There is a debate raging over the fate of the Affordable Care Act (or “Obamacare”). If you are partisan at all, or if you’ve just been listening to or paying attention to the news in whatever form you do that, this first sentence may hook you and elicit certain feelings within. Everyone seems to have an opinion and indeed the question of how we access health care and how we pay for it is an important one.

Whatever the fate of the ACA, I invite you to repeal all the heated rhetoric of the arguments surrounding it and replace it with some thoughtful consideration of what it is we are trying to access and afford in our medical systems in this country.

I have just finished an incredibly thoughtful book by a Physician named Atul Gawande: Being Mortal: Medicine and What Matters in the End. 

Dr. Gawande also gave a TED talk entitled How do we heal Medicine? in 2012 that is well worth a listen.

Gawande’s book gives a history of longevity and how medicine has played a role in lengthening life and in decision making processes about where and how we will live when lengthened life leads to the inevitability of declining faculties and frailty. The book also takes an honest look, through the stories of patients and Gawande’s own family, at medicine’s role in prolonging death. There is an honest assessment of  the difficulties patients and doctors alike have in talking about mortality, but also the tremendous benefits of confronting that reality and having honest conversations about it.

There is a passage in John 5: 1-9 where Jesus heals a man who had been ill for thirty-eight years. Before the healing, Jesus essentially asks the man what he wants: “do you want to be made well?” The question is important for two reasons:

1. When it comes to health care and medicine, we need to ask ourselves what we want. Because life and medicine have limitations, we have to decide what it is we want from both.
2. We secondly need to consider the difference between being cured and being made well. Is there a wellness that can be had even in the face of terminal illness or lifelong debility?

While the debate about cost and affordability continue, we would all do well to consider what it is we really want when it comes to medical care and the quality of life we hope for. I highly recommend Gawande’s book as a primer for your own thought and conversation. I also have come across two additional writings that have lent themselves to my own process of thinking about these things:

• One Man’s Quest to Change the Way We Die: How B.J. Miller, a doctor and triple amputee, used his own experience to pioneer a new model of palliative care at a small, quirky hospice in San Francisco.
•  Surrender, the Art of Living, Loving and Dying Without Training Wheels.