Note: due to privacy regulations, the author is using an amalgamation of patients and their stories and information to protect their confidentiality. The lesson contained herein is unchanged. 

mhBLxSa.jpgIt was an early spring afternoon, with a light breeze blowing the curtains in
their living room. I sat with my patient, talking quietly with family as he dozed in his easy chair. I held his hand in mine and thought about his hard-fought life.

His hand was gnarled by arthritis, years of hard work, and growing his own collards and tomatoes. His body was failing, and his mind, once a haven for numbers and formulas, had long since lost its capacity. His wife of many years died last year. His children, grandchildren and great-grands provide a constant stream of visitors. They moved him from his home in the country to an apartment near them. The local pastor doesn’t know him, and in any case, he can’t attend church services. As his hospice chaplain, I am his only connection to a lifelong investment of church work and worship.

My patient, unaware of all of the tension over his care needs, only knows that he still lives in his own apartment, that his family is nearby, and that his heart is “cantankerous” and needs medication. He accepts the help he is offered graciously, and thankfully. He prays in a rambling, confused way for family, friends, and even his chaplain.

I know that he is dependent on the subsidies of Medicare and the rest of his hard-earned savings. He has paid no attention to politics and the health insurance arguments. His children, however, are concerned.

If the entitlement programs are cut, how will they keep him at home? They have a certified nursing assistant covered at a reduced rate through a government subsidy. The medications and supplies are covered as part of his hospice benefit. The team from hospice (a nurse, social worker, chaplain, nursing assistant and volunteers) visits frequently so that he is rarely alone.

Without subsidies, they will not be able to afford to keep him at home. His daughter shrugged and said that it will end up costing the government more to put him in a nursing home, because he has no financial resources. “What’s the sense in that?” she asks me. “If we keep him at home, it will cost one-third to a half of the monthly cost of a facility.”

I have no answers.

Internationally, healthcare coverage sparks quite the debate. “Universal health care” is held up as the Cure-All or the Evil of all evils. It is vilified as Socialism or “metered care,” where a person’s access to healthcare is controlled and defined by an underwriter who does not know patients and outcomes, only cost effectiveness and “bang for the buck.” If one is an average citizen, there are trade-offs. Only the rich can afford the care they want, when they want it.

Hospice, like many other Medicare benefits, is designed to help a family cope with a challenging illness. But many families do not have the physical strength and endurance to care for someone at end-of-life. They also may not be able to have flexibility with their work schedules. They may not be covered under the Family Medical Leave Act (FMLA) here in the United States because they or their employer do not meet the criteria.

This man, like many others, is dependent on our elected officials to do the right thing. They will never meet him, never sit and read to him, never help him with a meal or handle his laundry. They won’t hand him his pills or call the doctor with questions about his condition. The representatives who so cavalierly dismiss entitlements forget that for many of our elderly, there is no “plan B.” Fiscally and spiritually, we bankrupt a nation if we do not care for “the least of these.”

My patient, a man of deep faith, has forgotten the years spent in the work force, the military, raising children, and serving God. I cannot. The study of Scripture reminds me that God knows and God judges us on the way we demonstrate the face of Christ to the needy ones of our society. My taxes provide him with food, medical care and more. My faith demands that I fight for his rights alongside his family. His face and name may be unknown to you, but his life and legacy are known to God.

Who will pay for his care? Taxpayers like you and me. Because the living out of our faith demands it.

In Matthew 25, Jesus said,

34 “Then the king will say to those on his right, ‘Come, you who will receive good things from my Father. Inherit the kingdom that was prepared for you before the world began. 35 I was hungry and you gave me food to eat. I was thirsty and you gave me a drink. I was a stranger and you welcomed me. 36 I was naked and you gave me clothes to wear. I was sick and you took care of me. I was in prison and you visited me.’
37 “Then those who are righteous will reply to him, ‘Lord, when did we see you hungry and feed you, or thirsty and give you a drink? 38 When did we see you as a stranger and welcome you, or naked and give you clothes to wear? 39 When did we see you sick or in prison and visit you?’
40 “Then the king will reply to them, ‘I assure you that when you have done it for one of the least of these brothers and sisters of mine, you have done it for me.’

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Rev. Deborah Vaughn is a hospice chaplain endorsed by the Alliance of Baptists, and Assistant Minister at Twinbrook Baptist Church in Rockville, MD. She blogs at An Unfinished Symphony and was a contributor to There’s a Woman in the Pulpit. She is an avid Buckeye fan despite living with her family live outside Washington, DC.

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One thought on “Pastoral is Political: Who Will Pay?

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