I approach the discussion about health-care reform from the perspective of an urban minister.  I’ve worked with urban core neighbors, neighborhoods, congregations, and community groups for more than 20 years.  I’ve watched people struggle to access basic health services in the shadow of world-class hospitals.  I know hardworking people caught in the “catch-22” level of income: They make too much to access Medicaid but too little to afford health insurance premiums.  They work for companies that either don’t offer health insurance or offer it partially at a level these employees can’t afford.  Workers are forced to use a patchwork of health fairs, free clinics, and doctors who will see them occasionally without cost (God bless these).  They put off illness or pain until it becomes chronic or unbearable and then make a dash to an emergency room. The health costs they incur are a greater portion of their household income than most Americans.  The cost to their dignity is inestimable.  But the cost to America’s integrity is even higher.

At the same time, I know that health-care costs are spiraling upward for higher-wage neighbors.  The monthly cost for my family’s health insurance is higher than our mortgage payment.  Our benefits are stripped down and our co-pays and deductibles are higher than ever.  I know people whose prescriptions are no longer covered, whose important procedures are denied, and whose insurance has been dropped.  Many people have filed bankruptcy due in large part to unpayable medical bills.  In short, while the health-care system has not been working for the working poor for a long time, it is not working for more and more middle-income neighbors.  None of this begins to factor in the significant levels of abuse of the system by those who game it — professional health-care providers, the insurance industry, and consumers of health-care services.  The current system is not sustainable, it is not reasonable, it is not just.  It does not reflect what we know is best about or for America.

So, I am completely on board with the call for quality, accessible, affordable health care for all citizens.  I’m advocating for this from the perspective of an urban Christian minister on the one hand, and as an American citizen on the other.  As a Christian minister, I am convinced that quality, accessible, affordable health care for all is a moral imperative.  As an American citizen, I am personally convinced it is a right that’s implied in the very intent of our Constitution and historic social contract.   But it is as a Christian minister that I offer the following considerations on health-care reform to the church I love:

1. The Samaritan principle sets the tone for the Christian church regarding care for the poor, uninsured, and desperate in our land. Simply put, in the care a Samaritan extends to a wounded, helpless victim, Jesus declares what it means to be an authentic neighbor. If we have the resources to help and heal, we should.  Not because we’ll get reimbursed.  Not because there’s profit involved.  Not because we’ll get recognized or rewarded.  But because it reflects the caring, healing intention of God for God’s people in relationship to one another and in witness to the world.  We cannot pass by because we presume somebody else will take care of uninsured people.  We cannot ignore what’s happening because it’s just bigger than us or beyond us.  Jesus calls us to see, respond, help, comfort, and restore — as if those left out and wounded were our very own.

2. Jesus’ ministry of healing was conducted in the face of structures and regulations designed to control, limit, and exclude. I’ve been reading the gospels again during this time of national concern about health care.  Health and healing was front and center for Jesus.  Undoubtedly, Jesus’ healings were a sign that he was the anticipated Messiah and that a new era was beginning.  However, Jesus’ healings also confronted, exposed, and undermined age-old systems that, in the name of health care, prevented healing from occurring.  Jesus cut through the red tape, system-serving regulations, and control-oriented rituals to actually offer what God desired for people — healing, restoration, and a future of dignity and hope. Instead of defending the current status quo practices that place ordinary folks in similar binds, the people who follow and claim to reflect Jesus should consider how he judged and exposed the ineffectiveness and meanness of structures that served themselves at others’ expense.

3. The context of community, inclusion, and sharing resources to assist the neediest — central in the early church witness — is a pattern and principle to renew. Beginning with Acts 2, we see the earliest believers holding things in common, pooling resources, and selling off assets in order to meet the needs of the weakest among them.  It was not about me and mine, but we and ours.  In the perspective of that early faith community, my personal self-interest includes your well-being.  They realized that we are deeply interconnected with one another.  The apostle Paul affirmed this principle with his counsel that we are members of one another, that no part can say to another, “I don’t need you.” To what extent are there such awarenesses or practices in the church today? And to what extent is our sense of community — over against asserting individual privilege and private right-bearing witness to the larger community and nation of what is good, possible, and godly?

4. Christian leaders should be leading the health-care dialog by seeking the truth and speaking the truth. To this point, it doesn’t seem to me that there has been a debate or dialog about health-care reform.  Much of the so-called debate to this point has focused on myths, distortions, and outright lies about proposed health reform legislation.  The news media focus has been on misinformed people shouting down congressional leaders, calling them Nazis, and burning them in effigy.  I’m convinced Christians should not only not be a part of those scenarios, but that we should make a contribution to the dialogue that is fact-based, truth-seeking, civil, and that moves all to find the common ground necessary to ensure that quality, accessible, affordable health care is available to all American citizens.  If the news media or partisan groups play to distortions and extremes, then people of Christian faith have a significant role to get the facts, convey them in understandable ways, and create conversations that deal in what’s real.  We are the people whose scriptures declare, “you will know the Truth and the Truth will set you free.”  We are the people who are reminded that “God has given us, not a spirit of fear, but of power, of love, and of self-discipline.”

5. Let us embody and advocate for the principles, practices, and norms of the beloved community toward which Jesus pointed. Christians have no stake in propping up old-order systems, or aligning ourselves with self-serving institutions, or playing to sub-Christian social stratifications.  At personal, community, and systemic levels, Christians are challenged to practice now the norms and promises of the future described in the scriptures.  I love the way Bible scholar Walter Brueggemann puts it: “God’s future is enacted as present neighborliness.”  Is not quality, accessible, affordable health care for all one such act of “present neighborliness” that is a signal of the direction God intends the future to move?  I think so.  And I invite Christians and people of other faiths to join me and others in this kairos moment — this period of unique opportunity to witness something magnanimous and restorative in our generation.

John Hay Jr., a longtime urban pastor and advocate in Indianapolis, Indiana, recently began working with international child sponsorship opportunities through the Free Methodist Church.

To learn more about health-care reform, click here to visit Sojourners’ Health-Care Resources Web page.