Homelessness and the high cost of medical care

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I’ve blogged repeatedly about the relationship between our medical system and homelessness–direct discharge from hospitals to homeless shelters for example. Here in Madison, we’re working to find solutions that could involve creating respite care for homeless individuals and families, a place to come after they’ve been discharged where they can receive the care they need as they recover from surgery or illness. But that’s only part of the problem.

A study in Chicago shows the effects of providing supporting housing for homeless people with chronic illnesses:

A beautiful randomized trial conducted here in Chicago supports Bendixen’s claims. That study found that placing homeless people with chronic illnesses in supportive housing reduces emergency department visits, residential substance abuse treatment, hospital inpatient admissions and nursing home use. Researchers also observed average annual cost savings of $6,307, with greater average savings among the chronically homeless ($6,607) and among those living with HIV ($9,809). The sample size of 407 was too small to establish statistically significant savings, but the results were obviously promising, especially when housing services are focused on men and women with high expected medical costs.

In Illinois, 3.2% of patients accounted for half of all Medicaid spending; the top.15% (4500 of a total 3.2 million enrollees), had required annual spending of $285,000 each.

The article points out that in addition to housing, chronically ill people need help with medications, reminders to keep appointments, and case managers. There are profiles of two people who are in the supportive housing program.

 

The full story is here.

Is the Anglican Communion Dead?

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Andrew Brown thinks so.

He’s writing about the recent GAFCON conference and how it is playing back home in England:

What’s new is that no one any longer cares. The split has happened, and it turns out not to matter at all.

This is in part because the movement of public opinion on sexuality has completely overwhelmed that of church politicians. Congregations by and large have moved on, too. They are part of the public, too. But until very recently the conservative evangelicals in the Church of England lived in a bubble of self-importance, whose boundaries were respected by Rowan Williams. And from within the bubble, the outside world could not be clearly seen. Only, the fight about gay marriage made it apparent to the main body of the church – and to Justin Welby – that their attitudes were repulsive and immoral to the majority of people in this country.

Thinking Anglicans’ coverage is here.

Skimming some of the documents linked at Thinking Anglicans is like entering an alternative universe. In fact, it is entering an alternative universe. For Africans, the cultural context is utterly different than in the West, and the Gospel is adapted rather differently to that context. But in the West, the language of GAFCON sounds surreal, inscribing a language and experience that seems utterly divorced from the reality that we encounter on the streets of our cities and in the hearts and minds of many people. Of course, those different cultures do not exist in isolation. We bring them with us when we enter new places and globalization means that cultural clash is not only between discrete peoples, religions, or continents, it is also internal to our societies, and internal to ourselves.

I’m struck again by the similarities between the polarization within Anglicanism and the polarization within American politics and society. Just as compromise seems impossible in Washington or even Madison, so too is unity in global Anglicanism. We have come to inhabit different worlds and because of that it seems that the Gospel we proclaim is utterly different, and the Jesus Christ whom we experience almost unrecognizable to others.

I think that’s what Brown is getting at and why I think he’s right.

Celebrating the Reformation

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My twitter and RSS feed gave me links to reflections on the significance of “Reformation Sunday.” One was from Crusty Old Dean; the other from Stanley Hauerwas (a sermon preached on Reformation Sunday, 1995). Both offer insights into this odd event. It’s not commemorated in the Episcopal Church—we’ve pretty much done away with the “Protestant” in our traditional name “The Protestant Episcopal Church.” But our communion partners the Lutherans observe it and rightly so.

Of course, Stanley is right. Reformation Day (or Sunday) celebrates the disunity of the Church. It commemorates Martin Luther’s break with Rome. Over the last almost 500 years, Reformation Day has meant many things—German Nationalism, the triumph of Martin Luther, the victory of the individual over the institution. Like almost every other historical event, it has been invested with all sort of meaning, world-historical significance. But that’s more than a single day, a single event, can bear.

When Luther posted his 95 Theses, he sought debate on matters that he thought were of eternal significance—the significance of the rite of penance. That his theses ended in a major schism within Western Christianity was unimaginable to him in 1517. That he might be excommunicated for his questions and for the ideas that he developed in response to his questions was also inconceivable.

Yes, it’s a tragedy that Luther’s courageous witness ended in schism. It’s a tragedy that the Roman Catholic Church couldn’t find a way to embrace the profound theological insights that Luther developed (as has been documented recently, Luther’s ideas were hardly unique in the early 16th century and there was significant support for much of what he wrote as late as the 1540s). It’s a tragedy that after 500 years we remain divided in so many ways.

On the other hand, Luther’s insistence on the correctness of his theological insight in the face of Papal and Imperial opposition did something else. It provided inspiration to all those who in the last 500 years have sought to follow their vision of God and of Jesus Christ even when the authorities of Church and State have claimed their vision was wrong. It has given voice and power to the voiceless and powerless. It has provided a stance of prophetic opposition to the complacency and power of church and state. It reminds us daily that the Gospel of Jesus Christ is not confined to the trappings of papal or imperial power, of state or church, or of institutional self-satisfaction.

For us Anglicans, by the way, who try to avoid the label of “Protestant” whenever possible, Luther and Reformation Day remind us of an uncomfortable historical reality. Without Luther, without his brazen defiance of papal authority, without his appeal to and protection by Frederick the Wise of Saxony, there might not have been an English Reformation. Had he not gone before, had he not shown a way, Henry VIII might not have had the courage to resist Clement VII.

Luther, the Protestant Reformation, remind us of the important role of critique. They remind us that it’s too easy to let the gospel be coopted by power; it’s too easy to compromise to make sure the institution survives. When we remember Reformation Day, when we sing “Ein feste Burg” we are not celebrating the victory of the Protestant Reformation over the forces of evil, we are calling for reformation of ourselves and of our churches; we are calling for transformation: ecclesia semper reformanda!

 Oh, and by the way, 2017 is the 500th anniversary of Luther’s posting of the 95 Theses. Start planning your party now!

 

Jill Lepore and Jane Franklin

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Jill Lepore gave a talk tonight at UW on her most recent book, Book of Ages: The Life and Opinions of Jane Franklin. It’s largely based on the correspondence between Jane and her famous brother, Benjamin.

Her work juxtaposes the fame of the brother with the obscurity of the sister and raises questions about gender and opportunity. Benjamin was given the opportunity to go to school, but his family’s poverty prevented him from getting a formal education. He was apprenticed to his brother who had a printshop and fled to Philadelphia, where he became famous. Jane married her next door neighbor at age fifteen and lived the typical life of a poor woman of the day. What set her apart was literacy and her famous brother.

Lepore talked mostly about their relationship and Jane’s life, relatively little about the topic implied by the subtitle of her book: Jane Franklin’s opinions. A few things came out at least. Jane was interested in politics and concerned about the plight of the poor. She was also opposed to war and violence. In her last letter to Benjamin before the beginning of the Constitutional Convention, she urged that the men gathered there would “beat swords into plowshares.”

Lepore is a fine historian, a beautiful writer, and an engaging speaker. It was a delightful evening.

a review from The New York Times.

Baptism: Learning from the Royal Christening

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One of the lovely and important aspects of the establishment of the Church of England is that the sacraments of the Church (marriage and baptism) can become teaching moments for a whole nation. We will be baptizing two babies at Grace on All Saints’ Sunday (November 3) and I was talking yesterday evening with one set of parents, I mentioned today’s baptism. I’m sharing these links because they help us reflect on what baptism means for us, and especially what it means in an increasingly secular society.

The Church of England created a lovely and thoughtful video in which the Archbishop articulates the meaning of the rite:

Cathleen Grossman writes about the decline in numbers of baptism across the US. The numbers of baptisms in the Southern Baptist Convention fell to about the same number as in 1948, when the total membership of the denomination was less than half what it is today. In 1970, about 20% of the babies born in the United States were baptized Roman Catholic; today, that has fallen to 8%.

The Guardian notes that the Duke and Duchess of Cambridge have selected seven of their friends to be Prince George’s godparents and have solicited stories from readers about what their experiences of the relationship.

And from the Church of England, prayers for the Royal Christening (actually, prayers for all baptisms):

Prayer for HRH Prince George

We thank almighty God for the gift of new life.
May God the Father, who has received you by baptism into his Church,
pour upon you the riches of his grace,
that within the company of Christ’s pilgrim people
you may daily be renewed by his anointing Spirit,
and come to the inheritance of the saints in glory.
Amen.

 

Prayer for the Duke and Duchess of Cambridge

Faithful and loving God,
bless those who care for this child
and grant them your gifts of love, wisdom and faith.
Pour upon them your healing and reconciling love,
and protect their home from all evil.
Fill them with the light of your presence
and establish them in the joy of your kingdom,
through Jesus Christ our Lord
Amen.

A lengthy piece on homelessness in New York City

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Written by Ian Frazier, it provides some interesting comparisons to our own situation here in Madison:

In fact, during the twelve years of the Bloomberg administration, the number of homeless people has gone through the roof they do not have. There are now two hundred and thirty-six homeless shelters in the city. Imagine Yankee Stadium almost four-fifths full of homeless families; about eighteen thousand adults in families in New York City were homeless as of January, 2013, and more than twenty-one thousand children. The C.F.H. says that during Bloomberg’s twelve years the number of homeless families went up by seventy-three per cent. One child out of every hundred children in the city is homeless.

Wrestling with God: A Sermon for Proper 24, Year C

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Reading the story of Jacob in Genesis always puts me in mind of what was easily among the most memorable incidents of my teaching career. I was grading midterm exams one year and the pile I was reading was just as unremarkable as every other pile of midterm exams I read over the years—I taught Intro to the Bible about twenty times. Unremarkable, that is, until I came across the essay that began with the following sentence: “Jacob was a good Christian Man.” I don’t remember how I responded—perhaps I banged my head on the desk in utter frustration; perhaps I yelled. Continue reading →

Let light perpetual shine upon him

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We said good bye to Thomas Merton this afternoon. It was a difficult decision but the correct one. For the last several days, he had been eating less and less. It was obvious that it was hard for him to chew and swallow, and especially sad when he came downstairs and banged his dish around the kitchen to try to wake us up or get our attention. That was something he learned early on and was a very effective method to get humans to respond to his needs. Unfortunately, last night and this morning when we tried to give him something after he had banged for our attention, he refused pretty much everything we offered.

A visit to the vet this morning confirmed that the tumor had grown considerably. In addition to making eating difficult, it’s likely Merton was in considerable pain because the cancer had entered the bone. But there was little sign of suffering. He was still jumping around,watching chipmunks and squirrels from our back porch, and even playing ball–catching it with his feet and batting it around.

So the vet and a vet tech (who had stayed with our cats in the past) came by the house this afternoon and ended his suffering. He died on my lap.

I’ve written about Merton’s final journey here and here. He’s been a good friend for almost fourteen and an amazing cat. He was very smart, very stubborn, and regal. We will miss him keenly.

Again, my favorite photo of him, relaxing with Augustine’s City of God:

162829_1565031438172_3235424_nThanks again to Dr. Tom Bach and all the good folk of Lakeview Veterinary Clinic.

Let us give thanks and praise: A Sermon for Proper 23, Year C

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On Friday evening, about 100 of us gathered at the Goodman Center to celebrate the more than thirty years Grace’s Food Pantry has been in operation, to thank those whose vision brought it into existence, and the many volunteers and donors who have given so much of their time, skills, and financial resources to help the pantry provide food for food-insecure families.

We also learned some sobering information about the need in our community. I’ll just throw out a couple of statistics: 48% of the children in Madison schools are eligible for free or reduced-price meals. The number of visits to food pantries in Dane County almost doubled between 2007 and 2012.  And it’s estimated that about 20% of all families are food insecure, that is to say, they aren’t sure whether they will have enough food to survive til their next paycheck.

We live in a society that is increasingly divided between have and have not; but it’s not just that. The problem is that the gap between the haves and have nots is growing wider day by day, and the number of those who are falling out of the middle class into poverty continues to grow.

Those are the statistics, but what I’m worried about is the effects of a government shutdown on the neediest in our society. Already we’re seeing that in many states, the WIC program, which provides food for pregnant mothers, and infant formula, is shut down. In some states, the supplemental food program, SNAP, what is often called food stamps, is already stopped, and if the shutdown continues, it will end everywhere. And the commodity programs, TEFAP, which provides free food to organizations like our food pantry, has enough food to last the month, but no more.

All of this is frankly, frightening. Whether our dysfunctional political system can come together long enough to avert even greater catastrophe is not at all clear. And even if it does, it’s likely that the most vulnerable in our society, children, mothers, the elderly, poor, and disabled will continue to be demonized by a culture that values only wealth, success, and celebrity.

By now, some of you may be thinking this sermon is veering into a political screed but I want to remind you that the Jesus we follow, the Jesus we encounter in the Gospel, is someone who ministered to and among the neediest members of Palestinian society. His first sermon in Nazareth proclaimed his mission statement: “to bring good news to the poor, to proclaim release to the captives, recovery of sight to the blind, to let the oppressed go free.”

As we have read the gospel of Luke, we have seen him do those things: offer hope to the hopeless, food to the hungry, heal the blind and the deaf, raise the dead. But it’s not just Jesus. When he sent out the seventy, when he commissioned his disciples, he sent them to extend his ministry, mission, the good news of God’s reign into the wider world.

In today’s gospel reading, he does it again. On the surface, it’s rather a simple story. Jesus cleanses ten lepers; he tells them to go to the priests to be certified as clean, and then to go back home. Only one of them returns to thank him, and it turns out to be a Samaritan who responds to Jesus’ acts with gratitude. On the surface, this story seems to be about etiquette, about giving thanks.

As an aside, let me offer a brief comment about leprosy. In the biblical tradition, leprosy seems to have been a number of possible skin conditions, even something as simple as psoriasis. And the biblical injunctions were not about keeping physical infection away; rather they were about purity and cleanliness. That’s made clear by what is a very curious element in the discussion of leprous diseases in Leviticus. You were only unclean if the condition was partial, that is to say, you were unclean if you had spots of the disease on your body. If it made you white from head to toe, the priest would certify you clean.

The important thing about leprosy is that it excluded you from the community. Leviticus dictates that a person with leprosy must live alone, away from human habitation, that lepers were to wear torn clothes and cry out “Unclean, unclean,” when anyone approached.

Jesus heals the ten lepers and then instructs them to go to the priests to be certified clean. This is was in perfect keeping with Jewish law as laid out in Leviticus. Nine obeyed him; one did not. The tenth came back, praising God with a loud voice, and thanking Jesus. Luke adds, as if in a marginal comment, “And he was a Samaritan.”

This story is not primarily about etiquette. It is about religious norms and values. The Samaritan was doubly unclean in the eyes of Jews. As a leper, he would have been excluded from the community, shunned. As a Samaritan, he would have been reviled for the religious traditions he followed. What is puzzling is that his being a Samaritan takes on significance only after his leprosy is cleansed. Jesus told all ten to present themselves to the priests, what the law required. But of course, as a Samaritan, he would not have had that option, or indeed, it would not have been necessary. No certificate from any priest deeming him free of leprosy would make him a part of the Jewish community. Perhaps that is why he came back to Jesus. He realized he had been cleansed, and that was all that mattered.

By contrast, the other nine needed the priests’ certification of being leprosy-free before they could rejoin their community and assume a role in the religious life of Judaism. There was more at stake for them. Still, whatever their motives, whatever Luke’s motives for telling the story in this way, what intrigues me here is what Jesus says in response to the actions of the Samaritan.

The nine lepers did nothing wrong. They cried out to Jesus, asking, “Jesus, master, have mercy on us!” Luke is careful to point out that they did not transgress any boundaries. They stayed as far away from Jesus as they could; they respected the boundaries set up in the law. When Jesus told them to go and present themselves to the priests, they obeyed without question. They followed the rules, and no doubt, they were quite happy that they were cleansed.

The Samaritan turned back, he glorified God, fell on his knees and thanked Jesus. We might think such a response would be natural, but isn’t it the case that most of us would follow the rules laid out? We would do whatever it took to be restored to our families, our livelihoods, and our religious lives? It was only the Samaritan who responded differently. He acted as unexpectedly and extravagantly as Jesus himself did. He came back; and because of his response, he was rewarded extravagantly. The NRSV , “Get up and go on your way. Your faith has made you well.” In fact, a better translation would read, “your faith has saved you.”

It’s the not just that the Samaritan was cured of his leprosy. He was saved. He recognized in the healing of his body the gracious power of the one who healed him. He looked beyond himself to Jesus. In so doing, he becomes for Luke a model of faith. The ten lepers had pleaded with Jesus, “Have mercy on us.” But only one, the Samaritan, the outsider, the foreigner, recognized and acknowledged their master, only he came to faith. In fact, only he was truly, completely, transformed by the experience.

When describing the Samaritan’s actions, Luke chooses a very interesting word. eucharistein. It’s translated as giving thanks, and it’s the word from which Eucharist comes. But it’s more than giving thanks—just as we do each Sunday in the Eucharist, it’s also about glorifying and praising God.

Having been cleansed of his leprosy, he had much for which to glorify, praise, and thank God. So do we. The Samaritan came back and thanked Jesus in an act of spontaneous, embarrassing joy. He made a spectacle of himself. It’s a response we should have to the saving love of God in Jesus Christ. That joy should be the heart of our experience of Jesus Christ. That joy should transform us

He gave thanks with all he had, and so should we. We are accustomed to thanking God in word, in prayer, in hymns. Thanking, praising, glorifying God should take place with our whole being as we acknowledge all that God has given us. We can give thanks in word. We can give thanks in our actions as we reach out to help the hungry and the homeless, to do the work necessary to maintain and build up the body of Christ in this place. And we also need to give of our financial resources—so that through Grace Church, its ministries and mission, people can come to wholeness, restored in body and spirit by their encounter with God’s love among us.

We all approach Jesus, begging him, “Jesus, Master, have mercy on us!” We all have experienced, or hope to experience, the power of his healing love. Jesus pronounced the words of salvation to the tenth Samaritant, “Your faith has saved you.” May we also experience that wholeness, in body, mind, and spirit, and respond to it from the wholeness of our being, in faith, and gratitude, and generosity. Like the Samaritan, may our joy be embarrassing.

Mark Oppenheimer on John Howard Yoder

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There’s an article in the New York Times about the controversy in Mennonite circles about John Howard Yoder. In a way, it seems like airing dirty laundry but if that’s the case the laundry has been dirty for a very long time. I mention it here for several reasons. First, because it’s another example of the difficulty Christian churches have in dealing with sexual abuse and sexual violence. Second, Yoder is a significant influence in my own theology. He has shaped my understanding of Jesus’ message, nonviolence, and the nature of the church. Yoder is an important witness and his thought has much to offer us as we enter a future where Christianity no longer has power and privilege in the west. Third, the relationship between the life and thought of a theologian raises significant issues. If Yoder acted abominably to women of his acquaintance, what does that say about his theology?

Like most Mennonites of my generation, John Howard Yoder was larger than life. He brought Anabaptist and Mennonite theology and ethics into the mainstream of Protestantism. I read The Politics of Jesus when I was a teenager in the mid-70s. It shaped my understanding of Jesus, my ethical stance, and my theology.

I spent one semester at what was then Associated Mennonite Biblical Seminaries and made sure that I took the only course Yoder offered that term. His theological brilliance did not extend to the classroom, nor to interpersonal relations and looking back, the course was less than successful. It was on ecumenical reform movements within Christianity and tried to bring together a number of very different movements that emerged in Western Christianity after the Protestant Reformation.

But at AMBS, Yoder was a presence in the classroom even when he wasn’t the instructor. In our Theology class, his “Preface to Theology” was a basic text though it existed only in photocopy. It, too, was an insightful and important work on my journey.

I left Elkhart for Boston after that semester and eventually entered Harvard Divinity School. It was there where I began to discern some of the structural problems in Yoder’s work. Reading Politics of Jesus again in the context of a strong Feminist community opened my eyes to the persistent power dynamics in the work. It’s easy for people (men) of power and privilege to speak of revolutionary subordination, but when people are oppressed and disenfranchised such a call may not be transformative. When people are victims of violence, following “revolutionary subordination” might be fatal.

With strong ties to the Mennonite community and to AMBS, I learned a little a bit at the time about why Yoder suddenly left the seminary in the mid 80s. I continued to engage his contemporary theological work over the years and his historical work on early Anabaptism played a significant role in my own dissertation. I write about the last time I saw him here.

All of these memories came back to me this summer when I learned of the latest, posthumous controversy concerning Yoder’s behavior. There’s been considerable coverage in the Mennonite press and among Mennonite theologians. For those of us who have paid attention to the sexual abuse scandal in the Roman Catholic Church and have observed similar problems in other denominations including the Episcopal Church, Mennonites’ response to Yoder’s behavior is troubling. That they are finally coming to terms with it and re-evaluating how they responded in the 1980s and 1990s is important both to that church and to Yoder’s continuing theological legacy.

 

This essay by Barbara Graber re-started the conversation.

If you’re interested I would recommend Ted Grimsrud’s reflections.

Anabaptist Mennonite Biblical Seminary has responded. Its President Sara Wenger Shenk has this to say.

Mark Thiessen Nation has written extensively about Yoder’s theology and offers a thoughtful and in-depth essay here.

The Mennonite World Review devoted an entire issue to sexual violence among Mennonites.