Monday, March 29, 2010

Dr. Poon on the Anglican Communion: First Reflection

Many of us have seen the recent paper by Dr. Michael Poon of the Center for the Study of Christianity in Asia titled, “The Anglican Communion as Communion of Churches: on the historic significance of the Anglican Covenant.” It has certainly gotten attention, and perhaps especially among those in the Episcopal Church concerned about an Anglican covenant or about specifically the draft Anglican Covenant as we have received it. The title alone has caused some folks to wax eloquent – and sometimes to wax without much eloquence.

I had planned to read it anyway, but Dr. Poon was gracious enough to email me and encourage me to do so. I had left a comment at Thinking Anglicans, and he and I had exchanged emails before on other topics of Anglican interest, and I was flattered that he was interested in my comments. I stand by what I wrote at Thinking Anglicans, that while I disagree with him, I respect Dr. Poon. Among the theologians of the Anglican Global South I have always found him thoughtful and respectful of those with whom he disagrees, and truly interested in engagement and debate.

There are several facets in my reaction to his paper, but let me begin by differing with some of my colleagues among progressive Episcopalians and Anglicans: this is not per se a paper about the Anglican Covenant. The title is accurate: this is a paper about the ecclesial character and characteristics of the Anglican Communion. Dr. Poon argues that as an ecclesial body the Anglican Communion has an “ecclesial deficit,” one that would perhaps mean that the Communion is not a “communion” at all. He then argues that the draft Anglican Covenant as we have it before us now, or more accurately, I think, a particular interpretation of the draft Anglican Covenant, is a tool to remedy that deficit.

I think the best way to understand the “ecclesial deficit” as Dr. Poon sees it is to look at two statements. The first is a sentence that he has chosen from the Report of the Windsor Continuation Group:

The challenge remains for Anglicans to come to a common stance and acceptance of the authority which we will give to the instruments, structures and processes of the Communion which can lead to decisions that carry force in the life of the Churches of the Communion.

He then reflects further on this description of “communion:”

To be sure, all Anglican Churches are willing to belong to the Anglican Communion. That is not the issue if “communion” is merely a matter of social fellowship between autonomous churches. National councils of churches and even Protestant Christian World Communions are such instances of communion. “Instruments of consultation” would do for these forms of fellowship. They are sufficient for fostering spiritual and social bonds of affection. What WCG has in mind is whether the Anglican Communion is at the verge of a historic decision. Are the Anglican Churches that are “in communion” with one another able to affirm they are indeed a Communion of Churches with one ecclesial identity?

So, the evidence of “ecclesial deficit” is that the Anglican Communion does not have “one ecclesial identity” expressed in “decisions that carry force for the life of the Churches of the Communion.”

Dr. Poon leans heavily on this section of the Report of the Windsor Continuation Group. I have commented before on that part of the Report, as well as on the related language of “separated Churches and communities… [that] we believe… suffer from defects” in the declaration Dominus Iesus written by then Cardinal Joseph Ratzinger (and now, of course, Benedict XVI). Critical in appreciating what Dr. Poon (and cited in his paper) is this from the WCG Report:

To be a communion, as opposed to a federation or association, is fundamentally to acknowledge that the fellowship of Churches is not a human construct; it is the gracious gift of God. Churches are enabled to live in communion because they recognise one another as truly an expression of the One Church of Jesus Christ.

We are all conscious, I think, of our various (and often confused and confusing) uses of the term “communion.” In this instance, the WCG has a specific approach in mind, as raised in the next paragraph:

The question of the limits of diversity becomes acute when major differences arise in the life of the communion of the Churches which concern the faith, order or moral life of the Communion. It is then that Anglicans need a common understanding of how together, in communion, they can, guided by the Spirit, discern and decide together. What are the sources that need to be brought to bear on any issue? What are the structures through which discernment takes place? What is the nature of their authority to guide discernment, to speak the mind of the Communion and even to request restraint while open reception takes place and the Churches of the Communion come to discover the mind of Christ for them?

“What are the structures, and what is the nature of their authority?” So, for the WCG, and by his usage for Dr. Poon, authoritative structures are essential for the Anglican Communion to truly be a Communion of churches.

In that light, the language of Dominus Iesus becomes helpful. Let me return to the paragraph cited in my earlier post.

Therefore, there exists a single Church of Christ, which subsists in the Catholic Church, governed by the Successor of Peter and by the Bishops in communion with him. The Churches which, while not existing in perfect communion with the Catholic Church, remain united to her by means of the closest bonds, that is, by apostolic succession and a valid Eucharist, are true particular Churches. Therefore, the Church of Christ is present and operative also in these Churches, even though they lack full communion with the Catholic Church, since they do not accept the Catholic doctrine of the Primacy, which, according to the will of God, the Bishop of Rome objectively has and exercises over the entire Church.

This is helpful in two ways. First, it emphasizes that the Church of Rome sees its authoritative structures as not “a human construct.” They are continuous from the time of Peter, established by the primacy of Peter (as Rome understands it), and formed and sustained by the will of God. Second, the model envisioned in the WCG Report (and consistent with the intent of Archbishop Williams), and supported in Dr. Poon’s paper, is for the Anglican Communion to be recognizable as a “true particular church” (what we might style a church whose defects are minor). I don’t know that anyone would consider that an attainable goal, as Rome continues to deny Anglican participation in the historic episcopate. That hasn’t changed since the Leo XIII, and has recently been reaffirmed, once again by Cardinal Ratzinger prior to his elevation. However, to have authoritative structures that can speak with one voice, in no small part because consistency (if not absolute conformity) is enforceable, is the model.

To me, this presents a previous question. Do we as Anglicans really want to affirm this Roman image of structures that are not a human construct? That seems in itself ahistorical in general, and denial of our Reformation history in particular. A significant part of the Reformers’ critique was that Roman structures and concepts, and especially the authority of the Papacy, were significantly if not entirely human, distortions of the models in Scripture and the experience of the early Church.

It also seems counter to the Anglican tradition of incarnational theology; for arguably it is only in our life in Christ, empowered by the Spirit, that we are able to come together in fellowship. I would hesitate to see that as somehow dependent on structure, much less a particular structure.  Nor would I want to suggest that particular structures would constitute a significant hindrance to the movement of the Spirit, even though some would certainly seem to us more or less conducive.

That question, I think, shines a different light on Dr. Poon’s comments that this “ecclesial deficit” is neither “an oversight” nor “an accident.” Certainly, our current structures and relationships are not continuations of imperial structures, whether Roman or British (or Asian: I have some further thoughts about the contexts in which the Holy Catholic Churches of China, Japan, and Korea were established). However, I would ask if it were not the case that our roots in the Reformation, and especially the English Reformation, included turning away from imperial structures as models for unity. Is that not for us related to Hooker looking for his models not to the Imperial Roman Church after Constantinian but to the pre-Imperial Church just prior, with the faith of the Church taking shape between the Councils of Nicea and Constantinople. If I recall my history correctly, that period was much more open, and much less structured than the Roman Church would become once it was the religion of the Empire.

Arguably, it was also remarkably creative. I might wonder whether we would be better served in our current differences to continue discussing rather than to recapitulate structures of the past. Certainly, I can follow Dr. Poon’s argument that his articulation of the draft Anglican Covenant could provide authoritative structures (although I think his interpretation of the functions of the Instruments goes well beyond the text). I can see how the draft Anglican Covenant as we have it might produce an institution closer to the Roman idea of a “true particular church.” I’m not convinced, however, that such a structure would be faithful to our Anglican heritage and experience. Would it better pass on “the faith once delivered to the saints?” Perhaps, although I’m not sure; for our Reformation ancestors weren’t convinced it worked for Rome. From a question of mission, would it serve? It might serve ecumenically for recognition from Rome and Constantinople (although current issues of the Roman view still remain). However, would it be flexible enough, creative enough to respond to the cultural dynamics of a changing world? Once again, our Reformation ancestors weren’t convinced for Rome; nor were our more immediate ancestors so convinced for the British Empire, for they chose to recognize national and regional churches instead of continuing as the Church of England in diverse places.

One of the last statements from Clarence Pope, sometime Episcopal Bishop of Fort Worth, was that “the Catholic experiment in Anglicanism has failed.” Dr. Poon’s reflection has logic, even if I don’t find it compelling. However, it is consistent with what Archbishop Williams and his structures press for, and with the wishes of many Anglican leaders around the globe. This model may prevail; in which case Clarence Pope may well have spoken too soon.

Wednesday, March 24, 2010

Taking a More Detailed Look

A chaplain colleague pointed me to this report from the Committee on Energy and Commerce of the U.S. House of Representatives.  It allows you to look at possible impacts of the new health reform program by state and Congressional district.

The report, "Benefits of Health Care Reform, District by District Impact," was posted on Saturday, before the House had acted.  It isn't clear whether these possible impacts are based on the Senate bill confirmed by the House, or on the Senate bill as the budget reconciliation bill will modify it.  However, it puts some of the benefits intended in health care reform into local context.

Now, all the impacts projected are positive.  After all, the bill was still in debate when this was published.  However, the report is at least based on what's in the bill, and not on speculation, much less noisy distraction (like that whole "Socialism" thing).  Take a look at your district, and see what you think.

Tuesday, March 23, 2010

More From the Bedside at Episcopal Cafe

I have a new piece up at the Episcopal Cafe.  Once again, it starts with one of those conversations that chaplains can find difficult.  Please take a look, and as you feel interested please leave a response.  (TypeKey has made that a lot easier, with more different ways to log in using other services.  We just ask that you include your real name.)

While you're there, look around and read what some of my colleagues have written.  I think you'll find much of interest there, both in news and opinion.  And like me my colleagues are interested in response and discussion, so let us know what you think.  We want to show the best of the Episcopal Church, including our willingness to discuss and differ while still remaining connected.

So, take a few minutes to catch my latest there, and then take some time looking at what others have contributed.

Monday, March 22, 2010

A Step Closer to Serving the Least of These

Like many of you, I stayed up last night to watch the House pass in sequence first the Senate health bill, and then amendments to that bill to be taken up by the Senate in the "reconciliation" process (these days perhaps one of the most ambiguous or ambivalent labels out there).  Now, there are complaints that some of the provisions in the plan don't start immediately.  However, some will begin immediately, and if you'd like to see which, one of my colleagues at Episcopal Cafe has prepared a list; and thanks, Anne, very much for that!

Of course, now is not the time to stop the pressure.  We do have health care reform; but like the Church, which is called to be "always reforming," we need to see the improvements in the reconciliation bill pass, too.  So, email or fax your senators today.  Sure, you can call their offices, but those lines may well be long.  Emails will get through, and faxes as well.  Let them know that you continue to support health care reform, and that the changes coming from the House are appropriate as is.  Let them know, too, that you will note any efforts to change or stall the reconciliation bill, and in the fall vote accordingly.

I have said often enough, here and elsewhere, that my standard for calling the United States a "Christian nation" is not the mention of Divine Providence in the writings of the "Founders," nor prayer in public schools, nor holiday displays on public property.  It is how we fare in light of Matthew 25 and Jesus' description of the last judgement.  With this reform that will make health care available to literally millions more than have it now, we've come that much closer to appropriate care for "the least of these."

Friday, March 19, 2010

Pushing for Health Care to Serve All

I've been thinking what I might do to express my opinion just one more time on the subject of health care reform.  Sure, I can send emails again, but what would I say that's different?

So, I wandered over to the Episcopal Public Policy Network, and looked in the Action Alert Archive.  There I discovered this, posted March 1:

This letter was sponsored by the Health Care Working Group of the Washington Interreligious Staff Community (WISC) and Faithful Reform in Health Care. In addition to the names and organizations listed above, over 4,000 members of faith communities from all 50 states have signed it. The letter and all signatures may be viewed at
You can read the letter in full here.

What I found compelling for me is that this is the wider community of faith standing together.  The Episcopal Church participated in this letter, as did many others.

So, I'm going to literally copy and paste this into emails to my Representative and my Senators  (remember, the Senate will still have to pass through reconciliation the House adjustments), adding at the top, "I agree with this letter and these religious leaders."

My Representative happens to be clergy, and his denomination is prominent in this letter.  I hope that's as meaningful for him as it is for me (and I believe it will be).  Check the letter out, and see if it's as meaningful for you.  Then decide what you can do to bring health care to all.

Thursday, March 18, 2010

Healthcare Reform and the Least of These Right Now

This week, as the President and the leadership work hard, and the House of Representatives gets ever closer to passing health care, one of the noisiest sticking points continues to be abortion. We’ve all heard the name of Bart Stupak, democratic Representative from Michigan, for his opposition to the health plan passed by the Senate. He continues to state that the language will allow Federal money to pay for abortions. Whether he has the support of his constituents remains to be seen. He already has one challenger for this year’s Democratic Primary. He has, however, has the support of the U.S. Conference of Catholic Bishops (but, then, that’s hardly a surprise).

However, in the past week we have heard from three groups of Roman Catholics, each of which has called for passage of healthcare reform. Sister Carol Keehans of the Catholic Health Association, the organization of Catholic hospitals, has called for passage. A group of theologians who oppose abortion have called for passage. And yesterday leaders of Catholic women’s orders called for passage.

It’s important to realize that these voices aren’t some hidden resistance on abortion in the Catholic Church. All of them continue to be anti-choice. They simply disagree with the bishops and with Congressman Stupak on whether the Senate bill will allow Federal funds to be spent to fund abortions. Indeed, the letter from the theologians (all anti-choice, but both Catholic and Evangelical) sets out in detail the various points in the Senate bill that insure Federal funds can’t be spent on abortion.

NPR had an interesting report on All Things Considered, pointing to Richard Doerflinger, the individual informing the Catholic bishops. His take on not only the Senate bill, but also on how Federal regulation and legislation happen, seems to me more ideological than historical or pragmatic; or as another person said in the NPR report, “a lot of worst-case scenarioism.”

However, what strikes me about this opposition based on a very arguable premises, is that it entirely bypasses some important numbers. We have perhaps 47 million un- or underinsured Americans. According to the Robert Wood Johnson Foundation, in 2005 we had 8.4 million uninsured children. According to the Guttmacher Institute, in 2005 there were 1.2 million abortions in the United States. Now, let’s assume for the moment that those numbers have been stable since then (and they haven’t: we know there are more uninsured children, and as of 2005 the number of abortions had been trending down). That means that opponents are willing to forsake 8.4 million existing, living children to assert concern for 1.2 million possible potential children. I say potential children, because this makes no consideration of how many abortions happen when conceptions cannot come to live birth - medical situations that represent at least a percentage of terminations each year. I say possible potential children, because none of these represent conceptions that have happened, or even been imagined (for if so many conceptions were planned and/or planned for, I think most of us believe there would be many fewer abortions). So, the numbers are stark: 8.4 million living children we can help now, vs. 1.2 million children in a year who might come to be in the future.

Now, I can appreciate that we don’t make moral arguments based on, or at least solely on, utilitarian arguments – the greatest good for the greatest number. However, when the existing bill actually goes to great length to avoid supporting abortion period, much less with Federal dollars, ignoring the utilitarian aspect of the argument seems not only short-sighted, but also sinful. That’s why we’ve had three statements from folks who oppose abortion on demand calling on passage of healthcare reform. I know the Catholic bishops won’t listen; but at the moment that’s not what’s important. I know the Catholic bishops won’t listen; but I certainly hope folks in Congress will.

Saturday, March 13, 2010

Episcopal Chaplain? Going to APC in Schaumburg? You Must Read This!

This year the Association of Professional Chaplains (APC) is meeting in Schaumburg, Illinois, a northwest suburb of Chicago.  As we have in the past, the Assembly of Episcopal Healthcare Chaplains (AEHC) has scheduled its annual events at the same time.  This gives our members the chance to combine the Episcopal gathering with numerous opportunities for continuing education. 

For some time, denominational breakfasts, including one of Episcopalians, have been part of the APC Conference schedule.  The Episcopal Breakfast was included once again in the schedule this year for online registration.  A number of folks, including me, included that in our registration.  So, some of you may have been as confused as I to receive a letter from the Executive Director of APC saying that "due to an unforeseen change of plans, the Episcopal Faith Group breakfast... has been cancelled."  I want to assure you that this is not true, but that we need you to know and to help.

Here's the story: for the past decade our Episcopal Breakfasts at APC have been underwritten by the Office of the Bishop Suffragan for Federal Chaplaincies, Bishop Packard's office.  (That name for the office may be new to you, but it's the same office, and the same Bishop Packard who has always been so supportive.)  This is consistent with the other denominational breakfasts, which have been paid for by national offices.  However, with the significant budget reductions in the Episcopal Church Center (815), and the refocusing of Bishop Packard’s office specifically for Federal chaplaincies, the office is not able to help this year.

With that in mind, the Executive Committee of AEHC has stepped up.  We feel it is important that Episcopalians meet. AEHC has agreed to sponsor the event, and has asked that as each of us registers for AEHC events we include $25 to pay for the breakfast.  However, there has been some confusion in the offices of APC about this, and so a poorly worded and inaccurate letter went out to those of us registered for APC including an Episcopal Breakfast.  Most of us have now received an email to let us know, and to provide contact information to register.

So, there will be an Episcopal breakfast at APC, along with our annual AEHC Eucharist and the AEHC Business meeting.  Our President, Margie Tuttle, is working with APC on arrangements, and is hoping to get the list of those who have registered so that we can reach out to the new folks as well.

If you’re not familiar with AEHC, or if you’re still considering registering for the Episcopal Breakfast, we’d love to have you join us.  I have posted below information about AEHC events and a registration form.  Just print this post, cut off and fill out the form, and send it to Margie Tuttle at the address on the form.  You are welcome to join us for the Breakfast, and also for the Banquet Cruise Tuesday evening (I’ve long said that the Episcopalians have the best party at APC.)  If you’d like to join us, but costs are an issue, email me at the address on my Profile, and I will forward it to Margie.  Some scholarship money is available, and we’d like to meet as many folks as possible.

We look forward to seeing you in Schaumburg.  On behalf of the Executive Committee of AEHC, please know that we’d like to know the healthcare chaplains in the Episcopal Church, and serve them in any way we can.

Information and Registration Form for AEHC Events in Schaumburg

2010 Annual Meeting and Banquet
The Assembly of Episcopal Health Care Chaplains
Schaumburg, Illinois 

Sunday, April 11 7:00 A.M.
(room to be announced) Holy Eucharist followed by Catered Breakfast and the Annual Meeting.
Speaker: Babs Meairs, Field Coordinator, Office of the Bishop Suffragan for Federal Ministries (Chaplaincies).
Tuesday, April 13 5:00 p.m.
Transportation provided to the Chicago waterfront of Lake Michigan as we dine in the Lake-Breeze Dinner Lounge of the Mystic Blue Cruise. We will have a docent tour of the architecture of the Chicago Skyline from the comfort of the Mystic Blue Yacht. A delicious dinner of Pulled Steak Panini, Fish and Chips, and Pasta Carbonara along with vegetarian options will be served, and alcoholic beverages will be available for purchase on board. (meeting place to be announced).

2010 Annual Meeting & Banquet Registration Form 
Name___________________________________________ Institution________________________________________ Address_____________________________________
City/State/Zip_________________________________________ Phone___________________________________________ Fax______________________________________________ E-mail___________________________________________
Please register me for _____ Breakfasts on Sunday, April 11 @ $25 each.
Please register me for _____ Cruise and Dinners on Tuesday, April 13 @ $75 each. Total Enclosed: __________ Make checks payable to Assembly of Episcopal Health Care Chaplains and mail to: Margie Tuttle, Director of Pastoral Care, Somerset Medical Center, 110 Rehill Ave., Somerville, NJ 08776-2598

Thursday, March 11, 2010

Remember That You Are Dust…

And to dust you shall return.

I am finding this a different and an interesting Lent. Lent is importantly to me personally, and I observe it each year.

Now, there are, more or less, two ways of that people observe Lent. There are those who “give something up,” and those who “take something up;” and I’m definitely one of the latter. Not that I’m one to take up big things, but the few small things I add to my discipline do keep my attention. I change from the seven week to the monthly cycle of the Psalms in my offices. I kneel rather than sitting when I meditate. I do some special reading. Again, not big changes, but steps that are important to me.

However, this year I’ve had an additional change, one that I didn’t choose for myself. See, I shared with my doctor that I’d been having some moments of dizziness, or an occasional sense that my face was flushing. As I told my mother, “I’ve been having the vapors” (pronounced “vay-puhs;” it’s a reference both cultural and generational, and I suppose some may not recognize it). I like my primary care physician. In general, I like the fact that he’s thoughtful, and that he’s thorough.

And so for most of Lent I’m wearing an event monitor. Actually, the 30 days I have to wear it actually ends on Holy Saturday. It’s a small device – about the size of an MP3 player (not the newest ones, but from a few years ago) - and, except for a couple of buttons, solid black. It’s edges are hard and sharp in a way that hasn’t been popular of late. It reminds me more than anything else of the sort of pocket transistor radio that in its day was the standard for portable music. It hangs on a ribbon around my neck, and attaches by a cable to two patches of the sort we use for other kinds of heart monitors.

That’s what it is, really: a heart monitor. However, it’s not constantly recording. Instead, when I have one of those funny feelings I push the button and it records whatever my heart is doing (hence, an “event monitor”). At a later point I call the company and send in the report through the phone. After 30 days I send it back in, and eventually my cardiologist gets a report that gets shared with my primary care physician – and, eventually, with me.

I’m finding this remarkably apt for Lent. It’s not exactly a hair shirt, but the patches can certainly itch, and it’s always there against my skin. It’s not exactly a thorn in my side, but there is some pain and irritation when I change the patches, and the cable manages to pull some hair on its own. It hangs at about the middle of my chest, and I was initially worried it would be at an inconvenience when I knelt at my prayer desk (turns out it wasn’t).

At a more basic level, it is a virtually constant reminder of mortality. As a Benedictine, that’s not so much a new thought. Saint Benedict in Chapter Four of the Rule calls on the monastic to keep death constantly in mind. As a hospital chaplain it’s even easier. It’s not at all uncommon for me to see a patient and think, “What if that were me? What if that was my Best Beloved?” I have said often enough that unless the Kingdom comes first, none of us gets out of life alive (and if the Kingdom does come, we’ll have a lot of other stuff to think about). I think about the possibility, and the possible circumstances of my death a lot.

But, there’s a qualitative difference here. This isn’t just a patient I care for. This time it is me, and every sensation becomes a reminder of mortality. Every time I feel the module bounce around under my shirt or feel the patch pull against my skin as the cable tangles in my clothes there’s a subtle reminder: “I’m human. I’m vulnerable. This time it could be me.” Any physical sensation out of the norm, from a muscle twinge to indigestion to a sense of weariness, raises the question, “Is this an event? Do I record it? Is it meaningful? Is it critical?” Not simply, “Is it me,” but also, “Is it now?”

Now, I’m not terribly worried. I have reason to believe my heart is fine. That, of course, will only point in a new direction about the symptoms that started all this, but I’m expecting my heart to be all right. With that perspective, the event monitor is mostly an inconvenient necessity.

Still, it has added something different to my Lent this year, and perhaps from now on. Lent began with the reminder to “remember that you are dust, and to dust you shall return.” Before this, the reminder was true and important, but a bit abstract. This year, thanks to a little black box, it is much more tangible, much more concrete – and, in one way or another, entirely real.

Saturday, March 06, 2010

Lies, Damn Lies, and Reconciliation in Health Care Reform

Yeah, I know I’ve been quiet for a while. I’m having a different sort of Lent. But, more about that later.

I’ve been stewing over the efforts to accomplish access to health care for all residents of the United States (and, yes, I do mean residents; but that’s me). There has been so much rhetoric, much of it moronic (not only in Umberto Eco’s sense of moronic, but also uninformed) – and some of it simply dishonest.

Of course, since power struggles in the Democratic Party have wasted the initial opportunity to provide this service and security, much of the rhetoric has been about the technique of “reconciliation.” We’ve all heard about this legislative tool. Basically, by setting the budget consequences of a particular law, it allows the law to be included in the budget legislation, even if its intent isn’t really a fiscal change.

Now, those who want to prevent health care and health insurance reform (and don’t you believe this nonsense, “Let’s get health care reform, but let’s start over and do it right.”) have been saying that “reconciliation has never been used for such a non-fiscal purpose,” or “reconciliation has never been used to affect something with as large an impact on the economy as health care.” I wouldn’t find that compelling, of course: since I believe it’s the right thing to do, the thought that we haven’t done it that way before doesn’t convince me that we shouldn’t do it that way now. But I certainly can’t find it compelling when I realize it’s blatantly false, and that the people who spout this are among those who know how false it is.

This is what brought me to this: I realized where I had heard that word, “reconciliation,” in relation to health care. It has come up – it has come up again and again – as part of the title, “Omnibus Reconciliation Act.” When I realized that, I suddenly began to realize just how important reconciliation has been in health care.

It’s never been used for health care? What about the Balanced Budget Act of 1997? It put into place Medicare reductions so severe that in 1998 and 1999 hospitals across the country reduced their budgets and long term plans by literally millions of dollars. And I don’t mean millions of dollars nationwide. I mean $60,000,000 just from my own small regional system, and comparable cuts from every hospital in town – and that’s just in my own middle-sized, Middle America metropolitan area. In my system alone, we lost 4% of our positions; in my own, then very new, very small hospital, 30%. No, reconciliation has certainly been used to affect health care before, and with huge fiscal consequences.

It hasn’t been used for such non-fiscal purposes? What about the Omnibus Budget Reconciliation Act of 1990? It had one of those non-fiscal amendments: the Patient Self-Determination Act. That is the Federal law that establishes the right of patient to make his or her own health care decisions. It is the law underlying Living Wills, Health Care Treatment Directives, and Durable Powers of Attorney for Health Care. It wasn’t introduced for fiscal purposes, but to accomplish a social good in health care. (And it was sponsored, by the way, by Jack Danforth, Republican Senator from Missouri, and an Episcopal priest.)

And then there was that more famous reconciliation act that was, really, one of the most important efforts at health care reform. Many of us (including me) have lost jobs but have been able to keep our insurance for a period of time because of COBRA. Under that law, an employee who leaves a position can continue insurance for up to 18 months (it has recently been extended) if the employee can pay the full cost (both the contribution the employee has been paying, and the employer’s contribution). While it isn’t cheap, it has saved many a family from major medical expenses between positions. And what does COBRA stand for? The Consolidated Omnibus Reconciliation Act of 1985. And few laws have had a more widespread and pervasive effect on the security of employer-based health insurance.

So, when you hear conservatives claiming, “reconciliation hasn’t been used that way before,” you’ll know the truth. They’re not simply uninformed or confused. They’re lying through their teeth, and they know it. The fact is that Mitch McConnell, Senior Senator from Kentucky and Senate Minority Leader, was elected to the Senate in 1984, and would have voted on all three of these acts. Whether he was for or against each law, he was in the Senate when each was passed. So, he of all people should know not only that reconciliation has been used this way, but that it has been used this way fairly often.

We Americans have a tendency to forget even recent history. That can keep us trying to reinvent the wheel, as it were, when it’s not really necessary. It can lead us to try to create a new tool when we already have a usable tool sufficient to the task. Worst, it can make us vulnerable to demagogues who make false assertions, secure in the hope that most folks won’t realize the falsehood. Let’s not make that mistake this time. Reconciliation has been used again and again, and used successfully, to make changes affecting access to health care for Americans in big and important ways. It is absolutely an apt tool to reform health care and health insurance now.