The people behind the statistics


Retired surgeon reflects on current health care debate

by Roger Fast

As a medical consultant for the Social Security disability program, every day I review the records of 15 to 20 people who are applying for disability benefits, to determine if they are credible from a medical point of view. 

A couple of months ago I reviewed the case of a 40-plus-year-old woman with rheumatoid arthritis. She was working and had health insurance, but she stopped the medication that controlled her arthritis because she could no longer afford her co-pay. The cheaper alternatives didn’t work well, and soon her hands were too deformed to work. She lost her job and with it her insurance, and then couldn’t afford even basic medication.

With health care reform in the news, I decided to track for one month how many such situations are in my caseload. I read the records of a 24-year-old woman who had a childhood kidney transplant. Her job did not provide health insurance benefits, and she could not get her own health insurance because of her pre-existing kidney problem. She could not afford the medications needed to prevent transplant rejection, and three years after stopping the medications her kidney failed, and she went on dialysis.

I read the story of a 40-year-old nurse who at 18 was treated for bone cancer with a combination of surgery, chemotherapy and radiation and was cured of the cancer without amputation. He tripped at work, broke the femur that had had the cancer and needed emergency surgery. Both the workers compensation insurance and the group health insurance refused to pay for or authorize the needed therapy to help the slow-healing bone to mend. He could no longer work as a nurse and with no job he couldn’t get insurance. He was left with a poorly treated injury, a huge debt, no job and no insurance.

Based on my survey, I see on average five cases per week like the ones I describe. Knowing there are about 100 other medical consultants in my state with similar caseloads, you can do the math. When I read a statistic like 47 million Americans are uninsured, it does not have the same impact as the stories of real people that I read in my work every day. Radio and TV speakers opposed to health insurance reform in the U.S. vilify these people, calling them “dirty hippies,” “lazy,” “aliens” and other epithets. And this to me is the ultimate insult—to vilify someone who has been victimized by a health care system that doesn’t work for them.

I do not believe that government should be the agent of any one religion, even though all religions advocate caring for the poor and sick in our land. But as individuals, we certainly should act and vote in accord with our religious values.

I am grateful for the biblical training I received from my parents and my church. It is implicit in the mission of our denomination that we bring healing to the sick and good news to the poor. I am shaped by what I have learned about Jesus and his teachings. Caring for the sick and the poor are major themes of Jesus’ ministry (Matt. 25:31-46, Matt. 11:2-6, and Luke 6:20). There is no question in my mind about Jesus’ attitude toward the people who are left out of our health care system. Surely he would not vilify them.

In the end, the decision on health care reform should be made on the basis of how we—religious or not—want our government to serve us. There are many areas where we think the government should be less involved and should let private enterprise and the free market system work. There are other obvious areas where we want the government to run the enterprise and where the private sector would lead to instability, such as national security. I think this is becoming true in health care.

Until now, our government has protected the right of private health insurance companies to leave out people who are not profitable at the expense of the poor and the unlucky. Accidents and illness can attack anyone. Just as we have a government military and policing system to provide security for all the people of our country, we should have a government-insured health care system that protects all of our citizens against such attacks. It may be against the grain of capitalist ideals, but it would be consistent with the ideals Jesus taught.


Roger Fast, a member of College Community Church in Clovis, Calif., is a retired general surgeon who served as a medical missionary to the Democratic Republic of the Congo in the 1980s.


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