Sunday, January 31, 2010

Healthcare and the market

I've mentioned the US debates about health insurance before. But it is graphs like this that are worth studying closely to get a quick handle on why universal healthcare is such a no-brainer to the rest of the developed world (a.k.a. "the den of socialism").
Notice that the much maligned NHS in the UK spends about 40% of what the US does per person and yet the UK has a higher average life-expectancy by more than a year. Portugal spends less than 30% of the US level and also has a higher life-expectancy. The country with the greatest longevity, Japan, spends about 35% per person of what the US spends. And this massive US spending is not just absolute, but also relative to GDP. The other salient feature of this graph is noting that the only industrialised nation without universal health care is the US.

Of course, there is not a simple correlation between health system and life expectancy. Also important are genetic and environmental factors (including diet). But it is at least worth pausing for thought and wondering whether the US system is really generating the quality of health care that is often claimed for it. Might not the introduction of market forces actually distort the system by giving doctors falsely inflated motives for unnecessary treatment? And by giving insurers incentive to deny treatment, or to deny cover to those already sick (who often need it most)?

This is not simply another cheap shot at US politics, but a way of raising a larger and more important issue. Namely, that there are parts of life where market forces distort healthy relationships. Introducing the logic of the market to situations requiring trust and gift doesn't improve efficiency; instead, it can often critically undermine the trust and generosity on which the relationship is built. To pick a somewhat facetious example, should we charge our daughter for each nappy that we change? Should breast milk operate on a user-pays system?

Nonetheless, the dominant expression of contemporary capitalism has an imperialist tendency based on the assumption that market logic ought to be extended to more and more spheres of life. Private ownership for profit is treated as though it is the most desirable kind of human sociality. This is not a recipe for good healthcare, and it is not a recipe for a healthy society.

UPDATE: Here are two very good contributions to the healthcare debate.
The simplest explanation of health care reform you will read, giving a very readable summary of the logic behind the proposed reforms.
Catch 22 for opponents of health care reform, or why a government option is neither a takeover nor a sneaky takeover (and why even if it were this wouldn't be a terrible thing). Note: the government option has been taken off the table, but this post is still worth reading to know why that was a bad move.

Thursday, January 28, 2010

Baptism: early or late?

Baptism by the Book (cont)
As mentioned in my previous post, my daughter's recent baptism gave me an excuse (not that one is ever really needed) to re-read "The Ministration of Publick Baptism of Infants" in the 1662 Book of Common Prayer. As one does, I also wanted to compare this service with the earlier prayer books of 1549, 1552, 1559 and 1604 (and the Scottish prayer book of 1637). All of these earlier texts included a very interesting paragraph regarding the timing of the baptism.

In my experience, infants are often (usually?) baptised once they are at least a couple of months old. This allows time for godparents to be selected and asked, family members invited and for an occasion to be made of the event. All this can be a fun and joyful celebration of new life, sometimes with informal festivities continuing after the service over a meal. Indeed, we did all this, though being in Scotland, only managed to get one of three godparents and one family member from each side to come and join us. Partially, we picked our timing based on when those family members could be here, and since we didn't want to wait too long, having the baptism exactly a month after the birth seemed appropriate (and means that we now have an alternative date for birthday celebrations if Christmas Eve tends to overshadow things).

However, in all the prayer books prior to 1662, some version of this rubric appeared:

The pastours amd curates shall oft admonyshe the people, that they differ [defer] not the Baptisme of infantes any longer then the Sondaye, or other holy daye, nexte after the chylde bee borne, onlesse upon a great and reasonable cause declared to the curate and by hym approved.
In other words, unless you have a very good excuse, it is best for your child to be baptised on the first Sunday (or other holy day (e.g. Christmas)) after birth. No mucking around here!

I will discuss the reason behind this in a little more detail in my next and final post on "Baptism by the Book". But the short answer is that when it comes to baptism, church family trumps blood family. No waiting until great aunt Gertrude can make it up from the farm; the child is welcomed immediately by and into the congregational family at their next major gathering. And this makes good sense. If children are to be welcomed into the household of God so that they are always raised within the Christian faith (as the practice of baptising infant baptism implies), then to be consistent, this baptismal welcome should occur as soon as possible. Why then wait until Sunday? Why not baptise on the day of birth? The answer to that will be in my final post.

Therefore, resolve to make your arrangements for a baptismal celebration prior to the birth. Expectant parents often spend hours researching prams and selecting nursery colours. Why not also (instead?) put some time into making preparations for the child's spiritual growth? Settle your conscience on the good gift of infant baptism. Meet with your priest or minister to discuss any concerns and to ensure you understand what baptism means and how it will work. Think about godparents early (and remember, godparenting is not primarily a chance to honour your closest friends, but a responsibility for those who will be faithful in prayer and example, taking the lead in discharging the duty and privilege of the whole church family in raising a new child in the faith and love of Christ). Check your church has a font or pool large enough for the infant to be dipped into. Have your child baptised at the first service available after their birth. And read your prayer book.

Tuesday, January 26, 2010

Baptism: dunk, dip, douse or dribble?

Baptism by the Book (of Common Prayer)
Our daughter was baptised on Sunday morning with little fuss and great joy. Praise God!

Although the service used a more contemporary liturgical pattern, I took the opportunity to re-read the baptism services in the 1662 Book of Common Prayer. I was struck by a number of things. First, as always, the saturation of Scripture throughout the service. The most obvious difference between traditional and contemporary Anglican liturgical services is not language, but length. And much of what has been cut is the reading of and reference to Scripture. For example, it really adds something to a service of infant baptism to read the passage in Mark 10.13-16 where Jesus tells his disciples (who are acting as overzealous bodyguards) to "let the little children come unto me".

Another more surprising element came in the rubric (the instructions accompanying the words to be said) at the point of baptism. But to show why it was surprising, first a little personal background.

Growing up in a Baptist church, I had only ever witnessed full immersion baptisms (dunking), where the candidate is plunged entirely under the surface of the water and then brought up again (for the hardcore, this can be done thrice: once for the Father, once for the Son, and once for good measure the Holy Spirit). This was how I was baptised just short of my sixteenth birthday. For me, immersion has always made good sense of the apostle Paul's discussion of baptism in Romans 6.3-4, where he speaks of our baptism as our having been "buried with Christ". Thus, full immersion baptism symbolises the burial of the old life and the resurrection to the new life that is experienced when a person is united with Christ by faith.

More recently, and in a tradition that embraces the baptism of infants, I have become familiar with two other methods of baptising: sprinkling (dribble) and pouring (dousing). The former can look to the sacrificial practice in the Old Testament temple (as recorded in the Pentateuch and referenced in the New Testament) and especially to the divine promise of a future cleansing through sprinkling with clean water recorded in Ezekiel 36.25. The latter may look to the frequent New Testament language of the Holy Spirit being poured out upon believers, an event associated with baptism.

As long as it was done in the name of the Father, and of the Son and of the Holy Spirit and using water, all three methods (dunking, dribbling and dousing) were accepted by the early church, though there seems to have been a preference for immersion.

Yet contemporary Anglican practice (insofar as I've seen or heard about it) only ever sprinkles or pours water on infants. Given this, I'd asked our minister to at least splash around as much water as possible, pouring rather than sprinkling. He agreed, saying that the water also symbolises God's love, so the more the merrier.

Therefore, it was with some interest that I noticed that in the 1662 service for "The Ministration of Publick Baptism of Infants" the actual baptising is described like this:

Then the Priest shall take the Child into his hands, and shall say to the Godfathers and Godmothers,
Name this Child. And then naming it after them (if they shall certify him that the Child may well endure it) he shall dip it in the Water discreetly and warily, saying,
I baptize thee in the Name of the Father, and of the Son, and of the Holy Ghost. Amen.

But if they certify that the Child is weak, it shall suffice to pour Water upon it, saying the foresaid words,

I baptize thee in the Name of the Father, and of the Son, and of the Holy Ghost. Amen. Notice that pouring is a concession for weak babies; the normal practice is for the child to be dipped. Is this immersion (done discretely and warily)? Or immersion without putting the head under? Is anyone familiar with this practice?

I checked, and the same instruction is found in all the early English Prayer Books (and the Scottish one too). Unfortunately, I was too late to ask for this to be incorporated into the service, but I think it should happen more often. If you are having a child baptised, make sure you take along the BCP and ask your priest for a dipping!

Friday, January 22, 2010


"And baptism, which this [i.e. Noah's rescue] prefigured, now saves you—not as a removal of dirt from the body, but as an appeal to God for a good conscience, through the resurrection of Jesus Christ... "
- 1 Peter 3.21
This Sunday, our daughter is to be baptised into the death and resurrection of Jesus Christ and so welcomed into the life of his church.

I grew up in a Baptist church and was not baptised until I was sixteen (many years after my faith in Christ had become explicit and personal). I'm excited that our little one is going to be baptised when she is still an infant.

I'm not going to give a defense or explanation of baptising infants just now (though I note that Andrew Errington has done so recently), though I will simply note that I have joyfully changed my mind on this matter over the last decade and heartily encourage Christian parents to have their children baptised as soon as possible.

Friday, January 01, 2010

Love casts out fear

Love casts out fear. The truth is that what is most likely to get us to take the right decisions for our global future is love. The temptation is to underline fear so as to persuade one another of the urgency of the situation: things are so bad, so threatening, that we have to do something. And indeed there are moments when we might think, rather bitterly, that the human race is still not frightened enough by the prospect of what it has stored up for itself. But this is to drive out one sickness by another. That kind of fear can simply paralyse us, as we all know; it can make us feel that the problem is too great and we may as well pull up the bedclothes and wait for disaster. What's more, it can tempt us into just blaming one another or waiting for someone else to make the first move because we don't trust them. We need more than that for lifegiving change to happen.

- Rowan Williams, "Act for the sake of love",
a sermon in Copenhagen Cathedral, 13th December 2009

This short piece is a good read to start the new year.* Archbishop Williams gave this sermon on 13th December at an ecumenical service in Copenhagen Cathedral in the middle of the climate negotiations. It is a reflection on 1 John 4.18a: "There is no fear in love, but perfect love casts out fear". Williams' argument is that despite many reasons to be fearful, only love can sustain a life-affirming response to the threat of climate change. While I'm not sure I'd follow his reading of Romans 8 in the penultimate paragraph, I think his central claim is an important one: fear is ultimately an insufficient and destructive motive for action. There is much fear-mongering used by both activists and deniers. While fears have a place in shaping a prudent response, only love is truly renewable.
* Though if you're looking for something with a bit more zing this Christmastide, you could do worse than have a look at Kim Fabricius's provocative Christmas sermon. And for some fun, try this caption competition.