Christianity and Healthcare | Rev. Adam Hamilton | Church of the Resurrection

2:27 I'd like to invite you to take out of your bulletin, your GPS, your Grow, Pray, and Study Guide. If you're watching at home, I'd like to encourage you to have a pen and paper handy. You'll find there's a place to take notes here, and then on the backside, you'll find our daily scripture readings that all tie back into today's message. I'd like to encourage you to be people who read your Bible every day and to find these scriptures that might encourage you to continue to think about what we're talking about today. So we continue in our series on the issues that divide us. One of those divisive issues in our country today is how we look at how we ensure that health care happens for the vulnerable in our midst. And really a whole host of other questions around health care and the role that government plays in that. And the Atlantic Monthly has said this last year that the question that will decide the 2016 election is how we will address health care needs of Americans beginning in 2017. That this will be at front and center of the debate, of the presidential debates this fall. You don't hear as much about it today, but when you get to having one Republican and one Democrat facing off for president, there are very different solutions about how we're going to solve some of these really important problems.

3:29 And so this is going to come front and center. I want you to be able to think about and understand what some of the issues are and to bring your faith to bear on this. I believe that there could be Republican solutions or it could be Democratic solutions that will solve the problem, but we need to make sure we understand the problem. And then what are we doing to make sure that we raise this to that kind of importance to say we have to make sure this is solved for. And we currently have one solution in place. Republicans would like to repeal the Affordable Care Act or what's commonly called Obamacare. They want to repeal and replace. Democrats want to retain and repair or fix. And so there's two very different ideas about what's commonly called Obamacare, what we know of as the Affordable Care Act. Now, this issue is important, and sometimes we don't see it because we may not be affected by it. We may be in places where we have employer-provided health insurance, or we have enough money to buy whatever kind of health insurance that we want. But this issue does affect real people, and some of them are in our own congregation, people that I know and some of you may know. Some of them are people outside the church. So just a few weeks ago, I heard about a woman that lives in another state. She's about my age. She's divorced. I've shared meals, broken bread with her before, and I learned that she was diagnosed with cancer. And that diagnosis by itself was terrifying, but she also didn't have health insurance. She didn't have health insurance because she works in a restaurant where there's a small number of employees, and the employer doesn't provide the health insurance, and on the income that she makes, the thought of spending that for health insurance for herself seemed an impossibility. It just didn't even seem possible. It was more than a car payment for her to be able to have health insurance, so she didn't have it.

5:05 And fortunately, her friends have come along and helped her to be able to get health insurance, some of her family members. Through the Affordable Care Act, she was able to provide health insurance. Now, she could not have gone to a clinic to get the treatment she's going to need for this form of cancer, and the cost of it will be far in excess of $100,000. And if you're making $25,000 $30,000 a year, that just is a death sentence. And so these are real people that we're talking about. And then there's the other end of the spectrum, that's just our young adults. So I think about my daughter, Rebecca, she turns 26 this year, which means that she will fall off my health insurance. I'm grateful we've got to keep her on there for an extra year, but she falls off my health insurance. And so I told her, you know, the month, the time you have to sign up for this year is January. You have to be signed up by January 31st. So last month I sent her a note, I said, honey, you got a month, but you got to get on, you know, one of the healthcare exchanges and sign up. You got to do this. And did she sign up then? No. So a couple of weeks ago, I sent her a note. I said, honey, don't forget, here's the web address. Please go on and get signed up for this because I don't want you to be without healthcare coverage. And okay, dad, did she sign up? No. So I said, honey, I want you to know there's a $695 penalty if you don't sign up. That got her attention. I was really glad for the penalty because my 26-year-old daughter doesn't really think she needs health insurance, and what I don't want to find is my 26-year-old daughter was something that's catastrophic, and she didn't sign up for the health care coverage.

6:25 Now, fortunately, even if she hadn't, while she would have had to pay the penalty, she could at least still get on with a pre-existing condition. But that's not the way things were in 2008. So today we're going to talk about this, and this is not an issue of, you know, if you're a Republican, you don't believe that government plays any role in health care, and if you're a Democrat, you do. Everybody agrees. Republicans and Democrats, all of the candidates for president agree government has to play some role in this. The question is just simply what role and how is this provided or how is this affected? Now, there will be some of you who would say, okay, really? I came to church and you're going to talk about health care today? Like, what does Christianity have to do with health care? I'm glad you asked. So, let's talk about that for just a second. And let me just remind you, in the Gospels, if you've read the Gospels, what is the one thing that Jesus does most often in the Gospels. He heals the sick. Matthew describes the beginning of Jesus' public ministry with these words, Jesus went throughout Galilee, teaching in their synagogues and proclaiming the good news of the kingdom and curing every disease and every sickness among the people. So his fame spread throughout all Syria, and they brought to him all the sick, those who were afflicted with various diseases and pains, demoniacs, epileptics, and paralytics, and he cured them. Mark's gospel begins describing Jesus' public ministry by saying that he stayed up all night long when he came to Capernaum. So great were the crowds of people who were sick, and he touched every one of them. 31 different accounts in the gospels of individuals that Jesus healed, in addition to these mass healings, 31 different accounts, and those are repeated multiple times, but 31 different people. Jesus stops what he's doing, and he touches them, and he brings healing to them. Clearly, this indicates God's concern for people who were sick, who were broken, people who had no other hope. God is a healer. Jesus came to be a healer. So, we recognize that then Jesus goes on to teach people. So, there comes this point, our scripture today, the context, is Jesus is teaching, and there's a certain lawyer who comes to him, a scribe, and he says, hey, Jesus, what's the most important commandment? Right? You know this story very, very well, I know. But let me just

8:31 remind you. He says, what's the most important commandment, Jesus? He says, well, there's really two you've got to remember. Love the Lord your God with all your heart, soul, mind, and strength, and what? Love your neighbors, you love yourself. And the lawyer says, okay, that's great, Jesus, but just tell me, who is my neighbor? And you remember what he's really asking is, who don't I have to love, right? So who is my neighbor? And Jesus tells him the story that we know of as the parable of the good Samaritan. And he says, there was a certain man going down from Jerusalem to Jericho. If I remember, about a 15-mile trek, and I'm taking 145 of you on that trek next week when we go to the Holy Land. So I'm looking forward to actually showing you this journey. Now, there's no trees on that trek. It's just dry, barren land, but there are caves along the road, and you can still follow the ancient road. There were caves, and people would hide in those caves, and when somebody would come by themselves on this, you know, from Jerusalem to Jericho, there was a chance that they would be accosted by somebody coming out of the caves, beating them up, stealing their clothes, stealing the money that they had, stealing their animals and leaving them for dead.

9:32 So what Jesus described in this parable had happened many times. It was something showed up in the news. So Jesus says a certain man was going from Jerusalem to Jericho, a Jew going to Jericho, and he's accosted by robbers. They strip him naked. They steal everything he has, including his animal, and they beat him up and they leave him for dead on the side of the road. Now, two different religious figures come along, religious leaders, a Levite and a priest. They come along and they see the man on the side of the road and they walk past. What were they thinking when they walked past? Maybe they were thinking there is certainly no connection between health care and religion. Maybe that's what they were thinking. I don't know. But they decided there was no reason to stop and help. The third person who comes along is a Samaritan. You remember Samaritans were sort of half Jews. They weren't real Jews. They were considered unclean by the Jews. They were unlikely heroes. They were heretics. And Jesus often paints them to be the hero in the story.

10:26 And so there's a Samaritan going from Jerusalem to Jericho. He sees the man on the side of the road, lying there writhing in pain. And what does he do? He stops and he becomes his emergency room. He stops and he bandages his wounds, pouring oil upon them. He then wraps them up. He takes part of his outer garments and he places them on the man. He puts the man on his own donkey. He takes him down to Jericho. He provides for new clothes. He provides for food and shelter for him. And when he leaves, he tells the innkeeper, Now, whatever else he needs, you take care of it, and I'll pay for it when I come back. And then Jesus turns to the scribe, and he says, which one of these do you think was his neighbor? And Jesus says, well, the man who stopped and helped. And Jesus said, go and do likewise. This is, in essence, what he's saying. He says, this is what it means to love your neighbor. I find it fascinating that to illustrate, to teach what it means to love your neighbor, Jesus uses the story of a man who was beaten up, who needed care. He says, this is what it looks like.

11:20 So when we think about this, this is for us as Christians a continuing, compelling call of Christ to care about the people who are sick, the people who are wounded, and to do something about it. And when we think about this, early Christians believed this as well. In 325, the Christian faith was legalized in the Roman Empire. And after that, some years after that, it became the official religion of the Roman Empire. A council of bishops gathered together. There were 1,400 of them, and they said, we need to start hospitals in every community where there is a bishop stationed across the Roman Empire. Up to this point, hospitals, there were military hospitals, but everyone else, if you could afford it, you went to the clinic or you had a doctor come to your house, but there were no hospitals. Christians started the hospitals across the Roman Empire in the fourth century, and those hospitals were for people who could not afford to pay for health care in their homes or in the clinic. Now, fast forward 1,400 years, and you come to London in 1739, and John Wesley has come to the city of London to open up a new building called the Foundry where they would have worship services and school and all of these things. And part of what they started there was a medical dispensary and a clinic to provide free medicine and medical care for people who were vulnerable in the city of London. That's what Methodists did. Fast forward 100 years to America. Who's starting the hospitals in America in the 1800s? A few were started by Jews. Most of them were started by Christians, by churches, even here in Kansas City. So when you think about this, in Kansas City, Kansas, the Methodists founded Bethany Medical Center. The Lutherans founded Trinity Lutheran Hospital. The Baptists founded Baptist Medical Center. The Catholics founded St. Joseph Medical Center. The Episcopalians had St. Luke's Hospital. And the Adventists started Shawnee Mission Medical Center. All of those hospitals were started by Christians who said, we need to provide care for people who are vulnerable. And by the way, when the hospitals were started, they weren't started for the wealthy or the upper middle class. They were started for the poor because they didn't have access to getting somebody to come to their home and provide the medical care they need.

13:13 they couldn't afford to go to the clinics, and so the hospitals were started to address the needs of the vulnerable. They didn't have the cutting-edge technologies at the time. They provided basic care for people who were in need. Now, all that began to change at some point, where hospitals were no longer primarily focused on the poor but began to be focused on others, and that began to happen with the First and the Second World War. With the First and the Second World War, there were tremendous leaps in medical advancement and understanding. So doctors and scientists began to discover new ways to treat things. This was the rise of the specialties in medicine. So you went from being a general practitioner to having all kinds of specializations. New technologies that were very expensive needed to be, the surgeries needed to be done in a certain kind of place. And so hospitals became the place where you got cutting-edge medical treatment, and you had an opportunity to have some of the finest practitioners gathered in these places. They became centers of healing for many people, eventually to the place where many of the poor were actually priced out of the hospitals.

14:09 Now, in 1929, there was a new product that came on the market. There had been people sort of experimenting with it before that, but it was really, it came out in a big way in Dallas, Texas, at Baylor Medical Center, by a new company called Blue Cross. And it was prepaid hospital care. And so there was a risk pool, and you paid into it, and then when somebody needed it, they could take advantage of having the hospital care. Then shortly after that, there was prepaid medical care from doctors from a company called Blue Shield. And so these companies began to develop this product. By 1940, still only 10% of the population had health insurance. So what we're talking about today is a relatively new phenomenon. 1940, only 10% of the population had health care coverage, health care insurance. What changed in that was World War II. And while the men were off in battle in Europe and in other parts in the Pacific, companies were only allowed to pay a certain amount. There were fixed wages during the war.

15:03 There was a labor board that set the wages. And there was a shortage of workers. But what they discovered was while they couldn't pay any more than this amount, they could start offering fringe benefits to attract the best workers to their company. And one of those fringe benefits was health insurance coverage. So during World War II and in the years after that, companies began offering employer-sponsored health care coverage. By 1955, 75% of the American population had health care coverage through their employers, mostly through their employers. So this became a different model for providing health care. At the same time, the costs of medicine continued to escalate after World War II. Now, this left one certain group out, actually a couple groups. Those who were unemployed were left out, and those who were at companies that didn't provide this benefit. But also, when you retired, what happened? If your insurance came from your employer, when you retired at the age of 65, about the time you would most need your health care coverage, you no longer had it. Most companies didn't pay for retiree benefits like this at the time.

16:00 And so in 1965, Lyndon Johnson came to Kansas City, of all places. He went to Truman Library and sat with Bess and Harry Truman, and he signed into law the Medicare Act in 1965 that provided universal health care coverage for people over 65 because they didn't get it with their employers, and this solved a problem that was out there. Why did he go to Truman Library? He went there because Harry Truman, 20 years before, had proposed this idea, and it really didn't get much traction. But in 1965, many Americans said, hey, this is really important. Here's a picture of Lyndon Johnson signing that bill into law with Harry Truman and his wife, Bess, behind him. And then in the next picture, you'll see Harry and Bess received the first two Medicare cards. And so there were their Medicare cards they received that day. Medicaid was also started at that time for the very, very poor. So in the last few decades, healthcare costs have skyrocketed. In 1970, the cost of healthcare in America was $75 billion.

16:56 1970, 75 billion. By 2010, it was $2.6 trillion. By 2021, it's expected to be $4.8 trillion, a huge amount of what we produce as Americans goes into providing health care. So what's the cause of these dramatic increases in health care? And I began doing some research this week. Many of you know this already. But this is what the experts seem to say. One of the drivers was the increased, you know, the medical care itself of the hospitals became more expensive, of medical clinics as they had greater needs for greater equipment. The technology itself was much more expensive and costly. MRI machines and all these other things were much more costly. These were things that people didn't do 30 or 40 years ago. In addition to that, there were provider prices, medical waste. And one of the key things was an increasingly unhealthy population of Americans who were increasingly obese, struggled with diabetes, heart disease, heart conditions. And so these were all factors. One of the other factors is we had greater expectations of medicine than our grandparents did. When my grandpa got a hurt knee, he didn't go to get a knee scoped out. He just lived with it, right? He didn't go and get a surgery like I had last year, you know, where my knee doesn't hurt anymore. I mean, this is a different way that we think about what happens in the way of medicine today than in the years or decades past. As the liabilities and the costs went up, some of the churches got out of the hospital business and sold their hospitals to for-profit corporations and entities. Now, by 2007, what's happened is the increasing cost of health care has caused employers to stop providing health care coverage in many companies. So the costs are going up, the number of people who are receiving health care at their employers is going down. So by 2007, we had a record number of people who were uninsured in America, 47 million people who were uninsured, and that represented about 14% of the workforce were no longer insured through their employers or able to provide or buy private insurance. You see, the problem was as the costs went up, not only could the employers not afford it, but individuals couldn't afford it anymore either. So this became a central focus of the 2008 presidential campaign, and in response to that, and out of that came the Affordable Care Act, or what we know of as Obamacare. This week I spoke with Doug Henley, who is the CEO of the American Academy of Family

19:03 Physicians, and I think Doug's in this service right now, and I spoke to Doug, who is himself a physician and now CEO of this organization. I also spoke with Samuel Turner, who was CEO of Shawnee Mission Medical Center for 10 years, and then left, retired, and now he's working as an associate dean at the UMKC Medical School. And I asked them both to reflect upon what was it that precipitated the Affordable Care Act, and how do they see that today? And finally, what are the continuing needs? This is what they had to say. Well, it's interesting that there's a lot of health services research in this country over several decades that show that there are two things that improve the quality of health care not only in this country but internationally in other developed countries as well and consistently lower costs those two things are having a usual source of care that you can name your primary care physician and have a relationship over time with that physician or other health care provider and two that you have health insurance coverage and that leads to improved quality and lower costs both at the individual level and the population level. There are millions of people that are that have insurance now that didn't have insurance before so that was a good thing as well. I definitely think that there needs to be more emphasis on getting the other 30 million or and that's probably growing insured. There There needs to be more emphasis on how do we truly provide care and keep costs from escalating.

20:40 At this point, that hasn't been addressed, but I think it's an opportunity for people of faith to just say, look, we can't depend on other people to solve this issue. Let's have the discussion and decide which way we're going to go because it's not really acceptable that we have millions, tens of millions of people that can't get basic healthcare. So part of what both of them said as I was interviewing them was, you know, the model that we used to think was working is let people who can't afford healthcare go to the emergency room, and then they won't be able to pay for it, and it'll be built in, baked into the hospital system after that. So that doesn't work, and it doesn't work for a variety of reasons. One is that it leads to people who get very, very sick before they show up, or they have babies, but they didn't have the preventative care or the training beforehand or the well-baby care afterwards, and it leads to greater illnesses or greater expenditures on healthcare. So it actually reduces the costs by making sure that people have access to insurance, and it improves their outcomes in their own lives. So both of them said this is really, really important, whether, you know, we solve it by Affordable Care Act and tweaking that, or whether we create something new that's even better, but we got to remember this is the problem we were trying to solve in this dilemma. Let me just mention that there is some success in what's happened in the Affordable Care Act. This is a chart that shows the percentage of uninsured Americans, and when the conversations began, we were down here at 14 and 15 percent. It peaked somewhere over 16 percent of uninsured Americans. And since the provisions of the Affordable Care Act kicked in this last year, we were at 9 percent of the American population that was uninsured. That's a record high now since we began having health insurance in the country. And so there is something to the fact that at least this part of the issue has or is in process of being resolved in some ways, at least for a large number of people. Now, the Affordable Care Act is not without its critics, as you know. Half the population doesn't like it. Half of them like it. Half of them don't like it.

22:35 And this week, I decided to go and find out, okay, what is it exactly that people don't like? And I went to a document prepared by the Heritage Foundation. It's a 66-page memo of all of the things that are wrong with the Affordable Care Act. And some of them seemed not a little contrived, but some of them seemed, you know, much more serious and legitimate. And so it's clear, and I think both sides would say what we have now isn't right yet, but it's at least, at least some would say on the right track, and some would say, no, it's on the wrong track, we've got to try something else. But we've got to solve for this no matter what we do. Now, I was thinking about this, and whether we retain and repair or repeal and replace, we've got to solve for these certain things. So I asked Dr. Turner, Samuel Turner, and I asked Dr. Henley, help us understand, help our people understand, what were the provisions, the key provisions of the Affordable Care Act that we're used to now but we didn't have before 2008 that you think we need to keep going forward. So here's what they had to say. Take a listen.

23:33 It's easy for us to remember that just a few years ago before the ACA got passed, people had minimal lifetime caps on their health insurance. So one major illness, and it's tough luck. People had preexisting illnesses and couldn't even get coverage. We didn't have first-dollar coverage for immunization services. or for preventive services. No first-dollar coverage for screening for colon and breast and cervical cancer. Another important thing was that it actually allowed students to stay on their parents insurance until they were 26 which is really helpful as well. It did help us focus on it and on the issue of the uninsured. There are millions of people that have insurance now that didn't have insurance before, so that was a good thing as well. We take those things for granted now five years after the passage of the ACA, but if a new piece of legislation came along, addressed the economics, addressed the patient protection provisions of the ACA, and emphasized health care coverage trawl. Let's have at it. Let's see what that is. But anything short of that, I think, would be insufficient for the American people. So again, I'm not an expert in this, but these guys, I think, know quite a bit about it. One ran a hospital system for 10 years. One runs the American Academy of Family Physicians. And I appreciate what they said and the things they mentioned, as you heard, lifetime caps existed in 2008, where some people with one major incident might use up all their insurance for the rest of their life. Pre-existing conditions, which would preclude someone from being able to get health care. The first dollar care that goes into screening or preventative care wasn't provided before and now is provided up front. Students being able to stay on their parents' insurance until they're age 26. And of course, subsidized costs for that health care.

25:33 So Rebecca, who is making a pretty modest income working in a restaurant in New York City, you know, her insurance was going to be more than her car payment, more than her house payment for her insurance, I think it was something like $500 a month, and received the subsidies bringing it back down to a price that she could actually afford. These are all the things that we currently have. Whether you're a Republican or a Democrat, somehow we've got to figure out how do we solve for these kinds of things. So if you don't like what we have, then let's make sure that these things are on the agenda to solve for whatever solution you come up with, or let's make sure that we fix the things that are broken so we continue to keep these things in the system as we have it today. Now that leads me to conclude by talking about three ways that I think our health and our thinking about health care might be affected by our faith. And these are really simple, but I think they're kind of big ideas where we as Christians bring something to the table, at least for us. So the first one is this, that one of the key contributors to the rising cost of health care is that Americans are not taking care of their bodies the way they once did.

26:31 We're not working outdoors, we're not working in physical jobs like Americans once did, and so what we find is many of us live a relatively sedentary life. I come to the office in the morning, I sit down in front of my computer, I get up from my desk and I sit down on my chair and meet with people. Then I go back behind my computer and I work on my computer. And then I get in my car and I drive home into the garage. And I go in and I sit down at the dinner room table. And I eat dinner and then I sit down in my easy chair and watch TV. That is my life many days. So I get home and by the end of the day, my smart watch says that I put in 2,500 steps. And I'm supposed to get in 10,000. Then I have other problems. Like I'm working on the sermon, sitting in the recliner at home. Actually, my rocking chair at home. Working on the sermon with a plate of warm cookies sitting next to me. Now, you know, all of this is contributing towards the fact that I'm not in as good a health as I need to be. And the Apostle Paul has this to say about it. He says, your body, he's asking this question of the Corinthians, he says, do you not know that your body is a temple of the Holy Spirit within you, which you have from God and that you are not your own?

27:25 For you were bought with a price, therefore glorify God in your body. Part of glorifying God and serving God and being a disciple may very well be making sure I'm taking care of my body well enough so that I'm not a drain on the system later on. Do you see this is sort of a moral issue? That if I'm not taking care of my body and I'm abusing my body, then the likelihood is I'm going to use a much larger portion of that health care resource that's out there in the years to come. And so if I'm having multi-million dollar surgeries down the road because I didn't care enough to take care of myself, and I'm drawing that resource to myself, what this might say to us is that one way that you love your neighbors, you love yourself, is by taking care of your own body so that it's healthy enough so that we're not needing to use that much healthcare resource for us. We may need that no matter what, but if we can do something to prevent that, maybe this is an act of Christian discipleship.

28:17 Maybe this is part of the solution to the problem. 70% of Americans claim to be Christians. What if we saw that as a part of our Christian responsibility, taking care of our bodies and understanding there's a cost to everyone of us not taking care of ourselves? Now, there's a second place where I think Christianity and our theological views as Christians comes to play in health care. And you know this, or you've probably heard this, an inordinate amount of health care costs are incurred in the last year of someone's life. And in that last year, an inordinate amount of that is occurring in the last month, and an inordinate amount of that is occurring in the last week of someone's life. Why? What's happening? Well, what's happening is that we are approaching our own deaths, and we don't have conversations with our family members about how we think about death. And as we're not having those conversations about how we think about death, our kids, when it's us, and now our kids are trying to figure out what to do while we're sedated or whatever's going on, they're thinking they've got to do everything possible to try to keep us alive for another month or another two months or another year.

29:17 And sometimes that makes sense. I mean, sometimes if you could stay alive for another few months and you can have a good quality of life, but if you can't have a good quality of life, why is it we're trying to postpone this so long? And you see, we can't have those conversations in the hospital because it just feels wrong to have that conversation. And we're not thinking clearly because we care so much about our parents or maybe it's our spouse or whatever else. So I was reading an article in the Journal of the American Medical Association that talked about, and this is interesting, there's an inverse relationship between the amount of money you spend on someone's health care in the last days of their life and the quality of their last days of their life. So the more you spend on their health care in the last days of their life, the lower the quality of life they have in those last days. But we're not talking about that. As I think about that, you know, part of what this means is you have to have conversations. And this was what JAMA was suggesting, is have conversations with your parents or your kids before you ever get there. Like, I've told my wife and my kids, look, if I'm in a car accident and I'm incapacitated and I can't make decisions and I can't think, I'm not able to communicate and the likelihood that I'm going to have a decent quality of life after that has diminished to almost nothing, please let me go.

30:28 Please let me go. It's okay. I'm not afraid to die. Let me go. Now, if it looks like I can, you know, have a quality of life after that, and all they need to do is keep pumping, you know, surgeries and medicine into me, then do it. You know, if I can, but if that's not a reasonable thing, I was listening to NPR the other day, and I heard the story of somebody who was in the hospital, and the doctors knew this person is not going to make it. They're not going to be better. But we could try this thing. It might give a little, there might be hope if we did this thing or that thing. And the nurses could tell. And this person, you know, they were physically in agony going through this. but the kids were like, we've got to do everything we can and by the time they were done, they'd spent millions of dollars before finally they realized they were putting their loved one through undue pain and they finally let them go. I mean, somewhere in there, we've got to have these kind of conversations. I asked some of our doctors about that this week. Actually, Sam Turner, I asked him about this as a hospital administrator and then I asked Dr. Sandy Archer, who is a family physician, a primary care physician at Ashanti Mission Medical Center and I asked them both to reflect upon this end-of-life care and why we spend so much money at the end of life.

31:31 This is what they had to say. Take a listen. When I grew up in West Virginia, I would say that most people, their grandparent or their elderly mother or father, they passed away at home with a lot of dignity. Now, I'm not suggesting that everybody pass away at home. You know, we've got great care and hospice now. But there has been really no discussion about that issue. I mean, even talking about pain management at the end of life is a volatile subject. We probably spend more in our insurance on that last year of life than we do all of the other years combined. I mean, that's one of the things that's a problem is Our country has become, I'm trying to think of the right word, uncomfortable with death.

32:28 I think that's probably it. We send people to the hospital when they're sick and that's where they die. And so there's this disconnect. Medicine doesn't always have the answers, but I think a lot of people think that doctors do have all the answers and we don't. And so they want to keep somebody alive at what cost and at what quality of life and is this really worth it. Because we're so insulated from death, we don't think about it rationally. And then when you're in that situation and it is your mother, you can't think rationally anyways. We shouldn't be so afraid of it. That's what it comes down to is we are so afraid of death in this country. We really are. I love that comment because it points right to who you are. What's your name again? Church of the... Oh, yeah. Church of the Resurrection. We're people who have hope, right? We're people who don't believe that death is the end. We're people who don't believe that the worst thing is ever the last thing or that death has the final word.

33:23 We're people who believe that when this life is over, we have a building not made by human hands eternal in the heavens. We believe that Jesus said, he meant it when he said, I go to prepare a place for you, and if I do, I'm going to come back for you that you might be with me where I am. And I've told my kids, listen, I not only believe this, I'm counting on it. So let me go when the time has come. because I can't wait to see what comes after this. And that's a Christian perspective we bring to end of life. How many of you would prefer to die in a hospital? How many of you would prefer to die at home if you can? Wouldn't that be almost all of us? We've got to be able to talk about these things. Now, sometimes you are going to be in the hospital. That's just where it happens sometimes, and that's sometimes the best place. But for many of us, if we had the kind of conversations about this, we might come up with different solutions to this problem that might address some of the health care issues we have today. Let me just end with this.

34:18 So I've mentioned to you, one of the things we do is we take care of our bodies as an act of Christian discipleship. We own responsibility for controlling health care costs by taking care of ourselves better. Second is we recognize that death is not the end and so it's not to be postponed forever. It's okay to die when you trust in Christ and you know you belong to Him. And the last thing that I would just remind you of is where we started and that is somebody has to be concerned about the vulnerable. You may have health insurance, and you know the very poor have health insurance through Medicaid. The problem that the ACA was trying to solve, and whatever else, if somebody else is elected president, a different party, and we've got to come up with something different, regardless, we've got to solve for this, is that there's a whole lot of people who are the working poor who can't afford another car payment to be able to pay for health insurance every month, or people who have a pre-existing condition who simply can't get health insurance, or it's so expensive it's impossible for them to get. I mean, these kinds of things, we've got to figure out what do we do because we are a just and caring nation, and we as Christians understand what the scriptures teach us, what it means to love your neighbor as you love yourself.

35:20 I end with a scripture, it comes from King Lemuel. We don't know anything about this guy. He wrote the 31st chapter of the book of Proverbs and we don't know when he ruled, we don't know anything else about him, but he was a king over Israel at some point, so he's a government leader and yet he says this amazing thing. Many of you have this passage memorized. He says, speak out on behalf of the voiceless and for the rights of all who are vulnerable. My hope and prayer is as you go into the elections this fall, whichever candidate you support, whichever party you choose to support, that you've at least asked the question, how does your health care coverage or how does your health care plan address the issues of the vulnerable in our midst and put pressure on people to say, we've got to think about this. This really matters. It matters to God. It should matter to us as human beings. I want to end this message with the last question that I asked Doug Henley as I was interviewing him, our member, and his response. It was just kind of a throwaway question.

36:15 I just was kind of curious. I asked him, I said, how does your faith relate to your work as a doctor, to you deciding to be a doctor and how you practice health care? And as he began to give the answer, he got choked up, and I got choked up listening to him. And he captures in this the sense of what it means to be human and what I think we ought to be feeling and thinking as individuals when it comes to health care. Take a listen. I was very fortunate to grow up in a small town in southeastern North Carolina. My dad was a pharmacist. I was born in 1951, so most of my growing up was in the 50s and early 60s. And at that time, most people didn't have health insurance coverage. In many respects, and my next-door neighbor was a family doctor, a general practitioner. So I grew up around health care in those days. And it was not unusual to see folks come into my dad's pharmacy needing appropriate medications but not being able to afford it.

37:16 But my dad always made sure that they got their medication in one way. That and my dad. I was very much a Christian. I grew up in the Methodist Church. And with my Christian faith, I was very much a Christian. the healthcare needs and growing up and seeing the healthcare needs of people. That led me to become a physician. He saw people who didn't have money to buy prescription drugs, and they came in and his dad made sure they got medicine no matter what. And that led him to say, I want to devote my life to bringing healing to people. And I think that's the heart that God wants us to have towards the vulnerable in our midst. And that's what I want to encourage you to take with you from the sermon today.

38:10 Take care of your bodies. Don't be afraid of death. and speak up for and stand with the vulnerable who need help. Let's pray. Lord God, how grateful we are that when you sent Jesus, he showed us your heart for people who were sick. How he stopped to heal the sick. How he was interrupted constantly, and yet he never minded. How he stayed up all night long to care for those whose bodies were racked in pain or were broken. God, we thank you for those Christians in the fourth century who built hospitals across Europe. For Wesley and the early Methodists who made sure that there was free medicine and medical care. for the Christians who came before us in America, who started hospitals and medical clinics to make sure that the vulnerable had access to health care. Help us, oh Lord, to have that heart today. Help our politicians, Republicans and Democrats alike, to find the solutions to these serious problems, to not make them political wedge issues, but instead to say, we've got to work together to find solutions that change the lives of the people who are suffering.

39:17 Help us, O Lord, as a congregation to speak up and to love our neighbor as we love ourselves. In Jesus' name.