by Martha Bebinger for WBUR
December 6, 2010
Get ready for the next hot religious campaign in Boston: rising health care costs. Yes, the group that chanted, prayed and sang its way to passage of the state's health coverage law says it's time to rein in health care spending.
Greater Boston Interfaith Organization launched a campaign Sunday, and WBUR's Martha Bebinger has this review of the first team meeting.
Bob Oakes: How important is it that this group is getting involved in the great debate about rising health care costs?
Martha Bebinger: GBIO was very active in lobbying for the state's health coverage law. My eardrums are still feeling the effects or the singing, chanting and praying that bounced off those marble State House walls, and they, along with Health Care for All and a few other health care advocacy groups, have decided to make sure now that consumers have a say in the debate about health care spending. So their track record makes this significant.
But it's also important because here in Massachusetts and across the country, we have not had an organized movement of educated consumers or patients saying, "Here's the way we would trim health care spending." And if that develops here it will be important to the national debate as well.
So why are they getting involved, and why does the Greater Boston Interfaith Organization see this as a religious issue?
Right, it doesn't seem very obvious up front, but they see this as a social justice issue. They say rising health care costs are eating away at the income people have for all kinds of other discretionary spending. Employers say they can't hire more people or give adequate raises because much of their profits, if they have any, are going towards higher health care premiums. And, we see all the time, municipal and state services are being cut because spending on health care is increasing three or four, maybe more times faster than the rate of inflation.
So, for the sake of the discussion, let's call those compelling reasons. But there's a huge difference between supporting coverage for the uninsured and the rallying members to hold down health care spending. What are they going chant? What will the bumper stickers say?
Well it is hard to imagine "Just say no to Fee for Service" or "How much was your MRI?" Health Care for All is pushing the message, "Better Quality Care Costs Less." Even that's a hard message to absorb because it runs counter to the way we think about health care.
But GBIO and Health Care for All have done this before. The first round of team leaders that gathered Sunday was fairly split about how hard it will be to explain health care costs, to sell this campaign to their congregations.
"There's a great need for people to actually deal with this on a personal level, and so anything that we can do to help congregants, as well as to help the larger community, there's a great appetite for that," said Karen Anne Zion, with the First Church in Cambridge.
But Debbie Wengrovitz, with Temple Isaiah in Lexington, would agree but she still think this will be a very tough issue.
"I think it is hard. I think you can look around and see there are a lot of smart people who've worked on this for a long time and are still having problems," Wengrovitz said.
So, what's the strategy here, Martha? How will the GBIO help people understand the issue and then persuade them to get involved in this campaign?
They're starting, Bob, by building a team of leaders who will take the information that they get from a lot of briefings and conversations back to their congregation.
They're also asking members to wrestle with what it would mean to spend less on health care, that's the ultimate question here. On Sunday, in small groups, the congregation leaders were given a role: they were a primary care doctor, an employer, an uninsured resident — 10 different roles. They had to decide, with a limited pool of money, what services to include and what they would leave out of a health care plan. So, Bob, here's the moment when they are sitting around a table, staring at this wheel that shows what they've included and what they left out. We hear first from the facilitator, Barbara Berke:
"Who's worried about the future now?" Berke asks.
"I have an elderly parent, we're taking care of him at home and now I don't have the resources to do that," Chuck Koplik says.
"I'm worried about pharmacy because I'm diabetic, and I'm probably going to need more medication as we go on. I think it's not what I would give up, it's what other people would give up," Michele Mitsumori says.
Mitsumori sums up a problem that people have with this issue: it's not what I'm going to give up, it's what somebody else is going to give up. You also heard from Koplik, who's worried about losing home health care hours for his elderly parent. You can see how these discussions get tense, even when people are role playing. In real life conversations they can really be explosive.
So while we'd all like to think that if we start spending money more efficiently on health care, we won't see our expenses double in the next 10 years, as they are projected to do, we probably will face some limits, and one thing this campaign will do is help people start to think about what they value most in health care — and what they can live without.
And what's the goal here? Is there a particular piece of legislation that the group is thinking about?
They aren't there yet, they're really at the point of educating people to try to get to some sense of common values or common principles. Now, of course, if Gov. Deval Patrick rolls out legislation in January, as he is expected to do, then there will be a lot of pressure on consumer groups, the doctors and hospitals and everybody to weigh in, to say, "Are you there?"