Without Cost You Have Received; Without Cost You Are To Give
by Deacon Bob Schnell
We all recognize that the health care system in the US is in crisis. Every year it comsumes more and more of out GDP, yet our outcomes do not seem to improve and rank poorly compared to other developed countries. All we seem to have been able to do in the last several years is change the "shape of the curve"-- lower the rate of increase in the amount which the voracious system consumes from the GDP. Not much of a victory. A big part of the problem, I think, is structural. There is something fundamentally "off" with a model that says it is a good thing for people to make as much money as they can off the sickness and suffering of others. But that's what we've got in a system dominated by "for-profit" companies. You can say that I am complaining about the way the free market works, and I suppose I am in some measure, but that response assumes a statement of facts which does not exist. There simply is no free market in health care. Try comparing prices for some common service among prividers (like a MRI or a CAT scan) and see what you get it you don't believe me. Free market indeed! OK, I'm ranting. My rant is provoked by today's Gospel (Mt 10: 7-15) in which Jesus sends his apostles out with the admonition: "Without cost you have received; without cost you are to give." What is the context for this instruction? Health care, at least as it was practiced in the first century. The antecedent for this admonition is Jesus' instruction that His apostles should: "Cure the sick, raise the dead, cleanse lepers (and) drive out demons." It is in that context that Jesus tells His followers not to charge for what they are doing. The Church founded hospitals and clinics not to make money, but to do what Jesus orders us to do. For centuries that was the way things worked. I suppose there is no going back, but I'm old enough to remember a time when folks who ran hospitals and clinics and drug companies and device manufacturers and medical insurance firms didn't make multiple millions of dollars every year, plus stock options. The nuns who founded St. Mary's Hospital in Rochester, MN, the world-class hospital which is a big part of the success of the Mayo Clinic, until very recently had no written agreement with the clinic. They just had an understanding that every year the clinic and the hospital would sit down and work out an economic arrangement that was fair. They finally were forced to put something in writing because the Mayo was such a big operation its managers couldn't live with something as undefined and unmeasurable as what the sisters, and the Mayo brothers, had created. I don't mean to say that the Mayo brothers, and all the rest of the folks in health care back in the day, didn't live well. They certainly did. But they didn't think of their work as running a for-profit company needing to get as big a return as possible for the shareholders. That's what seems to have changed. Now it seems like, at least in some quarters, the objective is to charge whatever it is possible to charge, regardless of what is fair or reasonable, to increase the bottom line. I don't know how else to explain what has happened to the price of some drugs, like insulin. Of course, there are still lots and lots of folks in the health care world who are there for the mission of saving or improving lives. God love them! But structurally we need to make a change that is more in line with what Jesus commands today. If we stay with the "for profit" model, there is no limiting principle to what can be charged. Maybe to solve our health care crisis we need to reflect on the true meaning of "without cost you have received; without cost you are to give."