Putting Our Faith in Health Care

Since the early days of the conversation, the White House pitch has focused on an economic and logistical case for change. In President Obama’s speech tonight, will he make the moral case for health care reform?

After an August recess filled with hair-pulling, chart-waving and town hall recriminations, the national debate on health care reform has come back to Washington. President Barack Obama’s joint address to Congress this evening has three audiences: lawmakers, pundits and a skittish public worried about what the contentious legislation means to them.

But as plan A for selling health care seems to have stalled, a growing number of organizers, activists and politicians want Obama to add a new argument to his arsenal: health care as a moral and civic obligation.

Why hasn't the White House, they want to know, used the bully pulpit more like a real pulpit?

Since the early days of the conversation, the White House pitch has focused on an economic and logistical case for change. Obama, the salesman in chief, has confined his sales pitch to cutting the costs of health care delivery in America—by far the most expensive and least efficient among developed nations. "Ultimately we can't afford this," he said at a July press conference devoted to health care. "We just can't afford what we're doing right now."

But as the president takes the podium for what may be the most important speech of his young presidency, the faith-based, moral case for helping the nation’s 46 million uninsured Americans—more than half of whom are people of color—hasn’t made an appearance.

What’s most needed in the debate, faith-based proponents say, is the idea that, in a rich country like the United States, leaving the poor and the sick to go broke and get sicker is just wrong. “The faith tradition says that when people are sick, that’s exactly when you need to pull them in and help them more,” says Tim King of Sojourners, a leading progressive Protestant organization. Delman Coates, a pastor and activist in Maryland, uses the tale of the Good Samaritan to make the case for government intervention. “Why wasn't that Jericho road better lit?” he asks. People of faith “are called not just to provide charity; we are challenged to look at systems and structures that cause people to become economically vulnerable.”

“The moral conversation has the most weight with the American public," says Rep. James Clyburn, D-S.C., House majority whip and an advocate for faith in politics. “If we had come out of the box talking about the moral case for insurance reform ... I really believe that the emotions of people would have been captured much better.”

During the 2008 campaign, Obama often made emotional appeals for insurance reform, taking a cue from Sen. Edward Kennedy, declaring that quality, affordable health care was an essential "right" of American citizenship. Denying coverage within Medicare? “It ain't right,” he told a crowd in Virginia. By summer 2009, whenever Obama spoke on health care, his speech was loaded with dry statistics, Congressional Budget Office numbers and frustrated refutations that his plan would not “pull the plug on Grandma.” Grim details may be a good strategy to prove a sure command of the issues, proponents of faith-based initiatives say. But it’s no way to win a national debate. After all, the notion of “death panels” cuts straight to the gut, and therefore dominated weeks of public discussion.

This Labor Day, at a rally in Cincinnati, Obama came closer to his impassioned campaign self: “Every debate at some point comes to an end,” he said, perhaps previewing tonight’s remarks. “At some point, it's time to decide. At some point, it's time to act. Ohio, it's time to act and get this thing done.”

Politically, a more forceful “moral case” for reform could prove quite savvy. In November 2008, Obama did better among regular churchgoers than any Democrat since Carter, with 43 percent of their votes—and among those who said they attend church monthly, Obama beat John McCain 53 percent to 46 percent. Going into tonight’s speech, only 37 percent of those polled by Gallup say they would direct their member of Congress to vote for health care reform (24 percent don’t know). Winning the moderate faith community could move those numbers in Obama’s reformist direction.

A number of liberal religious groups are poised to help. “The faith community has a unique and important role to play—to define and raise the moral issues right beneath the policy debate,” says Jim Wallis, a member of the White House faith advisory council. “People in my congregation see a clear connection between the message of scripture and an issue like health care,” says Coates. “This is a social justice issue that’s very consistent with the tradition of the biblical prophets.”

Since continuing the George W. Bush-established White House Office of Faith-based and Neighborhood partnerships, the Obama administration has tasked its director, Joshua DuBois, with a number of initiatives, from spreading awareness about the H1N1 flu virus to organizing around the 2010 census. The Faith Advisory Council will produce a report by year's end on how government can work with local faith outfits to advance the president's agenda.

Obama has frequently cited the biblical passage asking believers to care for “the least of these.” And if the moral case is a simple restatement of the Golden Rule—do unto others—the public might already be with Obama. Fifty-six percent of those surveyed in a midsummer Pew poll say that it is “more important to provide access to necessary medical care for all Americans” while only 36 percent say it is more important to control costs.

Yet the White House has downplayed the moral argument when it comes to health care. Part of this is because the health care reform debate does not fit easily into one of the four areas the president has tasked the faith office with handling: fatherhood, poverty reduction, abortion reduction and interfaith dialogue. And it may be hesitant to do such overtly religious outreach in a nation where the “nones”—the 1 in 6 Americans who describe themselves as nonbelievers—are some of Obama’s biggest backers.

Then again, the White House may have sensed more of an advantage in talking dollars and cents with families hurting in this recession. Taking action on climate change, for example, has gotten more public support when framed as a pocketbook issue. And as unemployment approaches 10 percent, it seems like explaining that health care will reduce premiums and help hack away at the federal deficit is good politics.

Others maintain that the wonkery has hurt. “We missed a tremendous opportunity,” says Clyburn, who is joined in his opinion by legislators such as Rep. Louise Slaughter of New York, David Scott of Georgia and in the Senate, Mary Landrieu of Louisiana. “Cost containment doesn’t mean a thing to a person that doesn't have any insurance … it doesn’t mean a single thing to people who have lost a job and no longer have insurance.”

Another part of this administration’s hesitation may be due to the lack of clear religious dicta on health reform: “We can’t look to the Bible for whether the best option is a public option or whether we should computerize medical records,” says King. “But Jesus went out of his way to heal people who were rich and who were poor. So there’s that idea of universal inclusion.” The Jewish faith has the principle of tikkun olam—making the world a better place; and several Old Testament chapters discuss caring for “the weak” and impoverished.

Yet conservative Catholics and Protestants have battled insurance reform based on fears it might open the door to government funding of abortion, which they oppose on religious grounds. Still, the inclusion of a religious component to health care reform might re-introduce civility into what has often degenerated into a shouting match. “That’s an important role the faith community can play, bringing the debate back to reasonable dialogue,” says Kristen Williams of progressive group Faith in Public Life. “You see these angry crowds on TV all the time, but that’s not most of America.”

The president showed signs of reaching out to the faith community on health care in August, addressing a conference call with over 140,000 politically engaged believers assembled by 32 multi-denominational Christian nonprofits. There, Obama suddenly transitioned into the language of faith that had been missing from his health care pitch, charging Republican opponents with “bearing false witness,” and stating that health reform is “a core ethical and moral obligation—that is, that we look out for one another, that I am my brother’s keeper, my sister’s keeper.” He even called cost containment and the skyrocketing deficit “an intergenerational mission” to heal the nation.

David Brody, an influential columnist at the Christian Broadcasting Network, said the call had an “infomercial-like” quality, yet proved “a rallying cry from the progressive religious left and the White House to essentially go out there and set the record straight.”

Despite the enthusiasm of these faith groups—a major rally in Washington is planned for Sept. 16, exactly one month before the deadline Obama set for Congressional action on reform—Obama may not invoke explicitly faith-based arguments in his address. When asked whether the White House was losing control over the narrative, White House spokesman Robert Gibbs said, “The argument is not over. The discussion is not over; the debate is not over; the legislative process isn't over.” He’s right—but as Congress gets back into session, faithful observers argue, it may be time to bring in the big guns. The divine ones.

Dayo Olopade is Washington reporter for The Root.