American Health Care

American Health Care Debate

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Fran Quigley, clinical professor at the Indiana University Robert H. McKinney School of Law, discusses how faith communities have influenced, and will continue to shape, the American health care debate, as part of CFR’s Religion and Foreign Policy Conference Call series.

Learn more about CFR’s Religion and Foreign Policy program. 

Speaker

Fran Quigley

Clinical Professor, Indiana University Robert H. McKinney School of Law

Presider

Irina Faskianos

Vice President for National Program and Outreach, Council on Foreign Relations

FASKIANOS: Good afternoon from New York and welcome to the Council on Foreign Relations Religion and Foreign Policy Conference Call Series. I’m Irina Faskianos, vice president for the National Program and Outreach here at CFR. Thanks for joining us.

 

As a reminder, today’s call is on the record. And the audio and transcript will be available on our website, www.CFR.org, and on our iTunes podcast channel, Religion and Foreign Policy.

 

We’re delighted to have Fran Quigley with us today to discuss the role of faith communities in the American health care debate. Professor Quigley teaches in the Health and Human Rights Clinic at Indiana University’s Robert H. McKinney School of Law.

 

Fran, thanks very much for being with us today. I thought it would be great if you could start us off with an overview of the role faith communities play in the or are playing in the current U.S. health care debate, and what role they should be playing.

 

QUIGLEY: Thanks, Irina. I am very, very excited to be talking with folks today, and especially to listen to folks today. I know there’s a lot of collective wisdom on the call, so I’m really excited to hear folks’ comments and insights after I get through yammering on a little bit.

 

But I think—to answer your question, I think that the faith community has been playing an enormous role in the health care debate and should be playing an enormous role in the health care debate currently and going forward. And I would support that with two different reading recommendations. I sound like a professor, don’t I, giving reading assignments; but it’s not assignments, just recommendations.

 

And one of them really talks about the historical context, and I think that inspires faith community involvement in the health care debate in the U.S. And that one is a new book by Adam Gaffney—G-A-F-F-N-E-Y, if folks are interested—and the last—and the title of the book is “To Heal Humankind: The Right to Health in History.” And Adam is a physician. He’s a faculty member at Harvard School of Medicine. And he writes really persuasively and compellingly about the right to human—human right to health’s development in history. And with it a significant portion of his book, especially the early third, is talking about the faith community’s impact on access to health care, both directly through history and, frankly, a little less obviously but really very importantly, access to health as a human right.

 

He goes all the way back and talks about the ancient world and medical care availability then, but then he pretty quickly gets to what the faith traditions have done in the context of health care; and that in India and China from 400 BCE onward, there was Buddhist/Daoist/Confucian traditions of universal care, that everyone who is in need of health care should receive it. And really importantly—and this is a theme that runs along all of the faith communities’ involvement in access to health care—a lot of walking the walk, right? There’s a lot of direct care, charitable care being provided, even during that time, you know, 400 BCE onward—charitable care directly, hospital-like institutions, et cetera from the Buddhist, Daoist, and Confucian traditions.

 

And then, of course, folks on the call are probably—many folks are already aware of the deep influence of access to health care in the Christian tradition. There’s something like 41 different New Testament references to Jesus performing acts of healing. You know, the early church was really built around, in many ways, medical charity, and eventually including hospitals for the poor.

 

There’s a long, long history of Arab Islamic commitment to access to health care, including really the earliest and most advanced charitable hospitals.

 

Adam in his book does a nice job of explaining all that history. And I think the big-picture reason why that history is important to us is because the charitable imperative in faith communities over generations and centuries really, I think, has started to forge the pathway to health care as a human right.

 

So that’s the first recommendation, Adam’s book. If folks are interested in that, I think it’s Routledge Press, R-O-U-T-L-E-D-G-E Press.

 

The second recommendation I would have is—zooms us forward to the 21st century and zooms us into the United States as a focus, and that is the work of Professor Ziad Munson—Z-I-A-D, his last name is M-U-N-S-O-N. And folks on the call, some folks may know his work. He’s a professor of sociology at Lehigh University, and he has studied and written extensively on the role of faith communities in social movements.

 

And I had the opportunity for Sojourners a few months ago to interview Ziad, and that’s on Sojourners’ website, that Q&A, and my involvement was mostly asking open-ended questions and printing Ziad’s really insightful answers. But he had really optimistic perspectives to offer on the role of the faith communities in access to health care going forward in the United States. He said that he’s not the first person to note that the 2016 election, that whether folks, you know, liked that result or not, that the—President Trump received this enormously high proportion of Catholic votes, of white Evangelical Protestant votes, and a lot of structural support. And again, you can not like the result, as many folks might not, but you can still respect the influence there.

 

And, as Ziad has pointed out and others have, is that here in the U.S. we have had the decline in a lot of our traditional politically influential institutions. Our civic groups have dropped down in membership. Labor unions have significantly dropped in their membership and their influence. We have the effect of social media and the internet having—you know, creating some physical isolation. And what has still remained as an influential institution and a respected institution has been the faith community. And in—again, the faith community has in many respects escaped some of the PR problems of other institutions. You know, there’s a lot of mistrust of the media. There’s a lot of mistrust of political parties. There’s a lot of mistrust of the judiciary, of Congress, et cetera. But churches and other houses of worship, as Ziad points out, are still very much respected.

 

And I think that’s really important when we talk about health care as a human right in particular, because that is—health care as a human right is very well-respected internationally. It’s in most national constitutions. The access to the highest attainable standard of health exists. Health care as a human right is enshrined in many international treaties. But in the U.S., unfortunately, that is not so much. We have not—we do not have the right to access to health in our Constitution, obviously. We are really the lone wolf staying out there, not signing on to the International Covenant on Economic and Social and Cultural Rights, which establishes a right to the highest attainable standard of health.

 

So that has led really, I think, to a vacuum that the faith community can fill, and I think in many respects has filled. Faith community pushed for the creation of the Medicare program. Faith community pushed for the creation of the Children’s Health Insurance Program, expansion of—essentially de facto expansion of Medicaid to children at 200 percent of federal poverty line and below. Faith community helped push for Part D Medicare, a drug benefits under Medicare program. And, of course, the faith community was very influential in the creation of the Affordable Care Act.

 

Now, that, of course, is not uniform, right? The ACA, and particularly the mandated employer-sponsored health insurance and that feared connection to abortion rights and access to birth control, has caused some faith communities, individual groups and larger congregations, to have at least hesitation about the ACA, if not outright opposition to some portions of it.

 

But still, the faith communities in the U.S. are still enormously involved in health care on the—on the ground level, still providing a significant amount of direct care, still providing an enormous amount of access to social determinants of health—the food, the shelter, the emergency assistance that determines the health of so many people here in the United States.

 

And, of course, the faith community, when the Affordable Care Act turned out to be not quite what folks had hoped for when the U.S. Supreme Court decided that states did not have to expand their Medicaid programs—and some 19 states still haven’t—but at the state level, many faith communities came together in coalition with others and pushed really hard for the expansion of Medicaid in those states. And I can tell you that from firsthand experience. I’m talking from Indianapolis, Indiana, and we had Vice President—then-Governor Pence. Now-Vice President Pence was our governor. We had a very tightly controlled legislature, controlled by Republicans who were very opposed to, quote/unquote, “Obamacare.” And they weren’t going to expand Medicaid originally. And the faith community was really an important part of advocating for the expansion of Medicaid in our home state, which has provided care for hundreds and hundreds of thousands of people who wouldn’t have it otherwise. So the faith community has, I think, a very enviable and positive record in the U.S. in promoting access to health care. But, of course, in the U.S., with our— with our troubled health care situation that we have, we— sometimes we have two steps forward and one step backward. And this year, of course, folks had to fight very hard to preserve the Affordable Care Act from being repealed.

 

And I do know we have folks on this call who were very intimately involved on that on a day-to-day basis. And I hope that they can chime in with what they thought in terms of advocacy in this past six months to nine months— what they thought was really impactful, what they think the lessons could be for us going forward. But I can say, as a summary, there were interfaith sign-on letters with dozens of organizations urging Congress not to repeal the Affordable Care Act without replacing it. Tens of thousands of calls were made by folks from their faith communities to their representatives in Congress. Those folks met with their representatives of their staff in their districts. There were rallies. There were vigils. There were op-eds. There were targeted state visits by high-level faith leaders, et cetera. So I think that there’s a lot to be— there was deservedly a lot of applause for the faith community’s action in terms of helping fight off the proposed repeal of the Affordable Care Act.

 

So I would like to close my remarks with a question. And that is, that I want to know if folks on this call— if they think that the faith community is prepared to play offense as well as defense when it comes to access to health care in the U.S. We have a very— even with the Affordable Care Act, we have enormous disparities in access to care, much worse outcomes, much high expenses than other similar countries. But there are proposals out there. There’s proposals in Congress and lots of discussion about universal coverage via single payer programs or other means. Certainly, at the international level, that’s kind of taken as a given, that the goal is universal coverage. And the faith communities have, at least on the international level, for the most— I’d say, almost uniformly signed onto supporting the idea of universal care.

 

But are folks going— are congregations and denominations or organizations going to get behind the idea of a single payer program or universal coverage, you know, really a Medicare for all type program in the U.S.? My own personal interest is access to medicines. I’m part of a group called People of Faith for Access to Medicines. And along with groups like Interfaith Center on Corporate Responsibility and U.S. Conference of Catholic Bishops has been good on this issue. Jubilee USA, et cetera, have been pushing for access to medicines, you know, not just at the international level, but also here in the U.S., because we have people— and, again, I’m talking to you from Indianapolis, Indiana. I know in your homes there are people who can’t afford insulin. There are people who can’t afford their asthma medicines. There are people who are going bankrupt because of their cancer medicine.

 

So we’ve got a lot of work in front of us, in my opinion, on access to health care in the U.S., even with the survival of the Affordable Care Act— as of today, anyway. And my question kind of to the group is do you think that the faith community is ready for the struggle for the next stage? So I rambled on enough. And I think now I would really appreciate hearing from other folks, your own comments. And if you have questions, those too.

 

FASKIANOS: Fran, thanks very much. That was a great way to get us started. And as he said, we would welcome your questions and comments and what you have been doing in your communities on this issue. So let’s open now to the group.

 

OPERATOR: Yes, ma’am. At this time, we will open the floor for questions.

 

(Gives queuing instructions.)

Our first question comes from Khosro Mehrfar.

 

Q: Yes. Good afternoon. Thank you so much for your informative information, professor. I think no matter what faith, one thing that is critical is the cost itself. So the cost breakdown structure of a health care system overall I think needs to be reviewed and find out what are the major costs that goes to it. Obviously less cost for the whole model is better, and the more coverage can be provided to more people.

 

And the reason I’m saying that is an actual example since 1600s in India that I am aware of, a tiny fraction of the population of India, known as Parsis, have done this very successfully. They have built major hospitals and clinics for everybody— not just necessarily for the Parsi— for everybody, which majority is Hindu, as we all know. And they have basically created a model of philanthropic investments rather than charity giveaways. So in other words, hands-up for the people rather than hands-out for the health. That has created a sustainable model that those people who needed the service and they got it, with their conscience, they came back a few years later when they could provide some kind of service back to the community. So it created a cycle of self-sufficiency, and has worked well. I was wondering if there is such a— such a consideration in your opinion that can create a recurring revenue model and keep the costs low.

 

QUIGLEY: Well, thank you for that. And, again, I’d be very interested to hear what other folks on the call have to say. I think— you know, I have heard of that example as well. And I think there are a few other examples where actually a more open-market type of very thoughtful approach to for-profit health care has had some success. I personally believe— and I think the evidence supports— that there’s a lot of reason to be skeptical, big picture and long term, about the market’s role in— whether health care is really a good fit for a for-profit enterprise, for a market enterprise. And in the U.S. we have, you know, an enormously privatized system. And we have enormously inefficient outcomes for the dollars that we put in.

 

And I don’t want to go into great details, but, you know, we do have— you know, we have— we have health care for-profit entities that are doing very well financially— the insurance companies— I mean, insurance industry and pharmaceutical industry, et cetera— while we still have some very poor outcomes and are paying a huge amount per person, you know, per patient for them. So I’m aware of those. And I’ve read some examples and I applaud those folks, or anybody who’s trying to solve the access issue. I don’t think there’s just one recipe for it. But I, for one, believe that some of the— the evidence internationally and even to some extent nationally certainly points towards movement away from the privatization and the profitization of health care. Just people who are sick, people who are in need, are not usually fitting the definition of free choice consumers that allow them to shop and compare and find competing best buys.

 

FASKIANOS: Thank you. Next question.

 

OPERATOR: Our next question comes from Ron Herms with Fresno Pacific University. Hello, Ron, your line is live.

 

Q: Thank you. Yes. Thank you very much.

I wondered whether you could make any comments about the role of faith-based organizations in the development of a nationalized health care system in a place like Canada, for example, where we have evidence of, you know, people who are in the clergy or others, who actually were a big part of that conversation?

 

QUIGLEY: Yeah. You know, that’s a great question, Ron. I have not— and maybe other folks on the call have— but I have not read a, you know, really in-depth study of the faith community’s role in the creation of the— either the Canadian or the U.K. systems, which are oftentimes held up as being, you know, models for the U.S. to try to move towards. But so I do— I know that they are— again, it sounds like we both know that the faith communities were involved and being supportive. But I haven’t seen an in-depth analysis of exactly how influential the faith communities were there.

 

And, again, in the U.S. we have, somewhat, I think a unique opportunity and maybe unique responsibility, because we are— even though less people are walking into congregations on Saturdays and Sundays in the U.S. than there were, you know, a few decades ago, we still are a very, you know, faith-based society in many respects, especially in many parts of the country including, you know, where I live, in the Midwest. So I think that we have an opportunity to maybe be even more influential as a faith community on this debate than, again, what I’m guessing was the case in Canada, or what my limited knowledge was in the case of Canada or the U.K. But if you have—

 

Q: Yeah, my experience is that, you know, Tommy Douglas, who was both a social politician as well as a Baptist minister in Canada, and began a provincial health care system in Saskatchewan, which really became a template for a national system. But it was really out of sort of the personal values and convictions in his world as a minister working with hurting people. And I think your comment is exactly right that, you know, in a context like Canada, where faith communities aren’t as out front or overt as they are in the United States, that should serve, actually, as, I think, a model of inspiration, perhaps.

 

QUIGLEY: Yeah. And I don’t know if— again, I don’t know if we have the mechanism to do it, but if you have a suggested reading or a profile of Tommy Douglas, who I’ve heard of but don’t know too much about, I think, you know, if we could share it with the group, that’d be really interesting.

 

Q: Yeah. Well, I’ll continue to listen and see if I can find something here.

 

QUIGLEY: Thank you.

 

FASKIANOS: Great. We can also— we can send out resources after the call as well, so we can do that.

 

Q: OK.

 

FASKIANOS: Next question or comment, please.

 

OPERATOR: Our next question comes from John Denker with United Religions Initiative.

 

Q: Yeah, I see the Patty Murray and Lamar Alexander in the Senate are getting together to try to, I guess, put a fix on the Affordable Care Act. And they’ve got till, like, September 25th to do that. What do you think is realistic at this time for a fix? And more generally, what do you think is possible in the current political climate for a fix? I mean, I’m like you, I’d like to see a single payer, but I just don’t know see that that’s possible, at least in the next few years, of anything like that happening. But what would you say would be a logical step, say, between what we have now and a single payer? And what would be a fix that the Senate Health Committee could come up with, now that they’ve got both the Democrats and the Republicans trying to work on something?

 

QUIGLEY: Yeah, John, this is— again, I think we are in agreement on what the end of the road should look like. But, boy, I think it’s interesting to see how we get there and what the waystations are going to be. What I think is really ironic about what the Trump administration is doing in— and I don’t think it’s too strong a word— attacking the Affordable— or, at least, undermining the Affordable Care Act, is that— is that the plan, and I think they’ve already started doing that, is to undermine the— you know, the most capitalistic forms— (laughs)— of the— of the Affordable Care Act, right, the market exchanges. Medicaid expansion, you know, is what it— is what it is there.

 

So I think that’s— I wonder whether, and there’s certainly a lot of folks who are universal coverage— or universal care advocates— and I’ll make that a little broader than single payer advocates. But I think a lot of folks think that there is a time of opportunity here because, you know, I would say six months ago, maybe at least 12 months ago, you didn’t have very many people who were big supporters of Medicaid, or maybe even understood what Medicaid did. And the proposed repeal of the ACA, you know, led to, I think, a very increased appreciation for what Medicaid does.

 

And so I’m intrigued by the ideas of lowering the age for eligibility for Medicare. I’m intrigued by— I think, again, there’s a thousand flowers out there. We’ll see how many bloom. But there’s ideas of expanding Medicaid instead of expanding Medicare. You know, Medicare for all is the slogan we hear, but Medicare itself— and certainly we have clients in our law school clinic who are on Medicare, but they still struggle with some of the deductibles and co-pays and premiums, et cetera. So Medicare itself has some gaps.

 

But I wonder whether Republicans and Democrats— and maybe that’s a bit too optimistic— but I wonder if they could come together with expanding some of the now very appreciated and popular, you know, government programs— like Medicare and Medicaid and— you know, along with whatever needs to be done to shore up the marketplaces created by the ACA. But, again, ironically, the Trump administration is— their plan is to undermine the most, you know, conservative, private enterprise-oriented parts of the ACA.

 

Q: I know one thing I’d like to see is to lower the Medicare age to 55. And that way you could take at least the most expensive people out of the private market and put them into the Medicare system. So maybe that could lower the costs for the insurance companies a little bit. That’s kind of a temporary solution, but—

 

QUIGLEY: Right. And not just because I’m creeping up on 55 do I think that’s a good idea, right? But I think it’s also— you know, there’s an interesting— if you look at it on a macro policy historical timeline, is that when we created the Children’s Health Insurance Program, again, that was the Bush administration signing off on that. That expanded Medicaid to all kids at 200 percent of the federal poverty and below. That greatly increased the number of kids in our state— I want to say it’s something like 40-plus percent of kids in Indiana are on Medicaid. We call it something different. Every state calls it something different, but it’s Medicaid.

 

So if we start to get to the point where we’re covering almost every kid through, you know, a health insurance program that’s a public health insurance program, and then we start covering everybody who’s 55 and above, you know, we’re starting to squeeze the population that is the issue. And as you say, that’s the cheapest population to cover, if we’re going to talk about, you know, folks under 55. So I’m intrigued by all that, and I’m daring to be optimistic about it too.

 

FASKIANOS: Thank you. And next question or comment.

 

OPERATOR: Our next question or comment comes from Lucas Allen with the NETWORK Lobby for Catholic Social Justice.

 

Q: Hi. I wanted to speak more to one particular role of the faith community which was kind of really playing a role in making Medicaid the issue of the recent debate. I work for an organization that kind of helps coordinate a coalition of different faith groups— Jewish, Muslim, Christian— and that really kind of got together and mobilized around December when we saw that there would be a massive threat to access to health care. And it wasn’t until really May or so that we decided to focus very intentionally in on Medicaid. And a lot of the discussion had been about preexisting conditions. But I think one effective strategic move was really putting a faith to this Medicaid program that covers 75 million Americans, and really building the faithful, moral case for how this speaks to our different faiths.

 

This is a program that covers, like Fran was talking about, kids, but also the elderly in nursing homes, people with disabilities, and really people experiencing poverty in our country who are on the margins. And there’s a very strong faith case— based and grounded in scripture that those are not the people that we should be cutting off of access to health care. And the bills that were being proposed were particularly egregious on— when it came to those cuts to Medicaid. So I think kind of the mobilization, writing op-eds in local papers, getting different interfaith leaders together for local events in the key states where there were sort of swing senators— all those strategies were effective in making Medicaid the wedge issue. And then going forward, we know that Medicaid is nowhere near safe in the future, whether it’s in budget negotiations, which might seek to cut Medicaid further, or whatever it might be with work requirements, different waiver policies that could limit eligibility for Medicaid.

 

So the faith community in Washington and with our presence around the country will certainly continue to be engaged. A few things that we’re working on very intensely right now is extending funding for the Children’s Health Insurance Program, which has been talked about, and also the market stabilization policies that we can promote in a bipartisan way to improve the Affordable Care Act, which we hope are promising.

 

But we are going to be very engaged in Medicaid in the future, whether that’s continued defense or, like Fran said, offense, with expanding Medicaid to more people.

 

QUIGLEY: And if I could, Lucas, do you have—I know that you all coordinated an original kind of sign-on letter to start. You shared that information with me before and—so there’s like 43 different organizations—I just think it would be interesting for folks on the call just to see the diversity of faith groups who did come together in agreement about the resistance to appealing the—repealing the Affordable Care Act without a replacement. Is that something—is it—I struggled to find it online. Is that a link maybe you could send? I don’t know if you can send it to me or—you can send it to me and I could share it with Irina. Maybe we can add that to the materials afterward.

 

Q: Yeah, absolutely. I can send it to you, Fran.

 

QUIGLEY: Because I just think that was—to me, at least—I don’t know if others on the call would share that—I think it was remarkable to see so much—so much agreement and so much diversity of so many different faith traditions coming together on this core—because, again, we do have that, no matter our faith traditions. I mean, there are just—you cannot find a faith tradition or even a moral tradition that doesn’t have, you know, caring for the sick at the very core of what we believe and what we’ve had our institutions built on.

 

So I think it’s inspiring to see, you know, folks coming together on a really tangible applied way, like you all have. So thank you. If you—if you—thank you for what you’ve done, and thank you if you could send that.

 

FASKIANOS: Wonderful. And we’ll circulate that.

OK. So we’ll go to the next question or comment.

 

OPERATOR: Next question comes William Howard with M.W. Howard, LLC.

 

Q: Thank you. Can you hear me OK?

 

QUIGLEY: Yes, I can, thank you.

 

FASKIANOS: Yes, we can. Mmm hmm.

 

Q: Oh, good, good. Well, by way of confession, I’m an old-time associate of ICCR, and I worked with Marilyn Clement in the early days of Healthcare-NOW!

 

My question—and I’d be very interested in that link you just reported, too, of those groups that came together. But my question is, are there any major religious voices opposing something approaching to universal health care? If so, would you say a few words about who they are? Because I’m assuming that there must be some religious contrarians on this question.

 

QUIGLEY: That’s a good question, William. I do not know of one. When you talk about universal care in the abstract—and my kind of—my sourcing for that is that our organization, People of Faith for Access to Medicines, does, you know, some work here in the U.S., mostly in the U.S., but we do some international advocacy work as well. And on the international level, this is just, you know, accepted core beliefs in the human rights community at the international—in the international health community, World Health Organization, et cetera. The new secretary-general of the World Health Organization is very explicitly in favor of universal care. And all of the faith communities that I’m aware of that have a presence or a participation in the world health community and kind of this—“bureaucracy” is too negative a word, but at least, you, the kind of organized form of it—are completely in favor of it and usually very passionately.

 

And you know that sometimes the—when the rubber hits the road is when we get in our disputes, right? When the Affordable Care Act had—has its employer mandate, and some employers and some faith groups object to that possibly including abortion, contraception, reproductive health, et cetera, then I think sometimes that’s when the issue comes in. Again, there may be some faith groups at a minor level who just mistrust government involvement, but again, you could—in the abstract level, it doesn’t necessarily even have to be government involvement. It could be private-sector—a supported private-sector form of universal coverage.

 

So I—and others on the call may educate me and may—but I’m not aware of a major faith push against it. I think that our challenge, right—and you did—you know that from your own advocacy—our challenge is not direct opposition. It’s just lethargy. (Chuckles.) So we need to make sure that—and again, this challenge that Lucas mentioned and I mentioned, which is, you know, we sometimes do a better job of fighting against threats, as opposed to being visionary and trying to—and trying to make it a more just system, broadly and proactively.

 

Q: And of course I was thinking about the U.S. discourse, because, you know, given how contentious the whole health care has been in the country—and I’m generally familiar with the coalitions in favor of broader access, but I’m just assuming that there must be some faith communities that are pushing in the opposite direction. And you know, I’m just curious about who that might be. But I appreciate your response.

 

QUIGLEY: Yeah, and I can tell you from—again, I won’t—you know, you’ve all figured this out by now—I won’t—I won’t hide the fact that I’m an advocate on these areas as well as, you know, teacher and writer about it. But I think that this is an area—and what you did with ICCR and what folks have done with NETWORK and others is that they do find this is a bit of common ground, where you do have some faith communities that can be very—you know, can have very different viewpoints on a lot of issues. But again, evangelical supporters of—you know, of a Trump presidency sometimes are very much in favor of universal care.

 

Now they can be very suspicious of government involvement, but I have not seen a concerted faith movement opposing expanded care—care access. But again, others may have seen it, and I haven’t.

 

FASKIANOS: And if anybody has or has some thoughts on this, please queue up and share those thoughts.

Next question?

 

OPERATOR: (Gives queueing instructions.)

Our next question comes from Morgan Wills.

 

Q: It’s actually not a question but a follow-up to the previous discussion.

 

FASKIANOS: Great.

 

Q: I’m sorry. I joined the call a little bit late, because I couldn’t find the access code. But I’m an internist and the CEO of a Christian health center in Nashville, Tennessee.

And I don’t know that there’s been a concerted effort against it, but I’m pretty confident the Christian Medical Association, which is a guild of Christian doctors that tends to skew more evangelical, has probably not come out, at least explicitly, in favor of a universal health care system. I know there’s some debate in that organization about the merits and primarily because of some of the government overreach fears regarding ethical considerations, as well as bureaucracy.

 

So once again, don’t know if they have confronted or combated any efforts towards universal health care, but certainly there is a pretty skeptical stance in some of the statements I’ve seen from that organization.

 

QUIGLEY: Thank you for that, Morgan. I’ve heard of them. I’ll look at that and see where—like you say, they’ve just been silent or if they’ve actually been giving that explicit opposition that William had mentioned. That’s good—that’s good to look for.

 

FASKIANOS: Fran, while we’re waiting for more questions or comments, could you tell us a little bit more about the work that you’re doing on the drug affordability crisis?

 

QUIGLEY: Yeah. So I’m the—I’m a volunteer and coordinator of a new group called People of Faith for Access to Medicines. And we’re really specifically trying to focus, as though—as the name suggests, on the drug access crisis, prescription drug access crisis, which is universal. It certainly exists in the U.S. It’s a little bit different in character than what exists internationally. But we do have an enormous, enormous challenge, which is the affordability of medicines, especially medicines that are not widely available or for patent reasons or whatever don’t have a competitor.

And it’s really kind of an interesting challenge advocacy-wise because this is something that is—you look at the polling numbers, and there’s—you know, 80-plus percent of Americans say they want the government to take significant action on lowering drug prices. We have President Trump, when he was a candidate and even after he got elected, saying, you know, that drug companies are, quote/unquote, “getting away with murder.”

 

At the same time, those companies are very, very, very strong politically in terms of their lobbying impact, their campaign contribution impact and their marketing skills, et cetera.

 

So it’s a really interesting challenge to try to translate populist frustration about drug pricing to real reform, which hasn’t—you know, frankly, lots of talk, but nothing’s happened yet.

 

And the faith communities—I think, as we’ve discussed, and in the broader context of health care, the faith communities have a unique role to play; and that the faith communities can take this debate out of an intellectual property argument or an economics theory argument, et cetera, and start with the baseline of a moral agreement, that there’s a moral imperative—if you want to use the term, “a human right”—that people who are suffering, people who are sick, people whose physicians have prescribed them medicines should be able to get those medicines; and that again, that’s absolute consensus across faith and moral traditions. And if you start there, then it becomes much easier to have a bipartisan conversation about fixing it.

 

So that’s what we’ve tried to do in People of Faith for Access to Medicines. Our website is PFAMRX—P-F-A-M-R-X—.org, if people are interested. But we’re trying to kind of link the existing access to medicines advocacy on an intellectual property side, on international—on very technical arguments and maybe in sometimes political arguments, trying to link that to the existing faith community commitment to health care for all.

 

FASKIANOS: Great. Thank you very much for that.

You mentioned that participation in organized religion has declined in recent years, yet the faith community still has significant social influence. So can you talk about this trend and how you—do you expect it to continue this way?

QUIGLEY: Yeah, I do, because folks who’ve studied it more than I do—(chuckles)—have told me that it will. And again, I’d refer folks to the work for—and he’s not the only one to do this, but Ziad Munson and others.

 

And kind of it’s a little bit of a phenomenon, Irina, of being just kind of the last institution standing. There is less—especially, you know, frankly, in the younger generations, there’s less active participation in faith congregations. But they are still—faith communities are still held in very high esteem by the public, even by folks who are not actively members of any particular congregation.

 

But also, relatively speaking, the faith community writ large has survived the unfortunate—I would say unfortunate; maybe others wouldn’t think, you know—degrading of other institutions. You know, we used to hold the—you know, more people held the media in higher regard than happens now. Congress is at record low respect levels. Folks, you know, do not respect political parties the way or don’t have active membership in political parties or civic groups the way they used to. And the faith communities kind of continue to stand among the rubble around them, if I can use that metaphor, and as a result have, you know, proportionately even more of an influence on social and political discourse than maybe in the past, probably not as consistently obedient—folks sitting in the pews who will, you know, follow that doctrine and dogma—but in terms of just being able to raise the moral voice.

 

And I do think you’ve—and when the dust settles and folks give a real thoughtful scholarly analysis of the—of the 2017 fight to preserve the Affordable Care Act, I think the work of the 43 different organizations that Lucas mentioned and NETWORK and groups like that coming together in interfaith way, raising the moral voice—I think that—I think they’re going to—history will treat the faith community’s role very well, with what the faith community’s done in the last nine months.

 

FASKIANOS: Great. Thank you.

Next question.

 

OPERATOR: We have no further questions in the queue at this time.

 

FASKIANOS: We must have covered everything, then. (Laughter.) Fran, I wanted to give you an opportunity to wrap up. If there are parting words that you can leave with the group today—many members of the faith community are on this call—about what they can bring back to their respective communities, groups, congregations, et cetera, or what they should be doing locally and any other words you—of wisdom you would like to leave us with. And can you also circulate after this call in the next couple of days some of the resources that you mentioned and the one from Lucas Allen, et cetera? So let me turn it over to you for final remarks.

 

QUIGLEY: Well, thank you, Irina, and thank you, everybody else on the call. I’ve already learned a lot and look forward to continued discussion. If folks have any—you know, I’m certainly every eager to have conversations, if folks want to continue to have those.

 

I think that the faith community’s challenge in many respects is translating what our—what we and our colleagues and our fellow congregation members maybe already are committed to, which is our own individual acts of charity and mercy, you know, which again cut across all faith traditions, our obligation to do that. And—but I do think this is a really—a somewhat uniquely American challenge, too, is that we are much better about charity than we are about justice. We’re much better about individual acts of, you know, donating to a food pantry than we are to making sure that there’s no hungry people writ large. And I think that applies to the health care situation as well, is that the faith communities do an amazing job nationally and internationally in providing direct care through hospitals and clinics and supporting those even that are not specifically faith-based in their orientation.

 

But I think that if you look at the faith traditions—and certainly my reading of them across the board is that we have a little bit more of an obligation than that and that we have an obligation to ensure that even the people who are not in front of us have access to medicines and access to care, and that that means some collective justice. And the rest of the globe for—especially the industrialized wealthier countries besides the U.S. have done a much better job of committing to access to health care for all than we have. And I think it’s a little bit sad that the nation that is so self-consciously faith-based, with this amazing faith tradition of working for access to health care, that we do a pretty poor job in the U.S.

 

So I think we have a challenge of translating our individual inclinations towards mercy and charity to a broader sense of justice in access to health care for all. And I really do have optimism that we’ll get there, but I do think we have work to do in the next, you know, five, 10, 15 years to see whether we have an opportunity in our history to finally start plugging the many gaps we have in access to health care in our U.S. system.

 

FASKIANOS: Well, Fran, thank you very much for sharing your insights with us today, as well as the great comments that we had from our colleagues on the call. We really appreciate it.

 

You can follow Fran Quigley on Twitter, @FranQuigley. We also encourage you to follow CFR’s Religion and Foreign Policy—Foreign Policy Program on Twitter, @CFR_Religion, for announcements about upcoming events and information about the latest CFR resources to sort through what’s going on in the world today.

 

So thank you all again. We look forward to your participation in future discussions, and look out for our email with additional resources.

 

QUIGLEY: Thank you, Irina.

 

FASKIANOS: Thanks, Fran.

(END)

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