In an article in the New York Times, “Onward, Christian Health Care?,”  Professor Molly Worthen questions the resemblance of Christian healthcare cost sharing ministries to their supposed biblical and church precedents. She notes (strangely) that Jesus’ healing ministry “didn’t take pre-existing conditions into account,” and that the early church “offered aid to nonbelievers.” She goes on to observe that the real precursors to healthcare cost sharing ministries are the mutual aid societies of the nineteenth- and early twentieth-centuries. These societies provided relief from medical expenses and lost wages while stressing a stringent ethical code of conduct. Similarly, contemporary Christian cost sharing requires members to “live by biblical standards,” which is integral to the formation of a distinctively Christian community.

Though appreciative of cost sharing ministries, Prof. Warthen remains skeptical. For her, the “great insight” of FDR’s New Deal was its exposing the fallacious notions that local communities and free markets can solve society’s problems. She instead defers to the Affordable Care Act, which is portrayed as the latest chapter of the New Deal’s commitment to grant “a basic level of economic security to people excluded by the market or mutual aid.”

I find a number of misconceptions in Prof. Worthen’s piece. First, her implied assertion that the early church provided healthcare to nonbelievers is historically inaccurate and reductionist. In his important book, From Monastery to Hospital: Christian Monasticism and the Transformation of Health Care in Late Antiquity, Andrew T. Crislip documents how the revolution of healthcare in the fourth- and fifth-centuries blossomed out of the medicinal practices of Christian monasteries in secluded desert communities. In fact, this seclusion was essential to the reformation of healthcare, since such care developed as the necessary consequence of the monk’s renunciation of the relationships constitutive of traditional society. The monastery thus provided surrogate services for a very specific group of believers, those without home or kin to take care of their physical needs.

Moreover, she overlooks the fact that the extension of healthcare by Christians to non-believers involved nothing less than a totalizing reimagining of health and disease in Greco-Roman society. For example, the church overcame successfully the ancient conception of the ubiquity and irreversibility of Fate, which for centuries had deterred charity in response to sickness and wretchedness, since such compassion could be interpreted as interfering with the punishment of the gods. Instead, the church proclaimed a Trinitarian theology manifested in the derelict form of the crucified one, which essentially did away with the ancient stigmatization of sickness. Furthermore, while Greek social care was limited to kinship ties, the Christian expansion of universal kinship in Christ entailed an expansion of universal social compassion. Hence, by the fourth-century, figures such as Ephraim the Syrian and Basil the Great established hospitals for those ravaged by plagues or leprosy. St. Benedict made caring for the sick a priority for his developing monastic order, and by the twelfth-century the Benedictines had established over 2,000 hospitals in Western Christendom. Furthermore, all of the hospitals were centers for food, clothing, and shelter for the poor, widows, and orphans.

However, in rooting Christian cost sharing ministries in the mutual aid societies of the nineteenth- and early twentieth-centuries, Prof. Worthen fails to mention that such societies were themselves constituents of centuries of Christian social recalibrations and the concomitant reinterpretation of sickness and disease.

As to Prof. Worthen’s deference to state-run healthcare, she disregards how the government regulation of healthcare represents nothing less than an inversion of the very social order that birthed Western healthcare in the first place, and as a result, redefines the very notion of humanity to which such healthcare has been inextricably wedded. By marginalizing the church to the private sphere of life, the modern state has increasingly transformed the calculus inherent in the church’s conception of healthcare from that constituted by charity and virtue to entitlement and taxation. As the executive mandate on contraception in the Affordable Care Act (ACA) indicates, this redefinition changes the very concept of humanity itself: while the cultivation of love and virtue was at the heart of the Christian social order, litigation and regulation constitute the life blood of the modern welfare state. And as a mechanistic humanism replaces sanctity and virtue, institutions dependent on such sanctity and virtue, such as the family, begin to lose their relevance. It is in such a world that abortion and contraception appear highly plausible and desirable, thus rendering the executive mandate on contraception in the ACA fairly predictable.

And so, Christian cost sharing provides more than just a way in which the church can give witness to what it means to be a shared lifeworld of mutuality and service. In continuity with centuries of philanthropic redefinitions and care, such ministries indeed provide a different and redeemed way of being human, where Christians across the nation enact an economy of gift and gratitude, in stark contrast to the dominant secular economy of entitlement and taxation.

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