Jesus focused on the meaning of suffering and the
healing of the whole person; little distinction is made between healing of the
body, mind, and spirit. Emphasis is placed on the power of the thought
life to affect health (Matthew 15:17-20). Early Christians believe that
sickness, whether or not caused by sin, can be healed through prayer (James
5:14).
Physical healing does not become a dominant and
widespread Christian practice until about the fourth or fifth century A. D.
During the first three centuries, mainstream Christianity does not promise
physical healing (as did the pagan healing cults) (Ferngren, 1992).
“Caring for” rather than curing the sick is the chief ministry of the
early Christian community. According to Ferngren (1992, pp. 13-14), caring for
the sick was Christianity’s truly novel contribution to healthcare. At that
time, pagans did not care for their sick in any organized fashion or on any
widespread basis. The Jewish community provided care primarily to its own. The
Christian Church, on the other hand, offered care not only to Christians but
also to non-Christians.
Clement
of Alexandria (150-215), one of the early church fathers who is well
versed in Greek, argues that health by
Medicine has its origin in and its existence from
God as well as resulting from human cooperation. He notes that the art of healing
learned by human wisdom is from God. This view is reinforced by Origen (185-254),
who notes that just as God allows trees to grow, so also does he give medical knowledge
to humans.
Until the Christian era (after 350),
there is no evidence of buildings (i.e., hospitals) devoted to the care and
treatment of sick persons in the general population (Gran-shaw, 1993, p. 1181).
Eastern Orthodox Christians, at the insistence of St. Basil, Bishop of
Caesarea, establish the first great hospital in Asia Minor around 370. It is
scattered among hotels, poorhouses, homes for the aged, buildings for diseases
and a special hospital for lepers. This is done to honor the biblical obligation,
in Matthew 25:36, 40, to clothe the poor and to heal the sick (Pollak, 1963, p.
74).
[Circa
400-550] There is great respect for physicians among Jews. The
Jewish Talmud prohibits Jews from living in a city in which there is no
physician (Dorff, 1998, p. 14). A hospital for the mentally ill is established
in Jerusalem in 490 (Alexander, 1966).
[Circa 500-1200] The
first period of medieval medicine is designated as “Monastic” or
“Monastery” medicine, since it is practiced and taught under the
direction of the Church (Pllak, 1963, p. 79).
[Circa
500-1000] Care for the poor and sick throughout this period is
provided primarily by the Church (Amundsen, 1998, p. 83).
The Knights Hospitallers
(equivalent to modern hospital physicians) are monks who operate hospitals in
Jerusalem at the time of the crusades (Stevens, 1989). Clergy-operated monasteries
continue as the primary institutions of healing. In medieval Europe, hospitals
“were usually associated with a church or monastery, with religion defining
life within them.” (Granshaw, 1993, p. 1182).
There is an intellectual awakening:
Institutions of higher learning are reopened (1200-1300) and are largely supported by the Church. The word “doctor” is first used to
indicate a learned person skilled in a profession. Science and the Church,
however, begin to butt heads. The Church condemns Aristotelian empiricism,
which incorporates the Greek scientific tradition and becomes widely popular
between 1200-1240 (Kroll, 1973). The Theologian and philosopher Thomas Aquinas (1225-1274) synthesizes
Christian faith and Aristotelian philosophy, which is finally accepted in the
mid-fourteenth century (Kroll, 1973). Under Aquinas’ influence, medieval
scientists begin to see their work as uncovering God’s plan. Aquinas writes
about the importance of dreams and the workings of the unconscious (almost 700
years before Freud). The later period of medieval medicine is known as “The Age
of Scholastic Medicine.” The relationship between religion and medicine
undergoes a crucial shift that separates the two ever so slightly as doctors
become certified by the state, rather than by the Church (Pollak, 1963, p. 91).
The greatest of the natural
philosophers: Sir Isaac Newton
composes his famous work Philosophiae Naturalis Frincipia Mathematica (1687),
which sets up mathematical and mechanical systems of physiology and
therapeutics to help guide a more scientific medicine. Newton argues that the
entire universe can be explained in terms of physical laws. According to Eerdman’s
Handbook to the History of Christianity, Newton “believed that his
scientific discoveries were communicated to him by the Holy Spirit, and regarded
the understanding of Scripture as more important than his scientific work.”
(Dowley, 1982, p. 490)
In the late 1600s, the Church holds the position that secular methods of cure
(medical or surgical) are God-given and work only through the exercise of God’s
power.
The Sisters of Charity of St. Vincent
de Paul organize Catholic nuns to serve both religious and secular hospitals. By
1789, there are 426 hospitals run by
the Sisters of Charity in France alone (Porter, 1993, p. 1543). Not until the
1830s do Protestants have anything similar, when a Lutheran pastor starts a
nursing school in Kaiserwerth, Germany, to train women (called “deaconesses“) for a life of
service to the sick. Later, Florence
Nightingale applies this concept to a secular setting to train the first
“nurses” (Numbers & Amundsen, 1998, p. 2). For a more
detailed history of the emergence of the nursing profession out of religious
orders, see Nelson (1997).
Julien de LeMettrie (1709-1731) publishes L’Homme Machine
(1749), which argues that humans are wholly material beings, that
modern anatomy and physiology can find no evidence of a soul or spirit. Soon afterward,
Denis Diderot (1713-1784) publishes his Reve d’Alemhert, which argues
that human consciousness is entirely organic in origin. These works characterize
the Enlightenment period (Porter, 1993, p. 1457).
Gamwell and Tomes (1995) note,
“The rise of science in the eighteenth century slowly eroded the
foundations of religion and ultimately led to the secular science of the modern
world.” (p. 19).
The Wesleyan-Methodist tradition
begins in England (as an offshoot of the Anglican tradition) with the work of
John and Charles Wesley. John Wesley
(1703-1791) writes extensively on health topics, including volumes such as Thoughts
on Nervous Disorders (1784), The Duty and Advantage of Early Rising (1789),
and his most famous work on the subject, Primitive Physick (1747). Primitive
Physick becomes one of the most popular medical manuals of the
eighteenth century.[1]
In 1765, the first medical school in North America is established
at the College of Philadelphia, which later (1791) merges with the medical
school of the University of Pennsylvania.
In the early 1800s, there are only three medical hospitals in the United States:
the New York Hospital, the Pennsylvania Hospital, and the Massachusetts
Hospital. The first official nursing organization in the United States is
initiated in Emmetsburg by the Catholic Sisters of Charity in 1803,
following a French model. The sisters perform home nursing as well as offer
institutional care (Nelson, 1997).
The Second Great Awakening [1780-1830], a Protestant revival, sweeps
the United States. Calvinistic teachings on man’s depraved nature are disputed,
and some theologians shift from a doctrine of predestination to the doctrine of
free will. It is possible, through good works and community volunteerism, for
humans to influence their own salvation. This movement has great social force
in America and helps prepare the country for a new approach to the treatment of
mental illness (Taubes, 1998).
The American Medical Association is established in 1847.
One of the earliest health care proposals at the federal
level was the 1854 Bill for the
Benefit of the Indigent Insane, which would have established asylums
for the indigent insane, as well as the blind, and deaf via federal land grants
to the states. This bill was proposed by activist Dorothea
Dix, which passed both houses of congress, but was vetoed by
president Franklin Pierce.
Pierce argued that the federal government should not
commit itself to social welfare, which he believed was properly
the responsibility of the states.[1][2] After
the Civil War, the federal government did establish the first system of
national medical care in the South. Known as the Freedmen’s Bureau, the
government constructed 40 hospitals, employed over 120 physicians, and treated
well over one million sick and dying former slaves. The hospitals were short
lived, lasting from 1865 to 1870. Freedmen’s Hospital in Washington, DC
remained in operation until the late nineteenth-century before it became part
of Howard University.[3][2]
The Progressive Era was a period of social
activism and political reform in the United
States that flourished from the 1890s to the 1920s.[1] One
main goal of the Progressive movement was
purification of government, as Progressives tried to eliminate corruption by
exposing and undercutting political
machines and bosses. Many (but not all) Progressives supported prohibition in order to
destroy the political power of local bosses based in saloons.[2] At the
same time, women’s suffrage was
promoted to bring a “purer” female vote into the arena.[3] A
second theme was building an Efficiency movement in every sector
that could identify old ways that needed modernizing, and bring to bear
scientific, medical and engineering solutions.
In 1932 Franklin Roosevelt (D) won the presidency, and the following year
his administration began an aggressive program of economic and social
intervention known as the “New Deal.”
Many liberal Democrats expected some form of national health insurance to be a
part of this program. Indeed, in 1933 Roosevelt’s Federal Emergency Relief Administration (FERA) declared healthcare to be a fundamental human right.
But during the war (WWII), a policy designed to keep inflation in check had
an unintended consequence that was to shape the way most Americans would
receive healthcare for the next seventy years. The federal government imposed
strict price and wage controls on many industries, so
companies found that they no longer could use competitive wages to attract
talent. A growing number found that company-subsidized health insurance, then
unregulated, fit this need.
In 1951 the IRS
declared group premiums paid by employers as a tax-deductible business expense,[6]
which solidified the third-party insurance companies’ place as primary
providers of access to health care in the United States.
Medicaid was
created by the Social Security Amendments of 1965 which
added Title XIX to the Social Security Act. Medicaid was
created as an entitlement program to help states provide medical coverage for
low-income families and other categorically related individuals who meet
eligibility requirements. Candidates include the blind, aged, disabled and
pregnant women. In essence, Medicaid serves as the nation’s primary source of
health insurance coverage for low-income populations. Each state administers
its own Medicaid program, establishes their own eligibility standards, determines
the scope and types of services they will cover, and sets the rate of payment.
Benefits vary from state to state, and because someone qualifies for Medicaid
in one state, it does not mean they will qualify in another.[6] The
federal Centers for
Medicare and Medicaid Services (CMS) monitors the state-run programs
and establishes requirements for service delivery, quality, funding, and
eligibility standards.
In 1965,
Congress created Medicare under
Title XVIII of the Social Security Act to
provide health insurance to people age 65 and older, regardless of income or
medical history. Before Medicare’s creation, only half of older adults had
health insurance, with coverage often unavailable or unaffordable to the other
half, because older adults had half as much income as younger people and paid
nearly three times as much for health insurance. Medicare also spurred the
racial integration of thousands of waiting rooms, hospital floors, and physician
practices by making payments to health care providers conditional on desegregation.[2]
In October 1972,
President Nixon signed the Social
Security Amendments of 1972 extending Medicare to those under 65 who have
been severely disabled for over two years or have end stage renal disease (ESRD),
and gradually raising the Medicare Part A payroll tax from 1.1% to 1.45% in
1986.[23] In
November 1972, Nixon won re-election in a landslide over the only Democratic
presidential nominee ever not endorsed by the AFL–CIO, Senator George
McGovern (D–SD),[24] who was
a cosponsor of the Kennedy-Griffiths bill, but did not make national health
insurance a major issue in his campaign.[25]
The HMO Act of 1973 created
incentives for the formation of for-profit HMOs and introduced the managed care
approach that would quickly come to dominate private insurance.
The Employee
Retirement Income Security Act of 1974 (ERISA) (Pub.L.
93–406, 88 Stat. 829, enacted
September 2, 1974, codified in part at 29 U.S.C. ch. 18) is a federal law which establishes
minimum standards for pension plans in private industry and provides for
extensive rules on the federal income tax effects of
transactions associated with employee benefit plans. ERISA was enacted to
protect the interests of employee benefit plan participants and their
beneficiaries by:
- Requiring the
disclosure of financial and other information concerning the plan to
beneficiaries;
- Establishing
standards of conduct for plan fiduciaries;
- Providing for
appropriate remedies and access to the federal courts.
The Age Discrimination Act of 1975 prohibits discrimination on the basis of age in programs and
activities receiving federal financial assistance. The Act, which applies to
all ages, permits the use of certain age distinctions and factors other than
age that meet the Act’s requirements. The Age Discrimination Act is enforced by
the Civil Rights Center.
The
Age Discrimination in Employment Act of 1967 (ADEA) protects certain applicants
and employees 40 years of age and older from discrimination on the basis of age
in hiring, promotion, discharge, compensation, or terms, conditions or
privileges of employment. The ADEA is enforced by the Equal Employment Opportunity Commission (EEOC).
Cafeteria Plans were added to
the Internal Revenue Code in November 1978.[10]
Internal Revenue Code Section 125 sets forth the requirements and tax treatment
of cafeteria plans.[11] Section
125 has been amended multiple times since its enactment.[12]
The
Cafeteria Benefits Plan was a result of the revelation that “one universal
benefit program can no longer do the job,” said Thomas E. Wood of Hewitt
Associates and chairman of the Corporate Board for the International Foundation
of Employee Benefit Plans. Wood was the originator of flexible compensation due
to the fact American corporations and households were becoming increasingly
dynamic and globalized. As quoted in his chapter of the business publication, Business,
Work, and Benefits: Adjusting to Change produced by the Employee Benefit
Research Institute, “Wood’s framework creates a specific detailed picture.
The concepts include the establishment of a basic “safety net” of
benefits to cover financial hazards associated with old age, death and
disability, and catastrophic medical expenses, with supplementary benefits
offered on a defined contribution basis”. [9]
1980
[August] – Janice Osborne (Belue) began working in Greensboro, North Carolina
Pilot Life Home Office.
1982 – Mark
Belue – Graduates from the University of South Carolina, with a BS degree in
Accounting, and goes to work for the Pilot Life Insurance Company, of
Greensboro, NC in the Group Division in 1984.
The Consolidated Omnibus Budget Reconciliation Act of
1985 (or COBRA) is a law passed by the U.S.
Congress on a reconciliation basis and
signed by President Ronald Reagan that, among other things,
mandates an insurance program giving terminating employees the ability to
continue health insurance coverage after
leaving employment. COBRA includes amendments to the Employee Retirement Income
Security Act of 1974 (ERISA). The law deals with a great variety of
subjects, such as tobacco price
supports, railroads, private pension plans, emergency room
treatment, disability insurance, and the postal service, but it is
perhaps best known for Title X, which amends the Internal Revenue Code and the Public Health Service Act to deny
income tax deductions to employers (generally those
with 20 or more full-time equivalent employees) for contributions to a group
health plan unless such plan meets certain continuing coverage requirements.
Section 89 of the
IRC, enacted as part of the 1986 tax
reform act, imposed qualification standards on healthcare and other welfare
benefit plans. However, this controversial legislation proved to be too costly
for companies to administer and it was repealed by Congress as part of
the Omnibus Budget Reconciliation Act of
1989 (OBRA ’89). Section 89(k) qualifications standards, although repealed,
remain very much alive in the qualification-type standards that continue to
exist in the IRC and the ERISA. Courts still use these rules as ERISA
guidelines.
1990 – Mark Belue moves to Charlotte, NC to open the
Charlotte Sales Office of Mid-South Insurance Company of Fayetteville, NC as
Regional Manager.
The Americans with Disabilities Act of 1990[1][2] (ADA) is a law that was enacted
by the U.S. Congress in 1990. It was signed into law on July 26, 1990, by President George H. W. Bush, and later amended with changes
effective January 1, 2009.[3]
The ADA is a wide-ranging civil rights law that prohibits, under certain
circumstances, discrimination based on disability. It affords similar protections
against discrimination to Americans with disabilities as the Civil Rights Act of 1964,[4] which made discrimination based on race, religion, sex, national origin, and other
characteristics illegal. Disability is defined by the ADA as “…a
physical or mental impairment that substantially limits a major life
activity.” The determination of whether any particular condition is
considered a disability is made on a case by case basis. Certain specific
conditions are excluded as disabilities, such as current substance abuse and
visual impairment that is correctable by prescription lenses.
President Bill Clinton had
campaigned heavily on health care in the 1992 U.S.
presidential election. The task force was created in January
1993, but its own processes were somewhat controversial and drew litigation.
Its goal was to come up with a comprehensive plan to provide universal healthcare for all
Americans, which was to be a cornerstone of the administration’s first-term
agenda. A major healthcare speech was delivered by President Clinton to the
U.S. Congress in September 1993. The core element of the proposed plan was an
enforced mandate for employers to provide health insurance coverage to all of
their employees through competitive but closely regulated health maintenance organizations.
In 1992, Bill
Clinton (D) made his plan for universal health insurance a prominent part of
his platform. Upon taking office, he appointed First Lady Hillary Rodham
Clinton to head up a healthcare task force and made achieving universal
healthcare legislation his principal
first-term goal. The Clinton bill was met with concentrated
opposition from conservatives and insurance industry groups. The bill, which
would use a complex series of mechanisms, national boards, and rules to achieve
universal coverage, was easy for opponents to demonize. Opponents contended
that Clinton’s reforms would lead to the government’s deciding on Americans’
healthcare rather than their doctors.
The bill died in Congress, and its failure contributed to
Republican victories in the mid-term elections in 1994, giving the GOP control
of both houses for the first time since the 1950s. Clinton spent the rest of
his presidency fighting for less ambitious healthcare reforms, including: the S-CHIP, a
program which dramatically reduced the number of uninsured children; the Health
Insurance Portability and Accountability Act, an initiative that helped some
Americans maintain their health insurance after losing or changing jobs; and Medicare
Advantage, which permitted Medicare recipients to receive
insurance coverage (including an expanded list of benefits) through subsidized
private insurance plans instead of traditional Medicare.
The Mental Health Parity Act (MHPA) is legislation
signed into United States law on September 26, 1996 that
requires that annual or lifetime dollar limits on mental
health benefits be no lower than any such dollar limits for
medical and surgical benefits offered by a group
health plan or health
insurance issuer offering coverage in connection with a group
health plan. MHPA was largely superseded by the Paul
Wellstone and Pete
Domenici‘s Mental
Health Parity and Addiction Equity Act (MHPAEA), which
the 110th United States Congress passed
as rider legislation on the Troubled Asset Relief Program (TARP),
signed into law by President George
W. Bush in October 2008. Prior to MHPA and similar legislation,
insurers were not required to cover mental health care and as a result access
to treatment was limited, underscoring the importance of the act.
The Health
Insurance Portability and Accountability Act of 1996 (HIPAA; Pub.L. 104–191, 110 Stat. 1936, enacted
August 21, 1996) was enacted by the United States Congress and signed by
President Bill Clinton in 1996. It was sponsored by Sen. Nancy Kassebaum (R–Kan.).[1] Title I of HIPAA
protects health insurance coverage for
workers and their families when they change or lose their jobs. Title II of
HIPAA, known as the Administrative Simplification (AS) provisions, requires the
establishment of national standards for electronic health care transactions and
national identifiers for providers, health insurance plans, and employers.[2] This act gives
the right to privacy to individuals from age 12 through 18. The provider must
have a signed disclosure from the affected insured before giving out any
information on provided health care to anyone, including parents.[3][4]
Mark & Jan Belue found, Belue & Associates, LLC
in March of 1997.
The Medicare Prescription Drug, Improvement, and
Modernization Act[1]
(also called the Medicare Modernization Act or MMA) is a federal
law of the United States, enacted in 2003.[2] It
produced the largest overhaul of Medicare in the public
health program’s 38-year history. Its most touted change is the
introduction of an entitlement benefit for prescription drugs, through tax
breaks and subsidies.
In the years since
Medicare’s creation in 1965, the role of prescription drugs in U.S. patient
care has significantly increased. As new and expensive drugs have come into
use, patients, particularly senior citizens for whom Medicare
was designed, have found prescriptions harder to afford. The MMA is meant to
address this problem.
The MMA created a new Health Savings Account statute that
replaced and expanded the previous Medical Savings Account law by expanding
allowable contributions and employer participation. After the first 10 years
over 12 million Americans were enrolled in HSAs (AHIP; EBRI).
“Economic
Survey of the United States 2008: Health Care Reform” by the Organization for
Economic Co-operation and Development, published in December 2008, said
that:[58]
- Tax benefits
of employer-based insurances should be abolished.
- The resulting
tax revenues should be used to subsidize the purchase of insurance by
individuals.
- These
subsidies, “which could take many forms, such as direct subsidies or
refundable tax credits, would improve the current situation in at least
two ways: they would reach those who do not now receive the benefit of the
tax exclusion; and they would encourage more cost-conscious purchase of
health insurance plans and health care services as, in contrast to the
uncapped tax exclusion, such subsidies would reduce the incentive to
purchase health plans with little cost sharing.”
When Barack Obama
(D) became president in 2009, his large Democratic majorities in both
houses of Congress offered the opportunity to achieve the substantial expansion
and reform of healthcare in the United States long envisioned by Democrats.
Compromises made to accommodate Democrats from conservative states and
districts, however, led to an intra-party fight over the legislation, with more
liberal Democrats championing a public option similar to Nixon’s proposal in
1974. Obama said he personally favored the public option, but in the end agreed
to a deal taking it off the table, and the Affordable Care Act, which was designed to
dramatically reduce the number of uninsured Americans, was signed into law in
March, 2010, with most of the changes staggered over the following four years.
Going into the 2010 mid-term election Republicans vowed to campaign against the
reform and repeal it if they regained control of Congress. Due to the
complexity of the law and its massive impact on the group and individual
markets, a summary is not possible, here.
Living
in this fallen world, under the curse due to man’s sin, with steady degradation
of creation from sin towards death, is a struggle. Treating and caring for the
sick and injured is a gift of God from the Great Physician, Himself. Belue
& Associates, LLC is dedicated to witnessing the love and care of Jesus
Christ of Nazareth and hold Him up as our model for selflessly serving our
clients. We regard our agency as actively participating in the financing of the
healing ministry of Yeshua the Messiah. By God’s grace, we are faithful He will
impart to us the knowledge and wisdom to properly care for and advise our
clients that He has given us for whatever changes and developments may come, as
He has already done, to date.
[1]
Harold G. Koenig, M. D., Handbook of Religion and Health (Oxford
University Press, Oxford, NY) Pages 31-47. Most references from the first 2
pages of this paper where taken directly from these referenced pages. Dr.
Koenig is the Director of Center for Spirituality, Theology, and Health, a
Professor of Psychiatry & Behavioral Sciences, and an Associate Professor
of Medicine.
[2]Most
of the following references and information containing hyper-links were taken
from Wikipedia and some other media websites.
