Over the past year, public discussion about the Affordable Care Act has led many Christians to question the proper roles of government and business in providing healthcare. Too often, though, the question left unexamined is what role the church should have in responding to the medical needs of the community.
Throughout the history of the church, Christians have been actively involved in the provision and funding of health and medical resources. But for the past 50 years, these functions have been treated as political problems reserved for the state rather than matters to be addressed by the church.
Some Christians though, are beginning to reassert this biblically mandated role by participating in health care sharing ministries (HCSM). HCSMs are not insurance companies, but nonprofit religious organizations that help members pay for medical treatments.
As the Alliance of Health Care Sharing Ministries explains, “A health care sharing ministry (HCSM) provides a health care cost sharing arrangement among persons of similar and sincerely held beliefs. HCSMs are not-for-profit religious organizations acting as a clearinghouse for those who have medical expenses and those who desire to share the burden of those medical expenses.”
Although the plans differ in details, their basic premise is to apply Galatians 6:2, “Bear one another’s burdens, and thus fulfill the law of Christ” to medical costs. HCSMs are similar to health insurance programs in that members send a monthly check — a “share” rather than a “premium”– either to the plan administrators or directly to those the plan designates with “needs.” The members also agree to send cards and letters or to pray for those members who are sick or injured.
The plans also require a degree of accountability and impose strict limits on treatment, restrictions that often would be illegal under regulations that apply to conventional insurance programs. Unlike traditional health insurance companies that undertake a contractual transfer of risk in exchange for payment, HCSMs are not guaranteed in any way and are exempt from government regulation.
Because of this, some critics contend that HCSMs are essentially unlicensed health insurers operating without regulation or public accountability. “These plans function just like health insurance, but they operate in a regulatory black hole,” said Mila Kofman, an assistant research professor at Georgetown University’s Health Policy Institute. “There is no accountability, no oversight, and the people who participate have no protection.”
This type of rigid adherence to political thinking poses a stumbling block to the search for biblical-based solutions to social problems. Politically minded Christians, though, present an even greater challenge. Liberal Christians, for instance, tend to believe the primary agent in issues of “social justice” is the state, and that the church’s role is merely to baptize the conscious of government. Conservative Christians, in contrast, often argue the “private sector” (i.e., private corporations) is the responsible agent and that the church’s contribution is merely to provide a “safety net” to catch the poor. Neither side of the spectrum, however, appears to believe that “bearing one another’s burdens” transcends socio-economic lines or is applicable to all Christians in the church. This needs to change.
Healthcare sharing ministries are certainly not the only possible solution for meeting the health needs of believers. And while the plans appear to provide a partial solution, they still require the ability to the individual to fund their “share” of the burden. That’s not always an option for the poor in our midst.
Still, these ministries offer fresh ways of looking at the issue. They also raise important questions about why we do not start with biblical, rather than political, presuppositions when addressing these questions. Hopefully, the recent problems in implementation of the Affordable Care Act and the inability of the private sector to keep costs under control will help lead us to realize that creative solutions are needed. Perhaps in the near future Christians may even realize that healthcare issues are best addressed by the community of believers rather than by political parties.
Access to health care is a basic requirement of a just social order. Physician Donald Condit, drawing on an impressive array of empirical research, skillfully applies the principles of Catholic social teaching to this vital area of concern.