Healthcare Reform’s Public Option and the Ezekiel Mandate

~ Rev. Jackson Day

Some of the values people of faith bring to discussion of health care are inclusivity and stewardship.  We’re hard put to justify the notion that there are some people who don’t deserve health care, so our faith groups tend to talk of health care as a right.  And when it comes to paying for it, we think in terms of stewardship, getting the best result for the resources expended, because we think it’s about using God’s resources to accomplish God’s will, and that’s not to be taken lightly.

The plan being promoted by the Obama administration is a public-private hybrid that is designed to keep employers and health insurers in the game but extend coverage to all.  You can easily argue we can do better than that, but the Obama plan is a marked improvement over the status quo.

To do that, there has to be a “public option” – a public plan alternative that is there to pick up the pieces, to provide health coverage to people that the private insurers don’t want, and to insure people whose resources aren’t sufficient for private plans.  Without the “public option”, whatever the Obama administration achieves will be impossible for some and too expensive for many.

We can predict that the “public option” will be the lightning rod for the controversy this plan will engender.  From the perspective of private-sector ideologues,  the “public option” will be seen as simply wrong, because they don’t want the public involved to a larger extent than the public already is in single-payer public plans like Medicare.  From the perspective of the insurance industry, the “public option” will be seen as extremely dangerous competition that will highlight how much more expensive private options are than the public.  Private insurance that keeps 14% of every premium for administration, marketing and profit absolutely does not want to compete with a government program like Medicare whose administrative costs are only 3%.   Thus the “public option” will threaten the ability of a whole industry to support itself and its profits from the neediness of the sick.  These motivations will make for stiff opposition to the “public option,” and the faith community must prepare to join those who fight back.

People of faith need to hear again the words of the prophet Ezekiel, who in sorting out what weakened ancient Israel and hastened its fall to its enemies, addressed exactly this topic:  “The word of the Lord came to me:  Mortal, prophesy against the shepherds of Israel:  prophesy and say to them – to the shepherds:  Thus says the Lord God:  Ah, you shepherds of Israel who have been feeding yourselves!  Should not shepherds feed the sheep?  You eat the fat, you clothe ourselves with the wool, you slaughter the fatlings; but you do not feed the sheep.  You have not strengthened the weak, you have not healed the sick, you have not bound up the injured, you have not brought back the strayed, you have not sought the lost, but with force and harshness you have ruled them.  (Ezekiel 34:1-4, NRSV)

The Ezekiel Mandate is an image of government leadership that is modeled on the responsibility of shepherds for their sheep.  A nation benefits from healthy citizens and therefore has a responsibility to help them stay that way and to help them recover when they need to.   The Ezekiel Mandate is that government must not allow any to be excluded, and when health care is needed, must take an active role to make sure that there is coverage for all.

The “public option” is essential to ensuring that everyone is in and nobody is out, and therefore from the perspective of the Ezekiel Mandate, it is essential in ensuring that government leadership meets its mandate to “strengthen the weak, heal the sick, and bind up the injured.”


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