The spiritual metaphors here are potentially endless. White American Christianity has glutted itself on the unhealthy calories of religious nationalism and prosperity theology; we will get to those in due course. We will likewise address the scriptural implications of a church and a self-styled “Christian nation” who ignore the provisions of food that Jesus made in the Gospels. For the moment, let us acknowledge that the wealthiest country in the world is not adequately feeding its own people.
Part of the rationalizing rhetoric used to dismantle domestic food aid programs like SNAP and TANF is to say that churches, not the government, should be the safety net. I want to disabuse us of that notion right away. Yes, there are wealthy churches that do a great deal of work to feed the hungry. There are still more wealthy churches that do not do anywhere near enough, which may be one of the reasons they remain so wealthy. But those churches are not the majority of congregations in the United States. The median worship attendance for the average American congregation is eighty, and the majority of congregations have less than one hundred attendees in Sunday worship.14 I pastored one such congregation for nearly seven years in the heart of a lovely but increasingly impoverished town that took the Great Recession on the chin. Nobody in our congregation was especially wealthy. Many were food insecure or bordering on homelessness. Even so, the congregation offered a full meal most every Sunday for anyone who was at worship, knowing that a number of folks would pack up more of that food to take home for dinner that night or breakfast the next morning. The meal was one of several ministries the parish faithfully performed to respond to the poverty that surrounded us. The efforts our members put into those ministries were positively herculean. To say “Let the churches do it” echoes the flippant obliviousness of “Let them eat cake.” Many churches are already doing the work. It is not enough.
Demanding that the poorer churches already addressing food insecurity do even more with what little we have is tantamount to demanding that the poor redistribute their food and money amongst themselves. Those Sunday meals and mission ministries were funded by the tithes that came out of my members’ paychecks and fixed incomes. To argue that the church should be the ones to fix food insecurity rather than to tax the multibillionaires who have built their fortunes on the backs of the food insecure is simply morally bankrupt.
None of this should be construed as absolving the church of its biblical and historical mandate to feed and care for the poor. But in an era when the churches that are suffering the most tend not to be the megachurches of the televangelists we love to hate on, but rather the neighborhood church down the street from you that has been quietly providing for your impoverished neighbors for years and decades, “Let the churches do it” cannot be seen as a viable solitary option.
This means that not only must our expectations adapt to this reality, but so too must our religious communities. Congregations and their leaders, both lay and clergy, must address economic inequality and stratification in a way that holds our government officials and institutions accountable. If the bleeding of the most vulnerable among us is to ever be stanched, we must move beyond band-aids to the surgeries and sutures that offer hope and healing.
Medically Induced Bankruptcy
In 2016, a meme declaring that 643,000 Americans go bankrupt every year due to medical expenses went viral on Facebook, prompting the fact-checking website snopes.com to investigate. Snopes found that the figure of 643,000 was probably high, but even conservative estimates said one in four of all personal bankruptcies in the United States was related to medical debt15—the most common source of personal bankruptcies.16
The total number of personal bankruptcies has fallen dramatically during the last decade, from a peak of nearly 1.6 million in 2010 to just under eight hundred thousand in 2017,17 a reduction of 50 percent. Two reasons come to mind. One is that 2010 saw the worst aftereffects of the Great Recession, with many areas of the country experiencing double-digit unemployment rates. The second is the passage of the Affordable Care Act, and the corresponding drop in the number of Americans lacking health insurance.
Even with the assistance of the Affordable Care Act, and using the most conservative estimates, 150,000 to 200,000 American households at a minimum declare bankruptcy every year because of their medical debt.
Into the breach to mitigate some of the bleeding has been the phenomenon of crowdfunding—raising money from friends, family, and people who hear your story online. For many crowdfunding websites, which typically take a commission from each campaign, fundraisers for medical expenses are their bread and butter. On the crowdfunding website GoFundMe, as many as one in three donation campaigns are for covering medical expenses, and the website’s CEO says that medical campaigns account for the highest amount of money raised of any of the site’s categories.18
Those numbers should come as a condemnation of an anti-life reality that we are not providing for one another as the Gospels would have us do. That basic healthcare could ever be claimed as a privilege rather than a right in a self-styled “Christian” nation represents a sort of theological and scriptural amnesia endemic to the era in which we live.
For a church that worships a Messiah who offered free healthcare as part of his ministry, alarms should be raised. As much as the church focuses upon the Cross, there is another cross, the equal-armed red cross of medical care, upon which Christ’s ministry demands that we focus our attention and resources. Just as Christ’s public ministry included the miraculous provision of food in the face of hunger during the feedings of the five thousand and four thousand, that ministry also included the miraculous provision of healthcare in the face of a number of physical maladies.
It is not simply that the healthcare Jesus provided to people suffering from conditions like leprosy and dropsy was miraculous, however. It is also that the healthcare he offered was free of charge. We Christians follow a Messiah who did not condition his miracles on copays and deductibles, but asked only that people follow him. Jesus’s public ministry will be discussed in more detail in chapter 3; integrating it here helps to frame this next statistic: according to the Centers for Disease Control and Prevention, 88.1 percent of Americans have a “usual place to go for medical care.”19 That might sound impressive until we consider the inverse: nearly 12 percent, or almost one in eight, Americans have no usual place to go for either routine or urgent medical care. With a population of roughly 325 million people, that translates to 38 million who lack access to basic medical care, even before the question of adequate insurance enters into the equation.
The good news is that we can rise to reach—if never fully meet—Jesus’s example, at least in the interim. While ordinary neighborhood churches may lack the resources to fix the crisis of healthcare bankruptcies, there are positive and concrete steps many churches are already taking. As we will see in the next chapter, some churches with the resources to do so are already tangibly contributing toward the forgiveness of medical debt and the accessibility and affordability of healthcare. Other congregations have taken their activism increasingly public, lobbying elected leaders for the sort of wholesale changes to healthcare that churches by themselves cannot effect. Even then, our task is not yet done: we must use our theological vocabularies to replace a healthcare framework of wealth-worship and profit generation with a Gospel message that has not been sanded away by the twin American idols of extreme individualism and unfettered plutocracy.
The Power of a New Frame
If you have ever changed the frame on a piece of artwork, you know the influence