One of the greatest but most overlooked needs in America is maternity care for inner-city women. When many of these women become pregnant, they are often pressured into considering an abortion. Even if they choose to keep their baby, the quality of maternity care they receive is often compromised and many women do not receive any prenatal care before going to the emergency room for labor and delivery.
In Memphis, Tennessee, for example, a city with one of the highest infant mortality rates in the nation, 19 percent of pregnant women who end up delivering their babies receive inadequate or no prenatal care. Thirty percent receive intermediate care. This means that 49 percent are not receiving what the state of Tennessee would call even “adequate” care. The state’s definition of “adequate” probably does not include counseling women in the art of mothering from a Biblical worldview either. What is ironic here, or maybe an actual correlation, is that 50.33 percent of births in Memphis are paid for by Medicaid.
Remember that these statistics only look at the percentages of pregnancies that result in deliveries. Twenty-four percent of pregnancies in Memphis end in abortion. In Philadelphia, 45 percent of pregnancies end in abortion; in Jacksonville, Florida, 36 percent; in San Francisco, California, also 36 percent. Location appears to make no difference, whether east, west, north, south, within the “Bible Belt” or outside.
The Macro-Economics of Maternity Care
Our population is in a decline (at a 2.06 fertility rate, the United States is below even the replacement fertility rate). This demographic trend is on a collision course with another trend, a large, aging “Baby Boomer” population that will have a lot of health care needs that will need to be provided and paid for by a younger generation. The importance of delivering quality maternity care that will ensure that we have a younger generation to help provide for our aging population, re-stabilize our economy, and care for our elderly cannot be emphasized enough.
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Unfortunately, the extremely short-sighted “fix” that we apparently have adopted culturally is completely to ignore the need to provide better maternity care (which, obviously when successful, produces the much-needed, younger generation). When “women’s health” is talked about in newsrooms and in roundtable discussions, the issue discussed is not how to provide more moms with more readily accessible, more affordable, patient-centered maternity care that values the life of the child. But this should be the number-one priority!
To say that we often ignore the need for reproduction is grossly to understate the problem. Here is how counterproductive our current system is: The largest “family planning” services provider network in the United States, Planned Parenthood, is generously funded by Medicaid, the largest source of public dollars supporting alleged “family planning” services.
But the majority of Planned Parenthood’s “services” involve planning not to have a family! Indeed, government funding to Planned Parenthood, while technically not allowed to fund abortions, easily does so indirectly because it frees up PP’s general funds to be channeled to that very purpose.
Meanwhile, they offer nothing (beyond basic parenting classes) that actually helps people plan on being reproductive and having a family. No prenatal care. No labor and delivery care. No post-partum care. One might think that any government or organization that really cared about family planning and parenthood would actually fund and offer resources that actually address family and parenthood.
One might also think that any government with common sense (rather than some agenda!) that is on the hook for trillions of dollars in unfunded liabilities, would not be carrying out policies that will reduce the number of people who can help meet that liability.
But that’s not half the problem.
The Failure (and eventual doom) of Government “Charity”
The model of handing charity and care of any kind over to the government is no longer just a bad philosophical idea that should be avoided at all costs, it’s a totally bankrupt system—in every sense of the word. The two largest public institutions that the overwhelming majority of the poor in the United States rely upon for charity and retirement— Social Security and the Centers for Medicare & Medicaid—are estimated to have a combined unfunded liability of at least $100 trillion.
We face an imploding system that will, in time, completely fall apart. As the government redistributes resources in attempts to meet health care needs it deems expedient, maternity care is being dealt an increasingly devastating blow. Apart from the question of whether public funding should be used for health care at all, the government disproportionately directs its “women’s health” dollars to pay for routine maintenance procedures like mammograms, pap smears, and “family planning services,” while reducing funding for maternity care.
As Rome burns, our solution, as demonstrated by our actions, is simply to maintain the downward trajectory into financial ruin and despair, while hoping for the best. This is evidenced in the popular view of the relationship between how we provide maternity care and who should pay for said care (government vs. private institutions and churches) which results in a catch-22 that is contrary to basic logical, economical, and moral principles.
By many accounts and admissions, Medicaid now pays for more than 50 percent of births not only in Memphis, but in the entire United States. We live in a nation where the system of health care flows through the coffers and control of the federal and state governments. That system simply does not work and maternity care takes the brunt of its shortcomings.
In a Wall Street Journal article last year, Dr. Scott Gottlieb wrote, “Why do Medicaid patients fare so badly? Payment to providers has been reduced to literally pennies on each dollar of customary charges because of sequential rounds of indiscriminate rate cuts. . . . As a result, doctors often cap how many Medicaid patients they’ll see in their practices. Meanwhile, patients can’t get timely access to routine and specialized medical care. We need an alternative model.”
We agree: we need an alternative model. What Christians have for too long forgotten is this: we’ve already got one! And it’s long past time we recovered it.
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Civil government is not designed to be charitable. It is designed to wield the sword against evil doers (Rom. 13). Charity is a duty of individuals and the Church (Lev. 23:22, Job 31:16–23, Psa. 41:1, Prov. 19:17, 1 Cor. 13:2–8). As 1 Corinthians 12 teaches us, there are differences in administrations. God ordained the several institutions of society (individual, familial, ecclesiastical, and civil) each for different purposes. A nation cannot demand one institution to perform the duties that belong to another and expect to see continuity and consistency—and certainly not the blessing of the God who has ordained each to its own purpose.
As the Church is not designed to wield the sword against evildoers, so the government is not called or equipped to administer charity. It should be no surprise to us that when we hand over the work of charity to institution that is designed to administer cold justice, and even vengeance and wrath when necessary, the results can only be less than charitable.
When we depart from God’s plan for society, we can always expect the results to be ineffective and, in fact, counter-productive.
Even Some Private Charities Need to be Reformed
Last year the Kaiser Family Foundation and McClatchy Newspapers produced a series of reports and articles on some of the nation’s largest nonprofit children’s hospitals. Their findings raised eyebrows as they uncovered facts like this:
The Children’s Hospital of Boston spends less than 1% of its annual expenditures on free medical care for children.
The Children’s Hospital of Boston was founded 150 years ago as a privately funded charity. It has always been exempted from paying taxes. The neglect of charitable work has caused many officials in both government and the nonprofit world to question the charitable intentions of this and other charitable hospitals who are neglecting those who need charity.(1)
The series mentioned above and other health care policy research papers published over the past several decades point to an increasingly inefficient and ineffective system of administering and paying for care in both the public, quasi-private, and even private sectors.
These systemic problems are multiplied in regard to paying for and administering care to the poor. But it wasn’t always this way. The Kaiser Family Foundation article on the Children’s Hospital of Boston reveals that care in general, and charity care in particular, hasn’t always been dangling from the precipice of financial disaster while providing low-quality services.
The Solution is Simple—Not Easy, but Simple.
Private charities, particularly churches and parachurch organizations, have a long history of providing cost-effective, personal care to the poor and needy. A common theme often found in these private charities is that they are geographically centered in areas where the need is the greatest: they are community oriented, operated, and funded.
And despite what proponents of state-funded welfare may say, private funding for these charities is more readily available than most people think.
In 2009, nonprofits in the U.S received donations totaling nearly $304 billion—75 percent of which came from individual donors. Ninety percent of those donations came from households with less than $90,000 annual income. These figures mean that most people want to give—they want to invest in the well-being of their community.
But, they also do not want to throw away their hard-earned money. With Medicaid and Medicare fraud at all-time highs, people generally do not want to put their money into the coffers of any medical institutions that abuse an overloaded and inefficient system that often misdiagnoses poor patients in an attempt to “game” a complicated catalogue of billing codes.
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One current good example of what works is the Zarephrath Health Center, a privately-funded, charitable health care clinic located in a small town 30 miles outside of New York City. The clinic is serving between 300 and 400 patients per month at a cost as low as $18 per patient visit. Zarephrath Health Center does not accept Medicaid or third-party payments—it simply gives health care to those who need it.
Donors and foundations that desire to invest in their communities and culture are drawn to this model because it is successful and more personal than referring people to fill out a Medicaid application.
Inner-city women and their in utero babies are the neediest, most vulnerable people-group in the United States, and we overlook them in their time of greatest need. When we as a Church fail to meet a woman’s need, and she has her baby on the State’s dime, to who do you think that woman and her family will give thanks and praise for the birth of her child—the State or God? Shouldn’t God receive all of the praise and admiration that He deserves every time a person who bears His image enters the world?
Now, there’s an even better solution. Samaritan Ministries International has founded a new initiative to prove maternity care:
It is called the Morning Center project, and its mission is to address the various problems presented above:
- Raise the quality of maternity care
- Meet the needs of pregnant women, especially in urban and under-served areas
- Provide that care for free
- Eliminate dependence on government funding
- Provide Christ-centered care that directs all glory to God
The Morning Center method is really quite simple: only accept private funds, and demonstrate the love of Christ through word and deed.
The most common reasons women give for seeking little or no prenatal care are: limited transportation; no insurance; and poor treatment by clinic staff. The Morning Center model will meet these needy women where they live, with mobile care units uniquely suited to the communities being served.
The Morning Center will bring quality, Christ-centered maternity care directly into the poorest neighborhoods. By coordinating prenatal visits through local churches, the Morning Center will also accomplish another important goal of connecting new mothers with churches and local ministries that will provide other vital maternity needs: long-term counseling, accountability, and support.
The Morning Center model provides an opportunity for members of a community to come together to meet the needs of the low or no income, expectant mothers who are normally forced to depend on Medicaid.
Morning Center mobile care units will be a precursor to establishing the larger, second phase of the Morning Center vision: charitable maternity hospitals. After building these private, charitable institutions, followers of Christ must diligently work to keep these as institutions of the Church, because it is very easy to lose the original vision, as we have seen. Private charity administered by the Church is the most reliable way to bring a new dawn to health care in general and maternity care in particular.
It is the most reliable way—because it is the most biblical and faithful way.
For more information on the Morning Center, visit its website at www.morningcenter.org.