Over the last couple of weeks there has been an explosion of debate concerning the impact of the 2009 Affordable Care Act (ACA) and the impact this sweeping national healthcare reform has on the right of individuals and institutions to make decisions based on conscience, faith or religious beliefs and practices.
As readers know, the individual mandate (requiring all citizens to purchase – or be covered by some form of – healthcare insurance) will be heard by the Supreme Court later this year to determine if it is even constitutional. And, it is across a broad spectrum of citizens the most hotly contested aspect of the reform. As former U.S. Representative Heather Wilson indicated in her letter last Saturday, there are many who simply say they “will not comply.”
At the same time, across the nation and here in New Mexico, legislatures are taking in funding to make the changes required and scrambling to meet a 2014 deadline to come into compliance with the ACA – just in case it actually goes entirely into effect. Despite numerous efforts and bills, it appears that our state will not move forward with key legislative actions to meet the federal requirements during the current session. At the same time, one well respected Senator has put forth a resolution as follows:
“Health care is a fundamental right that is an essential
safeguard of human life and dignity. The state shall ensure
that every resident has the opportunity to realize this right
by establishing a comprehensive system of quality health care
that is accessible to each resident on an equitable basis
regardless of ability to pay.”
Even if this NM resolution fails and even if the Supreme Court rejects the individual mandate and even if the entire 2000 (+) pages of federal legislation is dismantled, the debate concerning healthcare, fundamental rights, faith, conscientious objection, spirituality and religion will not go away.
In fact it will only increase. This is because:
1. Many people will still be seeking better health and, when needed, healthcare treatments they trust and find effective at an affordable price;
2. The public increasingly knows that meditative thought – for some it includes faith, spirituality and even religious practices and church attendance – contributes positively to health and well being; and,
3. Decisions about health – because they impact our very being and they can be “life or death” choices – come out of the core of what we believe. They embody what we think about well being, life, death and anything that might (or might not) come after this experience. They are de facto “ontological” decisions – even if some among us believe they are not.
Thus, if we are serious about healthcare reform (in NM and across our nation) and we want to design reform that does not land us right back in the “healthcare vs. faith” debate, we need to broaden the discussion about what health is and what constitutes true accessibility and patient choice.
To date, these two crucial conversations have not been had – either in NM or across the nation. The bulk of the discussions, debates, lobbying and positioning is about how our state (like the rest of the nation) will cover the costs of the current drug-based healthcare system. One has to assume that this is because legislators and many citizens, lobbying and grassroots groups believe that if we just figure out how to pay for the costs of this single system of care, we will have true health. We will not.
This is not because allopathic medicine hasn’t produced many incredible successes. It has. But, it is not the only pathway to preventing illness and achieving health.
Across the nation and in New Mexico, 40% of the population is regularly choosing what are known as complimentary and alternative (commonly referred to as CAM) treatments, including prayer. This is true according to both private and government funded research, studies and surveys. Many of these approaches to healthcare include what are now called “mindfulness” or “mind-body” practices – such as a wide variety of meditation methodologies and yoga as well as Ayurvedic medicine, Reike and here in New Mexico traditional healers. In many studies, researchers have found that some spiritual/meditative practice or regular participation in a religious community improves health outcomes.
Further, studies show that patients find CAM treatments effective, accessible and affordable – the three key outcomes healthcare reform is intended to produce. A recent survey by the American Hospital Association and the Samueli Institute indicated that the main reason even hospitals are now incorporating CAMis patient demand, which is running at 85%. Some say that the field of Spirituality and Health is a “new frontier” in medicine as they see growing representation at universities around the world, including the Spirituality and Healing in Medicine course at the Harvard Medical School, the Research Institute for Spirituality and Health in Switzerland and the Duke Center for Spirituality, Theology and Health, to mention only a few of many.
Any reform needs to take these trends into account. It should be based first on a common agreement as to what “health” is and second on a commitment to true patient choice and accessibility. And, it should provide access to those practices the patients find produce “health” as commonly defined. Health results are best when patients having access to care they trust and have found effective – at an affordable price. True choice and accessibility does not force patients to choose care that is not in alignment with their own conscience, faith or religious beliefs and practices. Nor does it require them to carry insurance that does not cover the system of care they find effective. It should not even do that in the name of “public health” or “safety.”
Keeping the public “safe” or “healthy” has been used as an argument for many things over the centuries that we today would say clearly violated human, religious, and/or civil rights. It should not be used as a blanket argument to take away an individual’s or an institution’s right to choose or provide care in alignment with their sincerely held beliefs. (A second and equally important – but not the same – issue is whether an institution that is taking government funding to provide services does or does not have to follow the law of that government.)
How can we reconcile the dissonance created by these current facts:
- The public is increasingly seeking healthcare that meets emotional and spiritual as well as physical needs;
- Providers who offer “mindfulness” practices to help people achieve health are on the increase;
- Physicians and hospitals and medical schools are incorporating modalities that include at least some that are based in “mindfulness” practices because of increased and overwhelming patient demand;
- We are all being told increasingly to exclude all conscience, faith or religious belief or practice from decision making about healthcare.
We can’t. It’s irreconcilable.
What we can do is begin – as many outside of the entrenched healthcare reform debate are already doing – recognizing that meditative thought, faith, and spirituality are beneficial to health. Then, we can begin the dialogue needed to create a healthcare system that honors the wide variety of pathways people are finding to health. This foundation will help us build, together, a system that achieves what we say we all want – improved effectiveness, affordability and access.