And now for something completely different...

It was the Monty Pythons who in the 1970s made famous the words, "And now for someting completely different..." After the bracing conversation on Toward2015 during the last week, let me bring that something completely different to the table.

A few weeks ago there was an article in The Economist dealing with the catastrophic effect of medical insurance bills on municipalities, and how promises made way back to retirees are coming home to haunt them. Meanwhile, pension and insurance woes are part of the mix that have humbled General Motors and Ford, and they were also major players in the recent transit strike in New York, but they are also in the process of wreaking havoc with Christian ministry.

Last Saturday at our diocesan council meeting in Tennessee we spent the longest time dealing with medical insurance-related issues. Like so many other Christian bodies we are struggling to keep premiums down, while at the same time providing adequate medical coverage to Christian leaders and their families. Smaller congregations are having a particularly hard time, but larger ones are not insulated from these problems. Patterns of insurance that have been standard in Episcopal circles, at least, for decades, are now in the process of being reconsidered, as they are in other traditions and denominations.

Looking on a macro scale, Medicare and Medicaid always seem to have funding problems, while 45-46 million Americans have no coverage whatsoever, while millions more, maybe 20-40 million, have totally inadequate coverage. I say all this even before the bulk of Baby Boomers start to retire, and begin placing untold pressures on an already overloaded and under-funded system.

We were chatting during the break that followed us dealing with insurance-related business at our council meeting, and I was surprised to discover that two of the archest capitalists on the council, men who have been successful in differing businesses, one of them related to insurance, agreeing with me that the system is badly damaged and needs to be re-assessed.

I have made no secret for years of my total disenchantment with our way of funding healthcare in this country, as well as our way of apportioning healthcare services. As a pastor I have walked alongside more people than I care to remember whose lives have been turned upside down by their lack of insurance or inadequate insurance when a crisis has struck. I was never presented with such gut-wrenching anxiety when dealing pastorally with folks covered by the much-maligned National Health Service in Britain, which provides basic coverage for everyone.

Add to this the fact that more and more information about our genetic make-up is being stored on medical databases, and despite all the privacy walls in the world, this is eventually going to fall into the hands of insurers, if some of it hasn't done so already. As the years progress, and as more and more congenital conditions (or potential conditions) can be identified, surmised, and tagged, it will become increasingly difficult for more and more people to get health coverage at anything approaching a reasonable price.

I suspect that in the next few years in the churches we are going to see more and more pastors either going without health coverage, or having to find additional funding or creative alternatives in order to get the healthcare their families need. It is entirely likely that we will see a steady flow of pastors leaving parish ministry because there is no way for them to get healthcare coverage, and we are going to see small dioceses and judicatories like our own here in Tennessee less and less able to cope with the medical pressures that are placed on us -- unless we can reduce the median age and the medical risk levels of our group.

I would go so far as to say that inadequate healthcare could very easily radically hamper the ministry of the People of God, unless we can find constructive way around the present mess that health insurance (and pensions) has become. I came away from our council meeting disturbed by the implications of what I was hearing but feeling helpless to do anything about it.

Rosemary and I have long since bailed out of the church-related system because we get a far better deal from the State, Rosemary's employer. In our case this is what makes it possible for our parish to afford a priest. However, our not being in the diocesan pool means with our very good record when it comes to consuming healthcare resources, doesn't help the Diocese of Tennessee as it seeks to deal with its ballooning problems.

Personally, I have believed for a long time that some kind of single-payer system is the only one that will work in the future, when so much information about what is hidden in our DNA is readily available to those who fund healthcare. I also believe that a single-payer system is probably the only way that healthcare can be provided with the justice that is presently lacking in America's healthcare delivery system. As the Kingdom of God has a strong justice component, we must take that into account in our thinking.

I would hazard that the place for us to begin tackling this issue as Christians is with the theology of healthcare (and tied with it justice and injustice in healthcare delivery), and then to move forward from there to exploring practical ways to ameliorate the intense challenge before our culture. Probably we need also to ask ourselves what we can as a society afford, and what we cannot afford, and then what are the best ways of helping people keep healthy.

So, there's something to chew on over Christmas...