Part VI: Care for the Poor

1. Catholic Social Practices & the Health Care Setting Part VI: Care for the Poor Darren M. Henson, Ph.D. [c]913-522-0246 DarrenHenson@sprintmail.com

2. The Poor What comes to mind? Who are “the poor?” What “care” ought to be given to “the poor?”

3. The Good Samaritan – Luke St. John the Divine, NYC – Side altar Photo by author

4. Objectives • Articulate the scriptural understanding of the poor • Compare & contrast to other diverse perspectives • The poor in Catholic Social Teaching • The Preferential Option for the Poor & Vulnerable • Connections to health care

5. Definitions – Merriam-Webster • Poverty: the state of one who lacks a usual or socially acceptable amount of money or material possessions; scarcity, dearth, and debility due to malnutrition. • Voluntary Poverty: renunciation of an individual’s right to own property. Such an understanding of poverty is not limited to the economic and material understanding of poverty.

6. Definitions – World Health Organization • Income: Absolute terms, < $2/day • Economically poor and poor health • Greater exposure to environmental health risks • Less well nourished • Less able to access health care / higher risk of debility • Illness reduces household savings, decreased ability to learn • Thus, the cycle of poverty World Health Organization: http://www.who.int/topics/poverty/en/

7. Definitions – United Nations • No mention of money • A denial of choices and opportunities, a violation of human dignity • Lacking schools & clinics • Susceptibility to violence • No access to clean water and sanitation • Global poverty: income < $1.25/day. • Nearly 1 billion people at or below this level www.un.org/esa/socdev/unyin/documents/ydiDavidGordon_poverty.pdf‎

8. Definitions – U.S. Government / Census Bureau • 2011 reported 15% of the population living in poverty • Matrix of 48 different thresholds • Monetary, pre-tax income • Family size & composition (# of dependents, etc.) • No geographic variation, updated for inflation • $11,702 – single individual, under 65, with no dependents. • $13,596 – two persons over 65 • Ratio of Income to Poverty  Income ÷ Threshold http://www.census.gov/hhes/www/poverty/about/overview/measure.html

9. US Poverty Thresholds

10. Scriptural Roots – Hebrew Scriptures • Suffering unequal treatment & injustices • Exod 23:6; 30:15 • Deut 24:10-15 – Give your cloak to the poor; Pay wages • Worthy of respect & special provisions • Lev 19:9-10; 23:22 – Leaving fruits in the fields for the poor • Exod 23:11; Lev 25:6-7, 12 – Permission to eat freely from the fields

11. Scriptural Roots – Psalms & Proverbs • “The Lord hears the cry of the poor” (Ps 34) • Generosity to the poor (112:9) • Prayers of deliverance • Assurance of God’s protection Those who mock the poor insult their Maker (Prov 17:5) Do not rob the poor or crush the afflicted; the Lord pleads their cause (Prov 22:22-23) The poor and the oppressed have this in common: the Lord gives light to the eyes of both (Prov 29:13).

12. Scriptural Roots – Hebrew Scriptures • Prophets: Isaiah, Amos, Jeremiah, Ezekiel, Zechariah • Those who are bought and sold, trampled, crushed, oppressed, forced, and denied justice • Exhort Israel and religious leaders to defend the poor • Failing to protect the poor – a scandalous justice (Isa 1:23) • Leaders deprived the poor of rights and lands (Isa 3:13-15, 5:8, 10:1-2; Jer. 5:27-28)

13. Scriptural Roots – New Testament • Jesus born poor • Luke’s Sermon on the Mount (Lk 6:20-23) • Blessed or “Happy” are you who are poor, hungry, weeping, and excluded” • Matt 5:3-12 – poor in spirit, meek, thirsting for righteousness, peacemakers, persecuted • Discipleship – leaving behind possessions / identification with the poor • Call & Mission of the Twelve (Mt 10:1-15; Mk 6:8-11; Lk 9:2-5) • Rich Young Man (Mt 19:16-30; Mk 10:17-31; Lk 18:18-30)

14. Scriptural Roots – New Testament • Pauline literature • Monetary collections to share with others. • Acts of solidarity and unity They were pleased to share their resources with the poor. (Rom 15:26) They ask that we remember the poor, which I was eager to do. (Gal 2:10; cf I Cor 16:1-4; II Cor 8-9) FreeDigitalPhotos.net

15. Early Christians • The Didache - Teaching of the Twelve Apostles (ca. 1-2c) • Early references to Christian ethics • Urges time with the poor • Keep children away from those who have no mercy for the poor • St. John Chrysostom (c. 347-407) – relentlessly preached about the plight of the poor and the obligation of Christians to practice almsgiving.

17. Encyclicals: Rerum Novarum, 1891 • Rights for poor workers • Relationship between wealthy owners and poor workers • Sets the foundation for the dignity of the poor

18. Encyclicals: Mater et Magistra, 1961 • Relationship between the prosperous & needy • Scientific & technological advancements • Achieved much good • Yet also, increased poverty – a counter-intuitive observation • Global sense of poverty • The “hunger, misery, and poverty of other nations” (par. 158).

19. Encyclicals: Pacem et Terris, 1965 • Rights: food, shelter, healthcare, to be looked after in times of vulnerability. • Role of the State toward the poor: “…give more attention to the less fortunate members of the community, since they are less able to defend their rights and to assert their legitimate claims.” (56, 63) Robert Lentz Icon

20. Vatican II Gaudium et Spes, 1965 • Ch. 3 – “Economic & Social Life” • Aid to poor – requires more than sharing “superfluous goods” • Whatever is necessary to free them from misery. Photo by CNS

21. Encyclicals: Populorum Progressio, 1967 • Passionate defense of the poor • Obligation of the wealthy to share resources • Authentic human development is not just economic • Reduce inequalities • Eliminate discrimination • Moral and spiritual growth • Redistribution of wealth is not enough. • Church stands with the poor: hospitals, schools, etc.

22. Beyond Encyclicals: Latin America • CELAM (Latin American Bishops’ Conference) • Medillin, Columbia 1968 • a “truly poor, missionary, and paschal” Church, • committed to “solidarity with the poor…[which] means that we make ours their problems and their struggles.” • Puebla, Mexico, 1979 • Preferential Option for the Poor • SolicitudoReiSocialis, 1987 – Pope John Paul II • Option or love of preference for the poor; It affects the life of each Christian. • Preference for the poor includes those without medical care (para. 42)

23. Beyond Encyclicals: Gustavo Gutiérrez, OP • A Theology of Liberation, 1972 • Rooted in scriptures of God’s intimacy and abiding care for the poor • Jesus’ interaction with the poor & rejected • Later works: poor are not just the economically poor • Those without options or opportunities • Those who die before their time. • Poverty – a negation of life, affecting creation and the richness of the resurrection. http://theology.nd.edu/people/faculty/gustavo-gutierrez-o-p/

24. Beyond Encyclicals: Bryan Massingale • Preferential Option for the Poor • A“profound religious conviction about the inherent dignity and worth of all persons,” especially the poor and marginalized. • Not an adversarial or exclusive relationship • The voices of the poor and marginalized receive a privileged hearing especially in matters of public debate and theological reflection. http://www.mu.edu/theology/massingale.shtml

25. How I would like a church that is poor and that is for the poor.

26. Connections to other Social Principles • Dignity of the human person • Solidarity • Justice • Creation / Ecology

27. Applications to Health Care

28. Applications to Health Care Ethical & Religious Directives • “The biblical mandate to care for the poor requires us to express this in concrete action at all levels of Catholic healthcare… to ensure that our country’s health care delivery system provides adequate health care for the poor… the uninsured, and the underinsured. (Intro, Part I) • Catholic health care should distinguish itself by service to and advocacy for… the poor, uninsured, underinsured, etc… (ERD, 3) • Medical exploitation of the poor (ERD, 42) • New joint ventures – opportunities to provide for the poor (Intro, Part VI)

29. Applications to Health Care Affordable Care Act • Role of CHA • 31 million Americans with new health coverage • $250m to vulnerable women • New challenges • Reduces number of uninsured • Community Benefit changes • Seeking out gaps in the system and disparities, social determinates of health • Broadens Medicaid eligibility yetlower reimbursements Steve Breen, http://www.cagle.com/2012/06/affordable-care-act/

30. Reflection & Discussion • Discuss and assess the relationship between the poor and the U.S. Healthcare system. • How does CST provide a vision for areas of growth? • What opportunities and challenges arise with the preferential option for the poor and marginalized? • Discuss how the particular religious founder(s) of your healthcare ministry can inform and direct your organization’s commitment to care for the poor. What does that look like concretely today?

31. THANK YOU! Darren M. Henson, Ph.D. [c]913-522-0246 DarrenHenson@sprintmail.com