General Motors attributes some of its current problems to the rising costs of health care for workers. The company says $1,400 of the cost of each car it makes goes to pay health care costs. That’s not the whole reason for GM’s difficulties, of course, but it’s significant that the company sees health care as a contributing factor
It’s not being discussed in these terms yet, but health care costs are also contributing to the re-shaping of ministry in many mainline denominations. Those denominations such as mine, The United Methodist Church, with many small local congregations–roughly 25,000 in our communion–are seeing personnel costs increase so rapidly they threaten placement of seminary-trained clergy.
My point here is not to debate whether this is a good or a bad thing. I have no axe to grind in this debate. But, it seems to me decisions about the quality of education and professional skills we want in our pastoral leaders should be made based on solid theological and biblical discussion and not on economic necessity. Economics should not dictate how the church carries out ministry.
However, when health care costs increase by double digits as they have for the past several years, that’s exactly what happens. The costs of maintaining full-time clergy become too burdensome for small membership congregations to sustain. They reduce costs by moving to part-time clergy leadership, lay pastors and the placement of a group of pastors defined in our denomination as “local pastors.” Often, these are persons who have full-time jobs and function as pastors in addition to their first vocation.
They are highly dedicated and often skilled in multiple disciplines. However, they face time constraints which limit their ability to seek seminary training in the disciplines that have historically been considered important for effective ministry–church history, Bible study, theology, and religious education. They are unlikely to pursue clinical pastoral education and other forms of specialized skill development because these require a time commitment they can’t make.
I came into the ministry through this route and I’m especially sensitive to the extraordinary demands that confront an individual who is trying to work full-time, serve the needs of a local congregation and complete a course of study leading to licensing and, ultimately, ordination.
Moreover, these individuals usually function without the community support of other clergy because they can’t attend group meetings except during their few off-hours. They do course work for ministry through correspondence. Thus, they function without benefit of professional support and pursue knowlege outside of an educational community while attempting to meet the considerable demands that dual vocations, family and congregations place upon them.
What does this have to do with health care? My denomination is sliding into this pattern not through a conscious, planned strategy, but by default. It’s the result of adaption to economic circumstances driven by health care costs.
Barbara Ehrenreich says in the LA Times that health care costs are sucking the life out of the economy of the United States. If General Motors and The United Methodist Church are both experiencing economic constraints because of health care, why, for Pete’s sake, isn’t someone doing something about it? Neither of these is a small business lacking in the resources to tackle a problem that is fundamentally changing them. You would think they’d rather be in control of their own destiny, in so far as possible, than to be in a reactionary posture that, basically, leaves them out of control.
I believe access to health care should be a universal human right. It should be beyond question that with the resources available to us in the 21st. Century that everyone should have access to prevention and treatment that make for physical health. But if that’s not enough reason to change our health care practices then the survival of our basic industries and institutions should be. We are at a point where that survival is put in jeopardy by runaway health care costs.
Rather than spurious debate about Social Security, we need to be problem-solving the health care crisis in this country.