incorporate
a theology of health promotion and healing as a vital part of
our ministry.
- We will encourage people to
make important health care decisions within the context of their
congregations.
- We will educate ourselves on
issues of healing, personal wellness, advance medical directives,
health care ethics, and health care alternatives.
- recognize with appreciation
the ministry and accountability of health care institutions,
health care professionals, and other caregivers.
- We challenge them to fulfill
their unique mission in a manner consistent with kingdom values
and priorities. We call on them to go beyond professional self-interest
in responding to the health care crisis.
- We call on both our health care
professionals and members to exercise greater restraint and stewardship
in the utilization of health care resources.
- recover a commitment to community
in bearing the cost of health care.
- We call for the utilization
of financial resources, institutions, and people to find new
ways of doing mutual aid in today's health care environment.
We ask the church and Mennonite Mutual Aid to reconsider the
justice of commercial underwriting practices and find alternatives
which embody the biblical ideals of justice and mutual aid.
- We call for the personal and
institutional sacrifices necessary to provide justice in the
health care system. We acknowledge that changing the health care
system will be painful. Those of us who have power, financial
resources, and access to care must be willing to pay more or
do with less so that those without may have access to care.
- share our vision and values
with government and support efforts to develop a comprehensive
national health care policy which sets priorities and brings
justice and order to our chaotic health care system.
The Mennonite Church General
Assembly adopts the "Resolution on Health Care in the United
States" and as delegates call on our congregations and institutions
to give attention to the actions identified in the resolution.
Mennonite Church General Assembly
July 30, 1993
Exhibit
2
A Resolution on Health Care, 1992
General Conference Mennonite Church
Preamble
The American health-care system
is in crisis. The system has become intolerably expensive, and
fails to provide equitable access to care or achieve a better
level of health. The cost of health care is rising much faster
than the rate of inflation, with health care now consuming more
than 11 percent of our Gross National Product. Nevertheless,
fewer and fewer people are being served by the system. Over 34
million people, including 12 million children, lack health insurance
which would provide them with access to care.
However, the crisis in health
care involves more than just politics and money. At its core
it reflects misguided values and beliefs: our obsession with
physical health, our unrealistic expectations of the medical
profession, our fear of death, our faith in unlimited scientific
progress, our individualism and the pursuit of unfair profit.
The church is called to respond
to this crisis out of its biblical concern for both healing and
social justice. These concerns are evident in the message of
Jesus: "The Spirit of the Lord is on me, because he has
anointed me to preach the good news to the poor. He has sent
me to proclaim freedom for the prisoners and recovery of sight
for the blind, to release the oppressed, to proclaim the year
of the Lord's favor" (Luke 4:18-19).
Historically, the healing ministry
of Jesus (Matthew 4:23-25) has been carried forward by the church
in efforts to restore health and wholeness to individuals and
communities. One example of this mission is the founding of hospitals
and medical missions throughout the world.
The concern for justice in health
care arises out of the belief in the sanctity and dignity of
persons created in God's image. This commitment to justice calls
us to free people from social structures which deny them that
dignity. Our concern for stewardship calls us to use our limited
resources wisely and in the promotion of justice.
Thus, as Mennonite Christians,
we are called to help shape the vision for a better and more
just health-care system. We must also actively work to help bring
it about. Therefore, we affirm the following vision of a health-care
system and commit ourselves to specific actions to work toward
its creation.
I. We call for a health-care
system that
- provides access to basic health
care to everyone, everywhere in the United States. As a social,
and not strictly individual good, basic health care should be
available to all regardless of ability to pay. While we cannot
provide everyone with all the services they might want or need,
all people should have access to basic preventive, curative,
supportive and emergency services.
- emphasizes prevention of illness
and health promotion. The health-care system should encourage
individual responsibility for a healthy lifestyle and for appropriate
use of the health-care system. To enable people to be responsible
we should emphasize health education, wellness promotion, illness
prevention and community- based primary care.
- places the curing of individuals
in the larger context of healing and caring for one another.
We need to shift from our endless pursuit of curing to a broader
vision of healing which stresses the overall well-being of the
person and community. There can be cure without healing and healing
without cure. We must always care, though we cannot always cure.
- recognizes our mortality and
the limits of our financial resources. We must acknowledge death
as an inevitable part of life, and resist the temptation to fight
it at all costs. We must also recognize that the financial resources
available for health care are limited and that we cannot continue
to spend without jeopardizing other social needs.
- controls cost and spending while
emphasizing quality care. While the system should continue to
emphasize quality of care, it should control cost and spending
through more simple administration, reduced malpractice litigation,
increased emphasis on primary care and the wise use of technology.
- is guided by a national health-care
policy. This comprehensive policy should guide management of
the health-care system by addressing issues of access to health
care, resource allocation and planning, technology assessment,
medical education and medical research.
II. As congregations, institutions
and members we resolve to
- reaffirm our biblical beliefs
about life and death, and our hope in the resurrection. Questions
about what we want from a health-care system are fundamentally
religious in nature. These foundational beliefs should provide
the basis from which we approach the healthcare system.
- promote the congregation as
a healing community. We must integrate a theology of healing
into our worship, teaching and small group ministries, incorporating
the practice of prayer and anointing for healing in worship services
and implementing congregational health-ministry programs.
- educate ourselves on issues
of healing, personal wellness, advance medical directives, health-care
ethics and health-care alternatives. Through education we can
help congregations become health-promotion communities.
- recognize and affirm the ministry
and accountability of health-care institutions, health-care professionals
and other caregivers. These people and institutions possess valuable
skills, knowledge and abilities. We support, encourage and challenge
them to fulfill their unique mission in a manner consistent with
kingdom values and priorities.
- recover a commitment to community
in bearing the cost of health care. We should utilize our financial
resources, institutions, volunteers and professionals to find
new ways of doing mutual aid in today's healthcare environment.
- become advocates for a health-care
system that includes fairness, accountability and accessibility.
Advocacy is a natural outgrowth of our Christian mission in health
and healing. We should share our vision of a just health-care
system with government and encourage the development of a national
health-care policy that sets priorities and brings justice and
order to our chaotic health-care system.
- call on Mennonite health-related
organizations (Mennonite Health Association, Mennonite Health
Services, Mennonite Nurses Association, Mennonite Medical Association
and Mennonite Mutual Aid) to lead in responding to the health
care crisis. We urge them to develop consultations, statements
and exemplary activities which are needed to move us from dialogue
to action in redefining the church's mission in health and healing
in the '90s.
Health Dialogue Steering Committee:
James Waltner (chair), Carl Good, Lawrence Greaser, Willard Krabill,
Anne Hershberger, James Lapp, Vyron Schmidt, and Gene Yoder.
Adopted by the
General Conference Mennonite Church Delegate Assembly, July 22,1992.
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