On the Corner

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DO SOMETHING”—William Booth

by Robert Docter, Editor-In-Chief – 

The nation’s health care crisis and poverty are linked together like souls drowning in a swamp, desperate for rescue in the darkness of night, pleading for unanswered help.

Shepherd-leaders of America: you’re in for a rough time. You mainly take care of yourselves —your swollen egos, your fat, self-centered tactics. You do not take care of the flock. Their primary needs go unmet. You have neither strengthened the weak nor healed the sick nor bound up the injured. You have not brought back the strays or searched for the lost.
You will be held accountable!
(My paraphrase from Ezekiel 34)

Who are the shepherds?
Who are the weak, the sick, the injured?
Where are the strays, the lost?
Who will be held accountable?

Responsible people must begin the process of examining and dealing with the highly complex issue of health care and poverty. It’s more than a problem. It’s a crisis of immense proportions. It involves humans and all their diversity—that makes it complex by itself. It involves a free society and many of the institutions that support it. Analyzing it demands some considerable awareness, knowledge and experience.

We’re talking about the nation’s health care system and including matters of poverty, race, culture, the roles of government, education, religion, and the individual idiosyncrasies of complex individuals with a wide variety of difficulties.

The U.S. Census Bureau issued a report in August 2005, titled “Income, Poverty, and Health Insurance Coverage in the United States.” About 40 million Americans live in poverty. The rate seems to remain unchanged. This indicates that either we are doing nothing or not enough.

About 18 percent of the poor are children. Many are seniors. Income inequality exists with the highest 20 percent of the population experiencing increased income and the lowest 60 percent a declining income.

The nation’s plan for health care seems employment-based with both employers and employees contributing to health insurance plans selected by the employer. Almost 60 percent of the population has this type of coverage. Employment-based coverage, however, has begun to decline.

Now, about 45.5 million Americans are without health insurance coverage, according to Kristen Gerencher of Market Watch. Over 11 percent of the nation’s children live without health coverage. A higher percentage of the children in poverty, 20 percent, are without health insurance.

Families living in poverty often must choose whether to put food on the table or seek medical help. Most simply do not go to the doctor until health problems have escalated to a point where health care is either too late or much more expensive. If they go anywhere, it’s most often to hospital emergency rooms, the “health care home for the uninsured.” They find them drastically overcrowded with waits measured in hours and, sometimes, even days.

Between 1993 and 2003, over 700 hospitals terminated emergency room service. Those remaining often find themselves at the “breaking point.”

Three factors drive health care costs: hospital care, physician and clinical service, and prescription drugs. Looking only at the prescription drug issue, any uninsured person filling a prescription today for a significant drug essential to their health often finds an annual payment in the $5,000 range. The Kaiser Family Foundation reports that spending in the U.S. for prescription drugs was $162.4 billion in 2002. The foundation projects an increase of 10.7 percent annually over the next ten years. If these projections are accurate, it seems the costs this year will exceed $200 billion.

Prescription cost increases are driven by (1) the increasing number of prescriptions written—42 percent of the increase; (2) the changes in the types of drugs used—34 percent; and (3) the manufacturers’ price increases—25 percent.

Sadly, I don’t have a solution—but I know several will be needed. An important question concerns the role of The Salvation Army in dealing with the crisis. We must speak for the poor—to God and to local, state, and federal legislative bodies. We must advocate.
William Booth told Bramwell to “Do something!” when he confronted desperate, hungry people sleeping under the London Bridge.

General Shaw Clifton, in a recent New Frontier interview stated: “When I say doing something about it, I’m talking causes, not just addressing the consequences. I think we’re not proactive enough in interacting with lawmakers and with the movers and shakers in high levels of society. I think The Salvation Army needs to rediscover its voice of advocacy for those who have no voice.”


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