A perspective on ACA

The repeal of the ACA has created quite the firestorm, as expected. No matter where you stand on the issue the fact that remains is that there are people, namely poor, venerable, and sick that are the ones that are going to hurt the most from this. As a follower of Jesus, I cannot ignore this question, “But if anyone has the world’s goods and sees (a person) in need, yet closes their heart against them, how does God’s love abide in them?” (I John 3:17).

I am not an expert on healthcare, and I do not claim to have the answer. However, I do think it is important for fellow Christ followers (and others) to do what is right and stand up for those who have critical needs. If you didn’t see this from Jimmy Kimmel, take the time to watch, here.

My daughter is getting a Masters of science in nursing, family nurse practitioner – MSN, FNP at University of Colorado, recently wrote about this. The question was asked,  if you had any suggestions for the amendment to better our healthcare system, what would those be? I have posted her answer below. 

Amendments without repeal is the direction that I think we should be headed. Considering the extensive implementation process that took place with the ACA, just getting the millions of Americans signed up for their new insurance, and then actually putting their insurance to use, the repeal and then initiation of another system will be anything but beneficial to the public. One of the main aspects of the ACA that is under scrutiny is its longterm benefit vs damage in regards to the average American family’s economic sustainability and prosperity. The question whether or not widespread coverage is fiscally responsible and beneficial has long since been answered. It has been demonstrated over and over again that when preventative care is provided to the public at large, national spending on healthcare decreases. The ACA provides expanded coverage and access to preventative services for the vulnerable in our population. Speaking generally, It is the vulnerable that increase overall healthcare costs because before the ACA, they would only access the system through emergency services when expensive interventions were required. When primary and preventative services are provided, expensive tertiary interventions are decreased. This is why, after the reform failed to move forward in congress, we are seeing Republican states that had previously denied medicaid expansion through federal dollars, now looking to access federal funding through the ACA to provide coverage to their more vulnerable citizens. Why? Because when the vulnerable are left uninsured, overall healthcare costs increase. It is advantageous for these states to expand coverage, to decrease overall state spending. 

Personally, I see it beneficial and actually quite necessary to continue to expand Medicaid throughout the nation. We run into a moral and ethical debate as we start to look at the effect of providing preventative services to the public at large and the effect that has on profit. In our country, healthcare is ran as a business, a true capitalist endeavor. The system is compensated for the services provided. In general, the more tertiary, the more expensive, the larger the profit. Therefore, it is impossible to ignore the inherent incentive within the system to keep the demand for tertiary services high. In a capitalist state, demand drives supply, which drives profit, which keeps the system afloat. So it makes sense, if we view the healthcare system as a business, aka as a for-profit entity, there is little benefit to keep people healthy and out of hospitals or in need of extensive procedures. I do not mean to say all the providers that benefit from these services are evil and are only in this for the money, that would be a waste of time to even try to argue, because I do not think that is the case. However, this is not based on individual intent, its just the reality of a business. It is driven by money. This is why I think it is impossible not to consider a completely different view of the healthcare system. When we consider healthcare as a service, there is an assumption that it requires compensation. If we considered healthcare as a necessity that every human needs access to regardless of status, then it starts to look more like a right. And if we consider something a right, why would be build a compensatory mechanism into it? Now, I do not mean that it should free. Because when people pay into something, they take ownership in it. However, if we make people pay per service, we will be building discrimination directly into our system. The rich get care, the poor do not. Simple. And regardless of morality, from an economic perspective, that doesn’t work. So, if we have all citizens pay into a system (based on income), and from that funding provided by the citizens, all humans are able to receive the care needed to maintain health, we would start to see the cost of healthcare as a whole, decline. I think I just described taxes. God forbid. 

Right now, we have one foot in, one foot out. Which, as described above, won’t work. Its like two philosophies crammed into one system. Aka dysfunction and stagnation. A federal system that allows states to opt out (which was allowed by the Court in 2012) defeats the purpose of a national system and chops off its ability to succeed right at the knees (for lack of a better description). So, 2 paragraphs later, what I think we need to do is jump in with two feet. I think we need to commit to a single payer system and let it play out. The reason why that is going to be so difficult is because the thought of more taxes turns people off, for good reason. In our country, we have high taxes directly taken from our paychecks, as well as high out of pocket costs. I am not just talking about healthcare, I am talking about food, travel, mortgages, rent, etc. It is expensive to live in this country, and the more money taken from our paychecks, the harder it is to survive here. Lets take a quick look at Europe. Why does this kind of healthcare system work in Europe? Well, they are taxed at something like 50% (Germany is specifically what I am thinking of). Those taxes cover healthcare, paid maternal/paternal leave (after birth and to care for sick children), more vacation time, higher retirement pensions, more affordable housing, childcare, low-cost higher education, etc. So their out-of-pocket costs are significantly lower than ours. In fact, if you look at the amount of money Europeans are taxed, and the amount of money we spend on those services, we end up paying more. So perhaps yet again, the problem is this one foot in one foot out mentality. High tax for healthcare, does not benefit us in other areas of life that may be currently more pressing for certain members of the population (such as childcare expenses or affordable housing). Perhaps we need to start to consider a more socialist-minded approach to these services if we want to decrease overall spending in this country and ultimately improve the overall health and wellbeing of each citizen. 

Thoughts?

Are you addicted?

I quit facebook 5 years ago, I just quit Instagram last week, and now I am trying to see the value of Twitter, although I enjoy getting my news and Broncos updates in 140. It is an interesting reaction when I tell people that I don’t have these social media accounts any longer. “How are you going to keep up with people?” “What about people seeing your pictures and updates?” I get the feeling there is a mixture of people thinking I will become irrelevant, but also a tinge of admiration that I am actually doing it.

It is fascinating how social media has literally changed the way we relate and made us all voyeurs in each other’s lives, and yet, it is an incredible tool to get your business and interests out there for people to see and become familiar with.

Now, here’s the kicker; the social media is what kept me on my smart phone constantly checking, scrolling, liking, and commenting on all the beautiful pictures and interesting stories from people I really like and love.  And then I wanted to check all of the likes, comments, and interest from people who were viewing and reading my contributions. I discovered that throughout the day I could spend up to 3 hours on my phone!!! It had to stop.

In his book, “Irresistible” Adam Alter describes the power of addictive behaviors that are “crowding out essential pursuits” and diminishing social interaction, primarily in younger generations. It was startling to learn that innovators in the tech world limit the amount of technology in their homes. These are the creators of Twitter, Blogger, etc. Incredibly, Steve Jobs did not allow his own children to have an iPad!

Alter lists the six ingredients for behavioral addiction: compelling goals that are beyond our reach; irresistible and unpredictable positive feedback; a sense of incremental progress and improvement; tasks that become slowly more difficult over time; unresolved tensions that demand resolution; and strong social connections.

While abstinence is almost impossible, there are solutions that we can employ to curb the addiction and make our devices useful, rather than our devices using us. I like the suggestions of a few people that may help you, friends, family, and co-workers limit the time on their device.

  1. Set a time limit for your device use. There are many apps out there that will power your device down after a certain amount of time, or you can set it to power down in the evening.
  2. Create device free time. The worst thing is to see people on their phones when they are dining, shopping, or riding the bus. Try conversation, reading, or actually talking to a human. Remember when we would do that on elevators?
  3. Read this

So, are you addicted?

Going Viral

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As I am continually asking the question: “What is the Church in our context?” I believe one important distinction is that the Church is a movement (bottom up, dynamic) rather than an institution (top down, static). However, it feels like the vast majority of churches operate as an institution. This, I believe, limits the church’s calling to be missional  as well as transformational.

Bobby Clinton, (Making of a Leader) has studied various movements from religious to secular. He concludes that movements have similar characteristics no matter their type. There are commonalities that exist whether the movements surround an ideology or a ministry.

There are five common commitments made on the part of those involved in a movement. Clinton defines a movement as a “groundswell of people committed to a person or ideals and characterized by the following important commitments.”

1) Commitment to Personal Involvement

2) Commitment to Persuade Others to Join

3) Commitment to the Beliefs and Ideals of the Movement

4) Commitment to Participate In a Non-Bureaucratic, Cell-Group Organization

5) Commitment to Endure Opposition and Misunderstanding

I believe these commitments create the right kind of tension and subversiveness that the church has commissioned to do.

What is Church?

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Recently, a colleague asked me, “what is church in your context?” I was a bit perplexed by his question, however it has led me on a bit of a soul search to answer that question. I have been working in a church for almost two decades. The church is embedded in a neighborhood, and we have continually worked to understand the changing dynamics that happens in a city that is gentrifying rapidly.

Sociologists have, what I believe, accurately assessed that churches offer models of reality and models for reality. I would agree that churches reflect all of the problems of their surrounding society because they share its people and deal with its dominant cultural values. This makes sense as we are forever trying to understand how to disciple people in their natural environment. This is a dilemma in a work based culture.

A sense of community requires how those attend interact with one another, and what does the greater community think about the church. I will argue that the hope of every neighborhood church would be that the local community would feel a loss if the church would move or close.

I believe it is important that those who lead these neighborhood churches are skilled at fostering community with those who align with the mission of the church and with those who may not agree or are indifferent.

In an era when we train pastors in methods of leadership, in how to deliver effective sermons, and so forth, we must not forget how simple conversations that express empathy, supportiveness, courtesy, and compassion affect those who call the church their home, and those who are on the periphery.

 

Exposed

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Vulnerability is our most accurate measurement of courage.” – Brene Brown

Being vulnerable is not a natural posture for any of us. The nature of vulnerability means that one is exposed, naked, unprotected from powers that can hurt and harm. As a city person, I feel so vulnerable when I am out on a hike wondering what beast is going to charge out of the forest and attack. I don’t like that feeling. Perhaps what’s worse is when I become vulnerable to another person, admitting my mistake, or failure. To be in a place of weakness and at the mercy of another is never a place any of us would choose.

And yet, as Brene Brown beautifully points out, vulnerability takes courage. It is in those moments of vulnerability where we learn what we are made of, where we are weak, and maybe a measurement of how much we value relationships. I think it was Freud who said, love makes us vulnerable. To love another requires vulnerability. To honor another requires vulnerability. To confess makes us vulnerable.

It is counter-intuitive to say being vulnerable is powerful. It is more acceptable to say, “keep a stiff upper lip,” or “don’t let anyone see you sweat.” To be vulnerable would appear to be the way of weakness. Not so. The way to love, strength, and peace is to be vulnerable. Perhaps the words of Christ paint a picture of what vulnerability looks like:

“I give you a new commandment, that you love one another. Just as I have loved you, you also should love one another. By this everyone will know that you are my disciples, if you have love for one another.” – John 13:34-35

Spiritual leader or guru?

Often, I get a bit angsty trying to understand my role in the church. I understand that my office is pastor, but I feel more often like a missionary to the city and neighborhood our church is part of. That being said, there are certain requirements with the office of pastor and one of those is spiritual leader. That does not mean guru, “know it all,” or resident authority on the lives of those who ask me a question about their spiritual life. It does mean taking responsibility and caring for people who identity as part of our church community.

From his Book, Practicing Greatness, Reggie McNeal points out some key disciplines that all spiritual leaders must develop, I have highlighted them here:

  1. The discipline of self-awareness – this protects leaders from being self-absorbed or merely role driven.

“The difficulty with which some spiritual leaders acknowledge their ambition to seek greatness betrays its motivation.” ~ Reggie McNeal (Practicing Greatness)

  1. The discipline of self-management – acknowledges that great leaders are great managers, not just of others, but, primarily of themselves. Failure to manage yourself leaves a leader vulnerable.
  1. The discipline of self-development – never stop growing. Leaders choose to not only grow through strength but also through failure.
  1. The discipline of mission – Leaders give themselves to great causes. They order their lives focused on their mission rather than allowing others to hijack their agendas or distracting them.
  1. The discipline of decision making – Great leaders consistently make good decisions, knowing how, when and what decisions need to be made.
  1. The discipline of belonging – Great leaders practice community but also make a conscious decision to belong to others. They belong despite the risk, b/c they know that to quit risking is to quit loving and that to quit loving is to quit leading in the spiritual arena.
  1. The discipline of aloneness – great leaders not only endure loneliness of leadership but to actually build solitude into their lives. They appreciate the depth of soul making that is possible only in solitude and heart to heart exchanges with their Leader.

These are challenging and incredibly rewarding. I believe all of them are necessary and yet, I certainly have some work to do. If you are leading a faith community make this book part of your library.

Church and Workspace

Theology and culture

We are a few weeks away from opening our work space to the public. This is a unique way to be a church in an urban setting, so…what is the difference between Church and a Collaborative Work Space?

Church: There is a faith community that meets every Sunday in the venue and we serve as the energetic core of the Work Space. This community is committed to living beyond Sunday gatherings, and strives to be fully engaged with the neighborhood as a whole. Suffice it to say, the values of the faith community – urban renewal, intentional community, Influential leadership – deeply influence the values of the Work Space which also centers around relationships and creative community development. It is the faith community that drives the desire to serve the marginalized of our city. It is the faith community that gives of their resources generously so we can afford to maintain our building and continue developing initiatives and partnerships.

The heart of the faith community is to serve Seattle and surrounding neighborhoods.

We will always position ourselves to be in relationships that are crucial to transform the city and neighborhood with the love of Jesus. Thus, we see the Work Space as a tool that will give us this opportunity.

Collaborative Work Space:  We look to celebrate the individuals, and agencies that are working to make the city better. We began to look around and see that there are some outstanding organizations (faith based or not) that we wanted to partner with, because we realize how big the job is to make the city better.

While the faith community holds to Christian beliefs, we do not project these on our neighborhood.

We feel like God gave us this building, in a very strategic neighborhood, and it would be a shame to only use it for ourselves. So we devised a plan to use what resources we have to support and encourage our city and neighborhood – hence our name SEAchange Building.

And we are proud of the diversity of partners we have built relationships with. On top of the two organizations we partner with, we currently have two outside organizations who use our facilities to share workspace and move forward their organizational dreams. We do not require that any of these agencies share our faith. We choose to focus on common goals of community development and life transformation. We welcome individuals who just need a place to work and don’t want to face a long commute or need a place other than a home office.

All Saints Church is meant to be urban missional hub. God has called us to carry out this mission as a church that introduces all who believe, doubt and seek to the reality Jesus Christ. We are called to the difficult task of interacting with the educated, upper middle class urbanites who don’t have obvious need for a church, let alone a relationship with Christ.