Pastoral Musings from Rain City

it's about 'what is church?' it's about whether 'emergent' is the latest Christian trend or something more substantial. it's musing on what it means to live faithfully...in the city, in America, in community, intergenerationally, at this time in history...

Monday, August 31, 2009

The Spinning Thing

Warning: I'm more of a pastor/poet than physicist, by several light years.

When I was a kid, our family spent a week each summer on the California coast. One of the highlights of that week was a trip to the boardwalk. One of the highlights of the boardwalk was the fun house, where for a quarter, you could slip into a magical world of crazy mirrors, tubes that turned, wave machines, slides, and best of all, the spinning thing. I don't know it's name, but it was this game you'd play, whereby 6 to 8 of us little kids would sit on a platter attached the ground. The platter began spinning, faster and faster, until one by one, kids begin to slide off. The object was to stay on as long as possible, so we'd scratch and claw as we sought to cling to the spinning thing, but invariably, the thing would win and we'd slide off onto a waxed floor, where we'd slide even further, landing only God knows where, in the fun house.

Later, in physics class, I learned the scientific principle governing the spinning thing: centrifugal force. Later still, like in the past five years, I've been learning about this same principle as applied to our collective life in Christ. Reading through the book of Acts in my early Christian days, I don't think I ever fully grasped how similar the young church was in mindset to we kids clinging to the spinning thing.

After all, the church was told from the beginning that the would be spun out of Jerusalem, "to Judea, Samaria, and the uttermost parts of the earth." Then they clung - to the heady power and fellowship that was found in earliest days of the church, right there in Jerusalem, right after Pentecost. "What, me leave? I'm fine right here, thank you very much." When we've connected with God and found some good friends with whom we're sharing openly and intimately, our instinct for stasis kicks in, and we begin to cling to what we have, rather than follow the flame and the cloud as it leads us into new frontiers.

The good news, though, is that the wheel begins to spin faster. Persecution breaks out in Jerusalem and some leave. It becomes increasingly obvious that this new chapter is going to include both Jews and Gentiles, because a whole new category of people is being created: "little Christs" who will make God's live visible. Our ideologies are spun out, as we wrestle with who actually constitute the "saved", and it slowly dawns on us that even those who (gasp) are uncircumcised, can know Christ. Even Roman soldiers are meeting Christ! Women are finding a voice. Slaves are finding a place at the table on equal footing with their masters. The wheel keeps spinning, faster and faster, in individual lives, lives of churches, and lives of nations, so that as the church grows old, it becomes this globally interconnected web of Christ followers, sharing their unique gifts across cultural chasms as heralds of the reconciliation of all peoples and all things that will come someday in fullness.

We'll look back and see that we clung to the spinning thing, that we resisted change, that we sought to freeze the present. We did it when we resisted our kid's growing up. We did it when we refused new relationships. We did it when we complained about the changes at church. We did it when we kept our prejudices and fears intact, choosing to kill the movement of God's spirit instead.

Ultimately, we pray, the spinning thing prevails and we let go, however reluctantly, of the past. When our family moved to Seattle, we left a town where the phone book consisted of one 8.5x11 piece of paper. We were afraid to leave our comfort zone, but the spinning thing had won, and we were flung into the thick of urban living. That was 14 years ago, and our church has subsequently grown from 250 to 2000, all because the wheel was spinning fast enough that we were forced to let go of our own dreams and plans. Thank God. He knew what was best for us.

I'm convinced that the force which breaks us free from the spinning thing is the centrifugal force force of the Holy Spirit. He knows just when to dial up the speed and fling us out of our existing geography, relational web, way of doing things, beliefs, prejudices. And if we cling (thanks be to God) He keeps dialing up the speed until we surrender. What are you clinging to: beliefs, geography, job, beliefs, prejudices, relational capacity, daily routine???

Thursday, August 27, 2009

The Image of God in Ted...

I remember, about a decade ago, interviewing for a ministry position and getting into a doctrinal discussion about the image of God in man, particularly debating the question of what extent the image of God resides in fallen humans. "None" was the right answer, according to the team across the table from me, steeped as they were in a strong reformed theology and doctrine of depravity. "Humanity lost any capacity at all to display the character of God when Adam aligned with Satan."
There it is. Simple. "Cut and dried" as they say. They quote some passages from Romans 3 that talk about none who do good, and how our righteousness is as filthy rags. Yes. I understand. I went to seminary.

The problem with this, it seems to me, is that it fails to take into account the profound respect that God has for all humanity in Genesis 9 where God says that human life is valuable precisely because we are made "in His image" - all of us. Fallen? Yes, tragically so, as each of our lives testifies in various ways. Yet, it's so often the case that, right there in the midst of our fallenness, we rise up for moments and align ourselves with God. Isn't Mozart's Requiem something that displays God's image, in spite of the drinking, gambling, and womenizing that characterized the composer? To declare that no unregenerate person displays the image of God in the face of evidence to the contrary seems tantamount to offering a mathematical explanation regarding why it's not raining while standing in the middle of a downpour; evidence to the contrary is everywhere, if we'll just pay attention.

All of this is the backdrop for my contention that, among politicians, Edward Kennedy displayed the glory of God's image more gloriously, and the tragedy of man's falleness more tragically, than most politicians who've graced the pages of history with their exploits.

The tragedy is easy to see. Chappaquiddick stands at the top of a sizable list of improprieties, leaving us with, at the very least, severe question marks regarding judgement and moral character. Christians will excoriate him for his treatment of Justice Bjork and his liberal views on abortion. All this is horribly true.

But there's another side to the man. In 1964 he was instrumental in passing the critical Civil Rights Act which has helped turn the ship of American history away from blatent racism towards egalitarianism. Kennedy's Immigration Act of 1965 sought to give non Europeans some sense of reality for the words that are inscribed at Ellis Island: Give me your tired, your poor, your huddled masses yearning to breath free. If you're a woman and you played high school sports, it's because you had an advocate in Ted Kennedy. If you're disabled, and you have access to major buildings and sidewalks in your city, it's because of the efforts of Kennedy. If you're a senior citizen living on fixed income and thus receiving "Meals on Wheels", it's because Kennedy went to bat for you.

A constant advocate for the downtrodden, marginalized, and weak, I can't help but think of James definition of true religion when I think of Kennedy, which has to do with caring for widows and orphans in their distress.

You can argue the politics if you like, declaring the government shouldn't care about racism, or gender equality, or health care, that the extent of their 'intrusion' should be to pave our roads and provide an army, leaving us to fend for ourselves with the rest of life. You can point to his failures. But what you can't do is declare that he didn't "give a damn" about the least of these. As the church has, in recent years awakened to her calling to care for those who can't care for themselves, we've been reminded that caring for those on the margins is our calling precisely because such acts of mercy make the character of Christ visible.

Ted cared for the "least of these" and in so doing, displayed something of the image of God. This is not only a blessing, but a challenge. The challenge lies in our propensity to put black or white hats on everyone, presuming the unfallen to display only the character of Satan,and painting the saved in white because, as we like to say, we're "clothed in Christ".

It's all a bit too convenient. Reality forces us to wrestle with the truths that Samaritans, the couple down the street who live together and smoke pot, and political liberals, all manifest compassion, sometimes more visibly than the "saved". Maybe it's time for a little humility on our part, and a little gratitude, and a little openness to the possibility that there are those in this world who've not yet been born again who, nonetheless, display Christ's character at times. May we learn from them by their acts, and honor them.

Wednesday, August 26, 2009

Infidelity comes out of the closet...

The hot new infidelity web site, which promises that you'll have an affair or you get your money back, is doing a bus tour! The bus stopped yesterday at, of all places, Temple Square in Salt Lake City as part of it's "have an affair anywhere tour", which you can read about here.

Of course, we're all shocked and offended at this new online access to cheating. And yet, a new person is signing up every fifteen seconds, which is considerably more web noise than pastoral musings are able to produce. It appears that there are more people interested in a romp in the hay than, say, a discussion about Christian ethics, or the ramblings of a middle aged guy about how he encounters God in the everyday things of life, like sunrises and good conversations. Who'd of thought???

All sarcasm aside, though, I'll just observe that this "coming out" of infidelity seems to be simply the next chapter in our cultural evolution as consumers. It's gone something like this:

1. Declare that our right to the pursuit of happiness is inalienable, a divine right granted by God.

2. Allow that pursuit of happiness to be defined materially, with the result that we become a people characterized, throughout our history, as claiming land by divine right, either displacing or killing the occupants (both animal and human) as a result.

3. Throw in a healthy dose of mobility, enabling us to move out of our settings when they become challenging.

4. Continue the relentless pursuit of our divine right to happiness by seeking an economic dominance that will enable us to try and fill the aching void in our souls by shopping for more, bigger, and faster stuff, in spite of the clear and undeniable evidence that such pursuits are killing our planet and failing to deliver on the hollow promise.

There it is. Suddenly you have the perfect cocktail of discontent, rootlessness, and predisposition to demand the fulfillment of personal needs as a means of happiness. Throw all these elements in a blender and what comes out? A web site that matches you, in your pursuit of happiness on demand, with someone else who is just as frustrated, wounded, discontent, or bored. Now you can have that happiness that neither a faster car, implants, or season tickets were ever able to provide; easily and privately. The web site even comes with an app for your i-phone so that your paranoid spouse, who monitors your web tracks, will remain none the wiser.

This isn't shocking at all. This is simply the next step in our culture's worship service, held perpetually at the altar of self-fulfillment. What's sad to me is that the church has been quick to aim the gun at adulterers and pull the trigger, without taking the time to see the cultural elements that have created this problem. Until we think about our collective values and choose intimacy and interdependency over isolation, and service over self-indulgence, and quiet simplicity over loud ambitions, the infidelity siren will continue to sing, and souls will continue to crash and burn on her rocks.

Monday, August 24, 2009

The Art of the small things...

Enjoy this picture. Blow it up and take a good look. It was taken Saturday, up by Mt. Baker, where I was hiking with my wife. This was as much view as we had all day, as the mountain parted her skirt for just a moment or two before draping herself in the modesty of fog again. The whole time up on the mountain was like this; a hint of the bigger vision followed by everything shutting down and closing in, forcing the micro view despite our achings for the macro view. Instead of glaciers, lichen. Instead of canyons, a marmot. Instead of summit, dew on a blossom.

I like the big picture, like a clear understanding of the final destination, the summit where we're going. I like clarity more than fog. But clarity isn't always an option, and in fact, if the truth be told, we'll humbly acknowledge that the very clarity we claim to have regarding lots of details regarding our future is, in fact, a mirage. We can't even figure out the weather, let alone markets, terrorists, why cancer cells lose and win, and the foibles of our own human hearts. There's fog - everywhere. It comes and goes with the winds of grace, but it's a reality for all of us. This summer my pastoral role has reminded me, numerous times, of the realities of fog. Someone's making a decision regarding med school, having been accepted, but not necessarily having the stomach to go. What is the future God has for her? Another is hanging by a thread over the abyss of foreclosure. Another has discovered her husband's affair, shattering her vision of intimacy and trust. Fog.

Fog, though, doesn't blind us. It simply reduces our range of vision, forcing us to pay attention to a smaller world. It's easy to whine when our vision is restricted, when the future is uncertain. Instead, try paying attention to the little things. This, after all, is what Jesus advised anyway, hinting that we wouldn't always understand the big picture, because the reality of the things is that there's more fog around us than we care to enjoy. And yet, said Jesus in the New Testament, and Jehovah in the Old, "I'll give you all you need for the day; all the guidance, all the provision; all the resources for whatever you're doing, even if what you're doing seems very very small."

So here we are, a lot of us, unable to see the future. But perhaps it's precisely because I can't see the future that I can see a sink filled with dirty dishes, or that I've not had a decent conversation with my spouse, or that the bedroom has become a giant storage closet of unsorted obligations that shout "you're too busy", but I only just now heard, because I was, well, too busy to listen.

The fog shrinks our view, but the things we see in our shrunken view aren't unimportant. In fact, it just might be that while we're in the midst of minding the micro vision of our lives, listening to our neighbors, cleaning our homes, tasting our food, praying, that we'll see the macro vision once again. When the fog clears I discover that it was my attention to the big vision is made up of millions of tiny acts of faithfulness anyway, and that it's those who pay attention to the little things that gain, not only a seeing of the grand vision, but the privilege of walking in it.

That's all for now... I'm going to go home and clean my room.

Thursday, August 20, 2009

Quick thoughts from a mentor...

Sometimes (often? usually?) my best thoughts aren't my own, but those that I mine from others. This morning, before heading off for a full day, it's a joy to share some words from a mentor of words, Wendell Barry. What he says here, I agree with, without reservation. He writes:

Let me be plain with you dear reader.
I am an old faishioned man I like
the world of nature despite its mortal
dangers. I like the domestic world
of humans, so long as it pays its debts
to the natural world, and keeps its obligations.
I like the promise of Heaven. My purpose
is a language that can pay just thanks
and honor for those gifts, a tongue
set free from fashionable lies.

neitjher this world nor any of its places
is an 'environment'. And a house
for sale is not a 'home.' Economics
is not 'science', nor 'information' knowledge.
A knave with a degree is a knave. A fool
in a public office is not a 'leader.'
A rich thief is a thief....

The world is babbled to pieces after
the divorce of things from their names.
Ceaseless preparation for war
is not peace. health is not procured
by sale of medication, or purity
by the addition of poison. Science
at the bidding of corporations
is knowledge reduced to merchandise;
it is a whoredom of the mind,
and so it the art that calls this, 'progress.'
So is the cowardice that calls it 'inevitable.'

Amen... preach it Wendell

Tuesday, August 18, 2009

Impact or Aroma? An important distinction


Pastors, just like real people, have trade journals and magazines, which of course, are filled with advertisments and articles intended to make us better at what we do. A quick purusal of these tools reveals that a recurring theme, in both articles and ads alike, is how important it is to make an IMPACT for Christ. "We're going to impact the world by planting one thousand churches." "How to impact your neighborhood with the gospel." "The impact factor!" "Impact your city for Jesus!!" "Real leaders make an impact!!"

I finally decided to look up the word in order to see what it really means. I discovered that the word, while occassionally used with positive connotation, is largely negative and destructive. It means,


"...to affect or influence, especially in a significant or undesirable manner..."



"...to collide or forcefully strike..."



I don't want to make too much out of a single word, but I'm afraid that overusing the word "impact" as it applies to our calling might not be wise. It can have the subtle effect of creating Christ followers who are militant, ambitious, unduly confrontive, and intent on overhauling the culture "for the cause of Christ." What does this look like?

It looks like Dobson's now famous letter intended to scare America away from Barack Obama.

It looks like calls to boycott certain companies because they offer employee benefits to same sex partners.

It looks like pastors and organizations with large audiences decrying a certain few sins, centering in on sexual issues and declaring that the future of the free world hangs on our wholesale condemnation of these issues, while turning a blind eye to the greed, militarism, and nationalism that might just be the bigger problems.

It looks churches driven by ambition and lofty goals, mobilizing their congregants to activist lifestyles that are ultimately exhausting. Working hard, like Martha, to make in impact, while neglecting the more important things. Thus do emotionally, phsyically, and spiritually spent pastors, flame out in nervous breakdown, financial misconduct, or sexual sin, in spite of their impactful message. IMPACT for certain, but too often, in the worst sense of the word. Did I mention that a quick look at my concordance revealed that this word is entirely absent from my Bible? There's a different word used by God to describe influence...

It's liberating for me to realize that even the great Paul, whom none of us could possibly characterize as a spiritual slacker, chose a gentler word to describe what He knew God was doing through him. In II Corinthians, he declares his confidence that God is expressing, through him, the sweet aroma of Christ.

It's the difference between a wrecking ball and the smell of your morning coffee, the difference between blowing up a building, and walking through a forest wet with fragrant morning dew. Which is noisier? Which elicits more public response? Which is more appealling?

I'm increasingly convinced that our ambitions related to making an impact are misguided, nothing more than a cloak to cover our own insecurities with God's 'blessing'. Instead of an impact, our ambitions ought to be related to being an aroma, as Paul says, "TO God... AMONG men." Aromas are a byproduct that reveal the essence of something. They don't set out to BE aromas, they simply are: Pine trees smell like pine; cigarette smoke like tabacco; coffee like heaven. That's the way it is.

Christ followers, when they're living in the moment as worshipplers, listening for the voice of Jesus and stepping into His calling, smell like Christ. They're bringing words and actions of hope. They're following their master in a thousand little acts of self-denial, putting their spouses needs before their own, loving, giving, encouraging. They're living creatively, embodying beauty in unique ways, whether through the cooking of a meal, the healing of a body, the encouragement of a tired soul, or the empowering and liberating of someone held in bondage, for whatever reason.

It's these unheralded, unprogrammed, un-noticed acts that are filling the world with the incense, the sweet aroma, of Christ's life. When I was young, I was obsessed with impact. As I grow older, I'm less impressed, even increasingly wary, of impact. Aroma is where it's at, becoming the quiet fragrance of life in a world where the stench and pollution of death is everywhere.

The aroma ambition is liberating, in that it frees me from the ambitions, constant measurements, fears, and obsessions, that are necessarily wed with IMPACT. I've pretty much traded in IMPACT for AROMA... wake up and smell the coffee. You'll like it better here.

Sunday, August 16, 2009

Meditations: So Sew

It's a good weekend for looking back, what with Woodstock and all that. My looking back though, doesn't go quite that far, since I was only 13 when the festival came down, and living on the wrong coast. Instead, I looked back this weekend, to an island, and was reminded of the parable about the seed and sower.

Back in 1990 I'd had enough of being a pastor, and so had set out to do something different (was it calling? frustration? my own initiative? God's? Yes). As a result, I would spend the next six years travelling the world and teaching from the scriptures for Torchbearers Missionary Fellowship, a coalition of Bible Schools scattered on various continents. Of all the places I taught, the place where I invested the most time was the school closest to home, located on a spectacular island in British Columbia. That first year of my new ministry, I probably spent 10 weeks up on this island teaching students. What I loved about doing that then is the very same thing I love about doing it now, which is that my role when I teach there is twofold: teach, and hang out with students, hearing their stories, and sharing in their lives.

I still remember when I was invited up for six weeks to simply teach and shepherd students. "Are you kidding me? You mean, besides teaching the Bible, you'd rather have me playing two on two volleyball with students, or roasting oysters on the beach than make budget proposals, attend board meetings, and interface with government officials about building codes? Um, yes, I'll be there on the next ferry." Thus began a relationship with the ministry on this little island that has continued for 19 years.

I still go teach there. I still love hanging out with students, sharing the scriptures with them, sharing meals with them, and hearing their stories. However, one of things that I've grown to wonder after all these years is, "what happens to these students?" Of course, I know that statistically speaking, some press forward and some don't. But my question is more personal. "What happened to Chris? Linda? Stacey? Liza? Darrin?" because these were some of the ones with whom I spent the most time during that very first year, when I lived there so much of the time.

I boarded the ferry again, one week ago today and headed there to teach this week, not for a week of Bible School, but for a family conference, which is like a "Bible study vacation" (unimaginable for some, I know, but in this big world, there are lots of people who love having their meals prepared, their dishes done, and their children cared for, while they in return wrestle with themes from a book of the Bible, as these guests did this past week while a taught Exodus).

My big surprise and joy came when, upon arriving, I realized that many of these past students had signed up for the week of teaching. Now in their mid-thirties, they'd made the trek from Alberta or Saskatchewan or wherever in order to return to this island, a place of their own spiritual roots. There they are, in the picture, only now they all have teenagers.

Yes, they have questions. Yes, they've faced disillusionment and trials. And yes, they're still walking with God! I was able, at various times throughout the week, to speak with most of them, amazed that they remembered specific things from talks I'd given in the springtime of 1990, when I was 34. We took the picture above on the ferry, as we were leaving (one student never left the island... he's the one working for the ferry).

As I stood here with the students, my heart warmed by the reality that, through all the joys and sorrows, all the disillusionment and idealism, these students are still showing up, still seeking and serving Jesus. And that's when I remembered those words from Jesus about a sower who went out to sow seeds in the field. As a kid, when I saw that parable on the flannel board, and we planted tiny seeds in the soil, I was told again and again, until I couldn't bear to hear it any more, that Iwas the soil and God was planting seed in me so, by God, be a good little boy so that the soil of your heart will let the seed grow.

Yeah. I get it. But Friday, on the ferry, I was reminded of something equally true: I'mnot just soil...I'm a sower of seed, and the reality is that, because of my particular calling with students, I don't always get to see whether the seed really takes root or not. But long after I've boarded the ferry and moved on to other things, the seed that's been sown will work it's mojo, not because I'm clever, but because God uses things like rocks, donkeys, and messed up humans to accomplish his purpose. I was reminded by the faithfulness of these old friends to keep on sowing; when I feel like and when I don't, when the soil seems receptive and when it doesn't. One never knows, nor does one need to know, what will happen when particular seed meets particular soil. But if seed and soil never meet, one knows for certain, that there will be no fruit.

O Lord, God of seed and soil;

Thanks be to you for the miracle of life
That happens as seed meets soil

Be our constant reminder that we are both:
seed and soil giver and receiver.
So enable us to sow faithfully that

Your blessings is spilled through us

Into the soil of this beautiful
and broken world.

Amen .

Thursday, August 13, 2009

Health Care - more than sound bytes needed

The health care debate is in full bloom and so it's time to write about it and, I hope, get some discussion going. From what I've seen though, on the news this week, I'm skeptical that any real healthy discussion is going to take place for two reasons.

The first reason is because this issue is revealing just how addicted we are, as a nation, to our political categories, and the vilifying of whoever our opposition might be. We vilify through sound bites, as Sarah Palin has done by talking about an imaginary death panel who hold the rights to live or die in their power. We vilify through implying that Obama's health care logo has it's origins in Hitler's Socialist Party Logo. These stupid accusations and associations don't help the conversation at all. Such comments make it difficult for many to even listen to the very good and important things that the pro-free market people have to say.

Secondly, and related, it's increasingly clear that the average American wants sound bytes, rather than doing the hard work of digesting the complexities of this issue. For those inclined though, to do that hard work, I'd recommend this very lengthy article, written by a life long Democrat whose first hand negative experiences with the health care industry have led to his thorough study of the problems, and his worthy, decidedly pro free-market proposals. If you've no time to read the whole article, please read the bullet points and quotes, at the very least, before commenting.

This conversation is important, not because we want to become like Europe or be different than Europe (or Canada), but because health care is consuming more of our resources every year, resources not used for other things. The path is unsustainable, even for the insured, let alone those who are losing their homes or dying because they have no insurance. What are some of the major issues? Pour a cup of coffee... this is long post. But please read... it's important!

1. Health Care isn't Health or Happiness

Medical care, of course, is merely one component of our overall health. Nutrition, exercise, education, emotional security, our natural environment, and public safety may now be more important than care in producing further advances in longevity and quality of life. (In 2005, almost half of all deaths in the U.S. resulted from heart disease, diabetes, lung cancer, homicide, suicide, and accidents—all of which are arguably influenced as much by lifestyle choices and living environment as by health care.) And of course even health itself is only one aspect of personal fulfillment, alongside family and friends, travel, recreation, the pursuit of knowledge and experience, and more.

Yet spending on health care, by families and by the government, is crowding out spending on almost everything else. As a nation, we now spend almost 18 percent of our GDP on health care. In 1966, Medicare and Medicaid made up 1 percent of total government spending; now that figure is 20 percent, and quickly rising. Already, the federal government spends eight times as much on health care as it does on education, 12 times what it spends on food aid to children and families, 30 times what it spends on law enforcement, 78 times what it spends on land management and conservation, 87 times the spending on water supply, and 830 times the spending on energy conservation. Education, public safety, environment, infrastructure—all other public priorities are being slowly devoured by the health-care beast.

2. Health Insurance isn't Health Care

After explaining why health insurance is so obviously important as a means of protecting one from going bankrupt because of catostrophic illness, Goldhill writes, "...health insurance is different from every other type of insurance. Health insurance is the primary payment mechanism not just for expenses that are unexpected and large, but for nearly all health-care expenses. We’ve become so used to health insurance that we don’t realize how absurd that is. We can’t imagine paying for gas with our auto-insurance policy, or for our electric bills with our homeowners insurance, but we all assume that our regular checkups and dental cleanings will be covered at least partially by insurance. Most pregnancies are planned, and deliveries are predictable many months in advance, yet they’re financed the same way we finance fixing a car after a wreck—through an insurance claim. Comprehensive health insurance is such an ingrained element of our thinking, we forget that its rise to dominance is relatively recent. Modern group health insurance was introduced in 1929, and employer-based insurance began to blossom during World War II, when wage freezes prompted employers to expand other benefits as a way of attracting workers. Still, as late as 1954, only a minority of Americans had health insurance.

3. the Moral Hazard Economy

Every time you walk into a doctor’s office, it’s implicit that someone else will be paying most or all of your bill; for most of us, that means we give less attention to prices for medical services than we do to prices for anything else. Most physicians, meanwhile, benefit financially from ordering diagnostic tests, doing procedures, and scheduling follow-up appointments. Combine these two features of the system with a third—the informational advantage that extensive training has given physicians over their patients, and the authority that advantage confers—and you have a system where physicians can, to some extent, generate demand at will.

Do they? Well, Medicare spends almost twice as much per patient in Dallas, where there are more doctors and care facilities per resident, as it does in Salem, Oregon, where supply is tighter. Why? Because doctors (particularly specialists) in surplus areas order more tests and treatments per capita, and keep their practices busy. Many studies have shown that the patients in areas like Dallas do not benefit in any measurable way from all this extra care. All of the physicians I know are genuinely dedicated to their patients. But at the margin, all of us are at least subconsciously influenced by our own economic interests. The data are clear: in our current system, physician supply often begets patient demand.

4. There's no one else to pay the bill

"...Let’s say you’re a 22-year-old single employee at my company today, starting out at a $30,000 annual salary. Let’s assume you’ll get married in six years, support two children for 20 years, retire at 65, and die at 80. Now let’s make a crazy assumption: insurance premiums, Medicare taxes and premiums, and out-of-pocket costs will grow no faster than your earnings—say, 3 percent a year. By the end of your working days, your annual salary will be up to $107,000. And over your lifetime, you and your employer together will have paid $1.77 million for your family’s health care. $1.77 million! And that’s only after assuming the taming of costs! In recent years, health-care costs have actually grown 2 to 3 percent faster than the economy. If that continues, your 22-year-old self is looking at an additional $2 million or so in expenses over your lifetime—roughly $4 million in total.

Would you have guessed these numbers were so large? If not, you have good cause: only a quarter would be paid by you directly (and much of that after retirement). The rest would be spent by others on your behalf, deducted from your earnings before you received your paycheck. And that’s a big reason why our health-care system is so expensive."

5. The Government is NOT good at cost reduction

"...Cost control is a feature of decentralized, competitive markets, not of centralized bureaucracy—a matter of incentives, not mandates. What’s more, cost control is dynamic. Even the simplest business faces constant variation in its costs for labor, facilities, and capital; to compete, management must react quickly, efficiently, and, most often, prospectively. By contrast, government bureaucracies set regulations and reimbursement rates through carefully evaluated and broadly applied rules. These bureaucracies first must notice market changes and resource misallocations, and then (sometimes subject to political considerations) issue additional regulations or change reimbursement rates to address each problem retrospectively."

6. Uncompetitive

This lengthy section of the article explains that our heatlh care industry is, properly, one of the more heavily regulated industry. I say properly because it's of some value to know, for example. that your doctor has proper training, and that the equipment being used in your hospital is sterile. However, the reality is that the regulatory system is prone to enact laws authored initiated by lobbyists with the intent to kill the competition. Goldhill shares several examples of this, including a congress enacted moratorium on starting small clinics that specialize in one form of surgery. Killing the competition, as we all know, has the effect of elevating costs.

Here's an example of how our health care providers refusal to talk about prices stifles competition: "...Eight years ago, my wife needed an MRI, but we did not have health insurance. I called up several area hospitals, clinics, and doctors’ offices—all within about a one-mile radius—to find the best price. I was surprised to discover that prices quoted, for an identical service, varied widely, and that the lowest price was $1,200. But what was truly astonishing was that several providers refused to quote any price. Only if I came in and actually ordered the MRI could we discuss price.

Several years later, when we were preparing for the birth of our second child, I requested the total cost of the delivery and related procedures from our hospital. The answer: the hospital discussed price only with uninsured patients. What about my co-pay? They would discuss my potential co-pay only if I were applying for financial assistance.

Keeping prices opaque is one way medical institutions seek to avoid competition and thereby keep prices up. And they get away with it in part because so few consumers pay directly for their own care—insurers, Medicare, and Medicaid are basically the whole game. But without transparency on prices—and the related data on measurable outcomes—efforts to give the consumer more control over health care have failed, and always will"

7. On the technology front...

We live in a culture where the production of new technologies eventuates in increased productivity and eventually, a decline in prices. Thus do DVD players today cost one tenth of what they cost when they first came out. But in the health care world, the lack of competition makes this nearly impossible. For example...

"...health-care technologies don’t exist in the same world as other technologies. Recall the MRI my wife needed a few years ago: $1,200 for 20 minutes’ use of a then 20-year-old technology, requiring a little electricity and a little labor from a single technician and a radiologist. Why was the price so high? Most MRIs in this country are reimbursed by insurance or Medicare, and operate in the limited-competition, nontransparent world of insurance pricing. I don’t even know the price of many of the diagnostic services I’ve needed over the years—usually I’ve just gone to whatever provider my physician recommended, without asking (my personal contribution to the moral-hazard economy).

By contrast, consider LASIK surgery. I still lack the (small amount of) courage required to get LASIK. But I’ve been considering it since it was introduced commercially in the 1990s. The surgery is seldom covered by insurance, and exists in the competitive economy typical of most other industries. So people who get LASIK surgery—or for that matter most cosmetic surgeries, dental procedures, or other mostly uninsured treatments—act like consumers. If you do an Internet search today, you can find LASIK procedures quoted as low as $499 per eye—a decline of roughly 80 percent since the procedure was introduced. You’ll also find sites where doctors advertise their own higher-priced surgeries (which more typically cost about $2,000 per eye) and warn against the dangers of discount LASIK. Many ads specify the quality of equipment being used and the performance record of the doctor, in addition to price. In other words, there’s been an active, competitive market for LASIK surgery of the same sort we’re used to seeing for most goods and services. The history of LASIK fits well with the pattern of all capital-intensive services outside the health-insurance economy."

8. A Way Forward

It's difficult to offer a representative quote for this part of the article, but you can read this part here. The summary though, would be to suggest that if we were to make health care MORE of a free market reality rather than less, we'd all be better off. However, the author goes on to also declare that there's a great need for us to address the fundamental moral issue of accessibility for low income people. If both of these truths are taken into consideration, at least two truths become clear:

First: the current proposal will fall terribly short of achieving real cost saving reform

Second: any proposal that will ultimately work must stand outside both the socialist and capitalist paradigms that are presently driving this conversation. Of course, this latter truth is in keeping with all that God proposed when He spoke to Israel about economics in the Old Testament. That system defied categorization in that it was terribly pro-private property, pro-wealth creation, and pro-communitarian sharing of responsibility for the poor, whom Jesus said we would, "always have with us".

Until we can free ourselves from party loyalties and sound bites, we're going to be a stuck on a treadmill.

I welcome your thoughts...



Wednesday, August 12, 2009

Sojourners or Settlers - an important question

I'm teaching in Canada this week at a place where the international mix of guests, staff, and students always makes for lively discussion. I could tell you about conversations regarding health care (I hope you'll talk to some real live Canadians and Europeans, whose assessments of this subject might be a tad more realistic than Rush Limbaugh's) but I'll save it for another time because there's a more important subject worth considering.

Last night, after my lecture, I spent some time with a couple of German women who are passing through Canada on holiday before returning to their medical careers in Europe. Both were raised in the communist, totalitarianism of the GDR (East Germany) and even the small fragments of their story that I learned last night are worth sharing with you so that you ponder some important questions with me. They spoke of their childhood, and the role that the church played in the demise of communism. They spoke of the challenges that came with growing up as Christ followers in a political climate intent on silencing any vestiges of the gospel. They explained how, towards the end of communism's run, the church buildings of old became strategic centers where people gathered for to offer prayers for a change in national direction. The few became groups. Groups became 'the masses'. The masses became a national movement. And the walls came down.

"Right after freedom came" one said, "the churches were full. Everyone came." Then, after a moment of silence, the other said, "but not anymore. I suppose it's the materialism that comes with freedom." I I left our conversation shortly after that, feeling that our conversation held some significant elements to ponder. In my ponderings, I've been reminded of several things:

1. Historically, it's the people who are, existentially speaking, sojourners, that live clinging to God. Consider the Black Church in America, or the Reformationists in the midst of Catholicism, or the Radical Reformationists in the midst of the Reformationists, or the house churches in China, or the random few believers in Eastern Europe in the mid-twentieth century. It always seems to be true that it's the people without the power that are clinging to Christ most profoundly and, in their clinging, are shaped by God's heart, filled with unquenchable light.

2. This unquenchable light seems to shine as long as we're sojourners, but it also seems true that as soon as we settle down, we settle into darkness. Political power has seduced the church countless times throughout history. It's as if the church, at various times, has 'gained the whole world, but lost it's soul'. Mediocrity, greed, complacency, division, boredom, and gross materialism become hallmarks of the people of God, who increasingly mirror the values of the principalities and powers of this world. Thus does salt lose its saltiness. Thus do we suffer loss as we gain.

I wonder if I'm right, and if I am right, I wonder what can be done about it. As Eastern Europe gains their own versions of Walmart and Costco; as they fill their ears with the buds of ipods and their minds with our values, their churches are emptying. What does that tell us? I know what Jesus says: "No man can serve two masters." But I'm wondering what we, who didn't ask to be born into wealth and comfort, can do, to become sojourners who are clinging desperately to our God, rather than settlers who've made a pact with the comforts of this world, and in the process blown out our candles?

I welcome your thoughts...

Monday, August 10, 2009

The Rain has come...


The Rains…

Monday morning – 2AM

Having fallen asleep to the sound of winds assaulting the various flags at the Bible Centre where I’m teaching this week, I wake to the sound of raindrops pelting the flat roof that extends right outside my open window as the skies, pregnant with moisture, give birth to long awaited showers. I smile and turn over, drifting quickly into contented sleep.

6AM

As light dawns, I waken slowly to the sound of wind, once again, gently caressing the flags, but also to the sound of birds. Gulls and geese are celebrating the rain with me, down on the field by the water, presumably feasting on the harvest that comes from a newly watered earth. Beyond the field, the sound. Beyond the sound, the mountains, with clouds captured by their walls, watering thirsty cedars.


Welcome rain. When last you left us, some 80 days ago, I didn’t know you’d be gone so long, didn’t know I’d miss your mists so much. Only your return awakens my slumbering longings for you, and all the beauty, cleansing, and contemplation that comes when you wash the earth, fill the seas, cleanse the souls. Welcome rain.


I ponder, as the clouds drift across their mountain canvass, the rains spoken of by Hosea. Our world gets parched, terribly so, by the absence of spirit, because sans spirit, we’re stripped of beauty, justice, hope, rest, joy. The dessert landscape of our parched souls is sparse, and we’re wearied by the looking, settling for substitute versions of life, in a dry barren land. Television and money, indulgences and diversions, ambitions and acquisitions, these become our food, bending our appetites towards destruction. Worst of all, our appetites adapt.


And then the rains come, and we realize that we’ve been feasting on dirt, realize that abundant streams await, from which we might imbibe hope, simplicity, hospitality, generosity.


Come Holy Spirit. Pour your rain on my soul this day. Saturate me with your life, that my appetites for life might be awakened, that rivers of living water might flow through me. I thirst. I thirst.

Saturday, August 08, 2009

The Sabbath dance, in 6/7

I'm privileged to teach in Europe every year for a week or two. Europe, you know, is what the Republican party is afraid we're becoming if we let everybody have access to health care. It's the "post Christian" culture that so many fear we'll become, at great cost to our personal freedoms, if we don't vote properly.

These fears seem almost entirely misguided to me because, though our culture has incredible riches and unique blessings, we'd be wise to exercise some humility and recognize the vestiges of the gospel that reside across the water. What would it mean if we harvested some of our European friends cultural values?

It would mean that we'll spend less on health care per capita while our mortality rates would drop and our longevity rates rise. Church bells would ring at the beginning, middle, and end of each day, along with each hour. Public schools would celebrate "prayer day" where they learn about prayer in history, and spend time actually praying. There would be less access to AK47s and other rapid assault rifles for common citizens, and rates for homocides would be lower, as would the rate of incarceration. It would mean that a barista wouldn't lose their home because they need open heart surgery. These are good and needed changes. I'd suggest the only thing we have to fear is fear itself (to quote a favorite recent socialist).

However, rather than tackle the whole "socialist, church bells, prayer day, gun control" culture, I'd like to just talk about the Sabbath, which is practiced far better in Europe than it is here. Our culture is open for business 24/7. As a result, we've collectively lost our sense of rhythm, and this has serious consequences:

1. Because shops are open 7 days a week, we buy! This piece of our culture has the effect of enabling our propensity to wear ourselves out. In contrast, only activities that enhance leisure and relationship building (cafes, ski areas) are open on Sundays in the places I travel in Europe.

2. Because we buy, we do stuff, and the stuff we do often has the effect of displacing the leisure of eating a meal, slowly, with good friends, good wine, good conversation. Instead we're painting the fence, or cleaning the house, or whatever.

3. These things we do, combined with our love of TV, are effecting our relational capacity. A friend from Europe visited some college students here in the states and found their capacity for lingering conversation lacking, as they preferred, instead to play wii or watch movies.

Of course these are generalizations. Of course there are exceptions. Still, I'd argue that we need to learn from our European friends, how to dance to the rhythm of 6/7 time. Work hard six days a week, and then spend a day investing in rest, restoration, recovery, relationship, recreation, receiving all of it as the gift God intended.

We surely have different vestiges of our Christian heritage more prominent in our culture than our European friends have, but we both have these 'hangovers' from the Reformation (good hangovers... if ever there could be such a thing). It's high time we acknowledged that, maybe they're onto something with this Sabbath thing, and we learn from them. We might not be able to change the culture at large, but surely we can march to a different drummer ourselves can't we?

Have friends over for a meal
Sleep in
Worship
Play music with companions
Do something with your spouse: take a bath together, go for a hike, read aloud to each other

In short, make one day different, a day when you quit fighting the battle for survival, and simply enjoy the relationships, food, creation, health, that God has placed on your plate right now. Here's a book that might help get you started... and good Sabbath to you.

Friday, August 07, 2009

calling and context... an important distinction

Reading through the comments about the quarter life crisis has had me thinking about my own trajectory over the past 30 years. Though there are many issues (relationships, money, ambivalence about commitment), it seems that the issue of finding one's 'destiny' remains (as it was when I was 25) one of the most important issues. Since this issue of decision making, and wanting to 'get it right' are important factors in this post college, post masters, post-post graduate period of life, I offer these observations, based on looking back:

1. Finding one's calling is the first thing. "Calling" might be a bad word because it can be interpreted as finding the particulars of life, such as where, in particular I'll live, and what, in particular I'll do. The prior question, though, really ought to be, "what energizes me?" because, as Frederick Beuchner said (approximately): "our calling is to be found in that place where the world's need and our deep gladness intersect." Each of us needs to discover the activities that energize us and those that drain us, the activities at which we excel, and those the one's at which we're terrible.

2. The calling is more general than you think. My own journey has included seemingly disparate pursuits; architecture, music composition, Bible teaching, beginning a wilderness ministry, pastoring an urban church, writing a book. Though, at first, these things seem utterly unrelated, looking back, I can clearly see a theme: I enjoy creating. Once something's been created, I'm not so good at maintaining it, but the creation of the new thing ( a new building, a new public space, a new string quartet, a new sermon) is deeply energizing to me. It slowly dawned on me, over the years, that the 'what' that was being created was less important to me, than the act of creating.

For others it's serving, or leading, or facilitating, or reconciling, or relating, or discovering that become the operative words. Finding that operative word, that thing which motivates and energizes, is terribly important. I'm not sure how it's found, other than to say that I was never told by my parents that I could "do anything". Instead I was taught, directly and indirectly, to follow a path that energized me, without giving much consideration to the possibilities of livelihood. Having received permission to pursue the energizing stuff, I gravitated naturally towards creating.

3. Finding contexts is more art than science. In my case, the movement from architecture to music, music to Bible teaching, came about as a result of what I can only describe as encounters with God. I wouldn't have chosen to be a Bible teacher or a pastor, wouldn't have known these things bring me joy, any more than I knew that I loved mushrooms until I tried them on a pizza once. Prior to that pizza, I'd presumed them to nothing more than disgustingly soft fungi. Who knew they'd be good? Who knew Bible study and teaching would be a joy? Someone asked me to teach a class once. After saying no a few times, I said yes. It's made all the difference. I'd better not presume that I know what context I'll like until I try it.

Along these lines, I'll note that we need to be open to contexts outside of our comfort zone, as Paul was when God gave him a Gentile context for ministry rather than a Jewish one. Am I open?

On the other hand, it's helpful to recognize that, like calling, some contexts can bring us deep gladness, and we should embrace that as a gift. I love the Pacific Northwest; the rain, the trees, the glaciers, the salmon, the mediocre sports teams, the great symphony, the coffee obsession, the casual lifestyle. It's as if I'm made for this place on the earth. Almost every morning, when I wake up, I thank God that I'm able to live in this place and do this thing that bring me joy.

In general, I wonder if all of us 't worry too much about context and not enough about calling? I wonder if we think that the key to fulfillment is finding the right context (ie: the right job in the right place) rather than seeking to understand our calling and, whatever the context, jumping into the deep end, absorbing ourselves in learning to do better whatever it is that we're created to do.

I hesitate to offer any of this because my own story is only my own story, and is certainly fraught with not only unique circumstances, but failures and shortcomings. Still, I hope that the principles related to context and calling are helpful to those in the quarter life crisis. I find them to be profoundly helpful right now, in midlife, as I think about my own future: context comes from calling.

Wednesday, August 05, 2009

1/4 Time Crisis?


Someone sent me an article in the mail recently. It came (gasp) in an envelope, which had a stamp attached and my name written on it. The article was photocopied, and with it was a note that said something like this...

"My daughter, in her twenties, sent this to me, and told me that this is pretty much exactly how she and her friends feel..." The article is, "welcome to your quarterlife crisis". I'm not sure how I feel about the article, because I'm not sure how I feel about the now popular notion that people in their mid-twenties are facing a crisis, as if twentyfive is the new fifty when it comes to emotional health, in the same way that our new discoveries of olive oil, meditation, and exercise, are supposed to have turned fifty into the new thirty when it comes to physical health.

The author spells out the crisis at several levels; it's a career crisis because these people don't yet have a firm sense of direction; it's a relationship crisis because these people are marrying later; it's a money crisis because these people are amassing debt due to school loans, lust for travel, and a general void that's filled by spending. Here are the author's anecdotal illustrations of the angst:

He bikes to work at an advertising agency, where he uses his master’s in English to proofread ad copy, and spends several hours reading music blogs and watching movie trailers, periodically Twittering updates about his workday to his 74 followers. He doesn’t really hate his job, but feels as if his skin is crawling with vermin most of the time that he’s there, so he has a plan to move to Thailand, or to maybe write a book. Or go to law school.

At her government job, she instant messages her friends and mostly ignores the report she’s drafting because she’s planning on quitting anyway — and has been planning to quit for about a year now. She spends her lunch hour buying boots that cost slightly more than her rent, then immediately regrets it.

The article goes on to talk about the multi-faceted nature of the crisis, concluding by offering support resources ranging from credit counseling, to social networking, to career counseling. I finished reading the article, and immediately wanted to share several musings for your feedback and reaction.

1. Does the fact that things have changed mean that this is a crisis? Maybe, but I'm not sure. OK, so people are marrying later now than they were when I was in college. When I was in college, my generation was marrying later than when our parents did. And the generation before that was even earlier. Debt? It's the same story. We carried more than our parents, and now our kids carry more than us. Part of me thinks this crisis is the product of baby-boomer's self-obsession. We're so self-referential that we think generations who don't do it like we did are somehow missing the mark. Narcissus would be proud of us, but I'm not sure this pathology even exists. Many, many of my friends in their twenties, though they've rejected the boomer's obsessions with upward mobility, and are often ambivalent about 'settling down', have a commitment to serving this broken world and making a difference that was decidely lacking in we, their parents. So perhaps we who are older need to lighten up and celebrate a new generation of adults who want to live meaningful, creative lives, and whose commitments to that make them marry a little later, change jobs a bit more often, and have a few more adventures. Personally, I admire and respect this new generation. Their energy, creativity, and authenticity inspire me.

2. On the other hand, it's possible that I'm idealizing this new generation and completely missing the mark. Maybe they are, in fact, self-absorbed, commitment phobic, and lacking any kind of ethical north star to ground them in commitments. It's even possible that both observations are true; there's greatness and new challenges.

3. If the artcile has any measure of accuracy, I'd want to offer the following bits of advice to this emerging generation:

A. I don't blame you for being a bit commitment shy, considering what we, your parents did to the notion of marriage. However, the truth remains that it's there are some elements of our souls that will only ripen in the context of profound commitments like buying a house (commitment to place), getting married (commitment to intimacy), and commitment to your faith community (commitment to Jesus' mission). Don't just DO any of these things because of social pressures, but don't run from any of these things either. There's a need, at some point, to jump in the water.

B. A rich storehouse of intimacy with Christ, and an ordering of life according the time honored practices of the faith, provide a rich center, out from which direction and guidance will come. Become a traveler of these ancient paths and you're more likely to be Gandalf at the end of your story than Gollum.

There's more that could be said, but I wrote primarily to hear from you, so please help me by responding:

1. Is this quarter life crisis real?
2. How does it show up?
3. What can we who are older offer?

Saturday, August 01, 2009

Julian's foot gives despair the boot...

Some weeks are harder than others and this past week, on the difficulty scale, was in the upper mid-range for me. The clash of theology and relationships; words misspoken, and misunderstood; friends, young and hospitalized; and enormous decisions in my work at a time when I feel tiny, not enormous. These all came together in one beautiful, overheated mess.

By the end of the week, I'm asking all kinds of theological questions, wondering if I've gotten right, or totally mucked it up, wondering if I'm on God's side or the side of fear, wondering why God couldn't have spelled a lot of His ideas out more clearly, rather than leaving us here to shoot at each other when we don't agree.

It was against this backdrop that I found myself at a party on Thursday night. Maybe you've been in that space where you know that you're supposed to be pleasant, know that it's a pleasant occassion and that you don't need to unload all your weariness and inner turmoil on these wonderful people, some of whom have flown cross country today to be here with old friends. You know that the last thing anyone needs is your baggage, your burden, your questions. It's a party, for God's sake. Lighten up. But I need answers, or at least an encouraging word, because if the truth could be told, I've mountains of doubt about what I believe and don't believe right now, and I'm supposed to be the answer man.

That's when I see my daughter, who's agreed to help serve at this party I'm attending. She smiles, gives me a hug, and walks away. That's when I notice something on her foot. What is that, a grease mark? She walked by again with a bowl of gaucamole or something, and I was able to see that it wasn't grease on her foot, but a brand new tatoo. She stopped and spoke with a friend, and I was able to read the text: "and all shall be well", which I immediately recognized as a quote from Julian of Norwich.

If I were to have a crush on a 14th century theologian, it would no doubt be Dame Julian, who offered expressions of hope and grace at a time when the Black Plague was fanning the flames of a theology of fear and judgement. She hoped for universal salvation, but though she didn't feel she could fully endorse that, she was able to claim with confidence that God would, in the end, make all things well. Here's the larger context of the now famous quote that "all's well, and all shall be well, and all manner of things shall be well":

Ah, good Lord, how could all things be well, because of the great

harm which has come through sin to your creatures?

This was God's response to her:

And so our good Lord answered

all the questions and doubts which I could raise,

saying most comfortingly:

I make all things well,

and I can make all things well,

and I shall make all things well,

and I will make all things well;

and you will see for yourself

that every kind of thing will be well.

...And in these words God wishes us

to be enclosed in rest and peace.

It's a good word, reminiscent of the mysterious optimisn of Paul found here. And it was the foot, with Julian's words on it, that kicked me back into hope. Yes, our present fog and ignorance is creating oceans of pain. Yes, we fail. Yes, we're motivated by fear, hurt, anger, way too much of time. Yes, injustices persist, and every step forward seems at time to be a step closer to a cliff. And yet, Julian and Paul are right. God is inexorably for us, and all of us are heading towards a time when the fog will clear, and Christ will reign, and beauty will transform, and disease will end, and... of course... all manner of things shall be well.

Oh Lord Christ...

For the reminder, a foot at a time, that the ship's headed somewhere beautiful, we give you thanks. In spite of our collective failings, our fears, our judgements, and capacity for breaking things, You remain at the helm. Let us see the end more clearly, that we might impart hope more fully, live more graciously, and be your hands and feet for hope.