A Neurosurgeon and a Pastor Work Hand-in-hand for Universal Healthcare
Unbound interviewed Dr. Bohmfalk and Rev. Thomas together because they demonstrate that faith and science have intersecting roles in inspiring just outcomes. They are an effective team in advocacy for an issue that the Presbyterian Church (U.S.A.), along with other mainline denominations, has supported for decades. This most recently includes support of single-payer National Health Plan in 1991 and re-affirmation of this goal in 2008.
Dr. George Bohmfalk
Could you say a little bit about yourself, how you became an advocate on the issue, and how you met Rev. Thomas?
I practiced neurosurgery in Texas; I was a lifelong Texan, and when I started practicing there was a lot of resistance from physicians who resented any interference from Government and thought it was just terrible. But then, over the course of 20 years, it became very obvious that a whole lot of folks were falling through the cracks.
A lot of my patients couldn’t get the care they needed. I mean, there were just all sorts of problems that were obvious to all of us, and I started coming around to the notion that we needed some sort of universal healthcare system. I was aware of this PNHP, Physicians for National Health Program, but I just never was prompted to get involved with them at the time—I have no real good excuse for that.
Then, after I quit practicing things got worse and worse. Because of a healthcare issue with one of our grandchildren, we ended up leaving Texas and pretty much dividing our year between North Carolina and Colorado. About a year and a half ago, there was mention in the paper about a presentation on a national healthcare program, and I thought I’d go see what they had to say. It was a very compelling presentation—it showed how much we’re spending and how bad our outcomes are. That was the spark that I needed…so I literally joined the national PNHP organization and its Charlotte chapter (Health Care Justice—NC) the next day. That’s how I met Rev. Thomas.
What are the reasons why you say Universal Healthcare is common sense?
I guess that the top three [arguments for Universal Healthcare] are:
- We’re spending too much and getting too little right now.
- Enormous waste in the system
- We’ll be spending less under a single-payer system.
Right now we’re paying twice as much per capita as every other [first-world] country in the world, and those countries do provide insurance to everybody. If you look at the outcomes—what are we getting for that money?—we rank near the bottom, for almost all of them: maternal child mortality, life expectancy, etc.
Then if you look at where the money’s going, because of the myriad of health insurance plans and managed care efforts, and all these other bureaucratic things in the system, there are all sorts of studies that show about 30% of all healthcare money goes to administrative overhead—and that’s absurd! There’s no individual American business that would tolerate that kind of administrative overhead, and a single payer system is projected to cut that in half.
So yes, Universal Healthcare would require some taxes to be directed toward it. But even though we’re going to be paying taxes, we’ll be spending less money overall than we now do in premiums, deductibles, and other out-of-pocket costs. .
What barriers do you face when trying to communicate your message on Universal Healthcare?
One I run up against is resistance to government: “the government is not accountable,” “the government can’t run things as well as the private sector,” or “the government is inefficient.” It’s really almost impossible to get past that bedrock apprehension toward the government. So I try to make this analogy about fire departments: nobody thinks about calling the fire department; we know it’s going to be there and we support it even when it’s a government function.
One of the things that I have heard over and over from people in the industry is that the Affordable Care Act tried to transition us over to more population-based care, that it was “getting us ready” for something like this.
Well yes, it’s both helped and hindered, hasn’t it?
My understanding is that once President Obama was in office he quickly realized single-payer was too tough a sell at the time, 10 years ago. So he tried to do something a little easier that gives real supports for everyone: inclusion for people with pre-existing conditions, being able to stay on your parents’ plan until you were 26, eliminating the lifetime cap. It was a fairly simple matter for private for-profits to smack down the public option—as they have done. But nonetheless, even with all their resistance, we’ve dropped the uninsured rate by about 10 million (30 instead of 40 million) and people have woken up to the issues of pre-existing conditions. Now when they try to roll that back, people come out in the streets!
So it’s helped that it has showed people that the government has done something that helped millions and millions of people. That ain’t bad!
It’s hurt because it did preserve the roles of the private insurance companies. In the last year they’ve done a lot more of vertical integration, buying up pharmacies and buying up hospitals and medical groups. So now you have the insurers and the providers and the drugs all in one huge network. Horizontal integration—buying more of the same type of companies—they’ve done that too! They may now present more formidable opposition to this work.
What about state-level solutions?
Well, Colorado’s an interesting situation, because they proposed one of these state-level single payer plans two years ago. And for a whole lot of reasons, they just got soundly defeated. There may be a chance to get it through with the next attempt. But many think that state-level solutions are doomed from the outset, mainly because they require congressional waivers for rerouting federal funds. I find very little reason to go down the route of state-by-state block grants for this kind of thing—it may get us there, but even then it would take 30 years and a lot of suffering.
We really feel like there’s momentum in the general population. When we get the message right, there’s a lot of support. So we’ve got to get something going in Washington, while people are really clamoring for this.
Rev. Zach Thomas
Could you say a little bit about yourself, how you became an advocate for this issue, and how you met Dr. Bohmfalk?
In the 1950s and 60s Dr. Martin Luther King, Jr. modeled the Christian values that my two brothers and I learned from our Baptist mom and Presbyterian dad. Later as a hospital chaplain I invested that activism into the hospice movement, serving as founding president of Hospice At Charlotte (now Hospice & Palliative Care Charlotte Region). In the early 80s we celebrated when hospice care was approved for reimbursement through Medicare.
Though retired, I still hear the same values calling me. Medicare need not be reserved for us old folks. It works well, and if made available to everyone, it would address what Dr. King saw as society’s greatest inequity — namely, “injustice in healthcare.” The idea of Medicare-for-all feels a lot like what the grassroots movement for hospice was: an idea whose time has come.
Health Care Justice—North Carolina (HCJ—NC) educates its members and elected officials for a more just universal health care system. I often saw the chair of HCJ—NC, Dr. Jessica Schorr Saxe, making her rounds in the hospital. She worked in a clinic bringing health care to under-served populations in Charlotte. As a result of many kindred organizations around the country, those supporting a national universal health program have grown to over 70% of the population. Not long after I joined HCJ—NC I met George Bohmfalk, MD, retired neurosurgeon. Now we both serve on HCJ—NC’s board of directors. George’s ability to sift through misinformation about health insurance and communicate about practical solutions opens a rational path forward.
How do you think the role of the church is helping to nurture both body and spirit, and how has this role historically intersected with the public sphere?
I think that if we look back, we see that the church has been at its best when it considered health holistically, and at its worst when it ignored the causes of human suffering.
I became a parish minister in eastern NC at the same month that Rev. Dr. Martin Luther King, Jr. was assassinated. I was told by the Clerk of the Session of the church not to preach on brotherhood. It didn’t take long for me to realize I walked around with an inner love-hate struggle with The Church. At the time, I thought, “So what else is new?” But it turns out, looking back over the decades, that a lot is new—the Civil Rights Act (Title VI), the re-unification of the northern and southern Presbyterian churches, the struggle by African American physicians to integrate hospitals resulting in the implementation of Medicare, the ordination of women, the acceptance of LGBTQ members, the pill, etc. All these and more have changed and strengthened the church.
The holistic health movement, especially, has poured new wine into old wineskins and made them new. Say what you will about the “holistic health movement” that arose in the 60s and 70s, roll your eyes at its infatuation with drugs, dreams, and drums, but remember how it re-connected us with a deeper consciousness of “body- awareness”—a consciousness that has seeped into every nook and cranny of our society. The word “holistic” brings integrity to our plans and protocols.
The holistic health movement…has poured new wine into old wineskins and made them new.
Nowadays, many large churches have a gym, a parish nurse, a Stephen ministry, a certified pastoral counselor. Hospitals have clinical pastoral education programs, behavioral and movement therapists, music therapists, transcendental meditation training for chronic pain. Ultimately our General Assembly in 2008 recommended a national universal program of single-payer health insurance as the program most consistent with the moral mandates of the gospel.
Holistic health brought us closer to traditional health practices in other countries, closer communication between cultures and deeper appreciation for multilingual and multicultural experience. It is helping us even now as we come to grips with our original sin of slavery and its consequences of dysfunctional and unjust systems of housing, education and health.
I worked for 5 years in Guatemala with physicians in areas of extreme poverty around Antigua. For pulmonary problems they often wrote prescriptions that read “cement floor,” “install vent for stove,” “baño con agua.” They knew that a cough drop could suppress symptoms for awhile, but true health called for a more holistic approach.
I often feel that in the USA we’d rather suppress symptoms than deal with the larger issues that have direct bearing on chronic conditions. Our main dysfunction is the financial threat that prohibits access to care. We will always suffer from anxiety, bankruptcies, and lack of care as long as the cost is so prohibitive. A healthcare system based on making a profit for shareholders of insurance companies will always contain such dysfunction. A more holistic approach that lets everyone enjoy healthcare without financial risk is what Medicare-for-all can provide.
Where in scripture and in Christian practice do you see support for Universal Healthcare?
Arguments for health care as a right soar in rarified air but rarely get to the nitty-gritty. The point is that the more people suffer from lack of healthcare because of the greed of those who make outrageous profit on the backs of the patients, the sicker the society becomes. I read more frequently of insurance administrators who can no longer stand the job of retroactively cancelling policyholders with large medical bills (a policy known as “rescission”). Our present system crosses the ancient ethical mandate for caregivers to do no harm. If we are all in this together, a greedy rationing model undermines the system’s integrity and is unacceptable.
Luke, the physician, reminds us that healing is for the common good and not to be used for private gain:
Simon saw that the Spirit had been given to the believers when the apostles placed their hands on them. So he offered money to Peter and John, and said, “Give this power to me too, so that anyone I place my hands on will receive the Holy Spirit.” But Peter answered him, “May you and your money go to hell, for thinking that you can buy God’s gift with money! Repent then, of this evil plan of yours, and pray to the Lord that he will forgive you for thinking such a thing as this. For I see that you are full of bitter envy and are a prisoner of sin.”
(Acts 8: 18 – 24, Good News Bible: Today’s English Version)
What are next steps? How can we tap into grassroots and advocacy networks that seek to expand access to healthcare?
The roll-out of a universal system of health care can occur within an imperfect society. Back in the 50s and 60s people would often say, “You can’t just declare integration all of a sudden. You have to give people time.” It turned out that black and white folks who were rolled into the same hospital room often became friends, all of a sudden.
So, even after Medicare-for-all is suddenly in place, we will still need to address inequities in housing and education that bear directly on health, as well as wealth inequality and other nefarious Gordian knots of systemic dysfunction.
People and churches of wealth often prefer to condemn external evils rather than examining themselves. ”Enemies” abroad allow them to push off the table the issues of universal health. The “evils” of socialism are alive and well as buzzwords among conservatives who are always uncomfortable with anyone talking about “their money.”
The irony is that conservatives more than anyone else, should be seen as the ones most supportive of Medicare-for-all. The issue lies squarely in being good “stewards” — especially good stewards of taxpayer monies and business’s profits. The decrease of per-patient costs and the return on a universal investment in health care are obvious in Medicare-for-all.. Why do conservatives think it is extreme to draw from a tax-based fund for the health of the community?
If there is one issue that Christian conservatives and liberals could come together on, it is a just health care system for everyone. We can all be better stewards.
Dr. George Bohmfalk grew up in Texas, went to med school and did a neurosurgical residency in San Antonio, then moved to Texarkana, where he practiced medicine before retiring and moving to Charlotte 11 years ago, in pursuit of his grandchildren. He became involved with HCJNC a year and a half ago, after attending a presentation on Improved Medicare for All
Rev. Zach Thomas is a retired pastor who has worked in hospital chaplaincy and hospice; in bodywork therapy; in gardening for 5 years, with Common Hope in Guatemala; and in teaching life skills with Latino inmates in Mecklenburg county jail. He has published four CDs, available at zachthomasmusic.com, and now feel called to support Health Care Justice–NC (www.pnhphcjnc.org).