On September 24, a Thursday -- the day after our 2009 Charge Conference -- St. Peter's United Methodist Church hosted an Open Forum on Health Care.

Held in the sanctuary, the forum began with the question, "How can health care in the United States be improved?" It continued with responses from Dr. Jennifer Bell (M.D.), Mr. William B. Burns (BB&T Insurance), Mr. Philip Clarke (Attorney at Law, Clarke & Hewlett), Mr. Gregory H. Harrison (Carteret County Conference of the NAACP), Mr. Ken Humphrey (Carteret County Democratic Party), Dr. Larry Lawrence (M.D., Carteret General Hospital), and Mr. Walter D. Phillips (The Carteret County News-Times). After the responses, people in the audience were invited -- by Rev. Ben Ball, the evening's moderator -- to offer comments and/or ask questions related to the topic under discussion. The following Sunday's edition of The Carteret County News-Times carried a front-page, above-the-fold, report on the forum by Lori Wynn. Though the Open Forum certainly did not settle the issues, political and otherwise, related to health-care reform in America, it did offer a time and place for civil discourse on a most contentious issue.

Mr. Bert Herring and Dr. Ron Montaperto were the ones who suggested that this forum take place. Their suggestion stemmed from Rev. Richard John Neuhaus' description of the "open church," which reads: "Within our several churches disagreement about the meaning of social justice should not merely be tolerated; it should be cherished... An open church engages sympathetically the diversity of Christian views both within and outside denominational structures. An open church welcomes dissent for the strengthening of truth and the correction of error. An open church makes decisions in the light of day, not in the shadowed corners of bureaucratic power. An open church has leaders who are not afraid but eager to engage in the fullest consultation with all its members. An open church addresses social issues not so much to advance a particular position as to inform and empower people to make their own decisions responsibly. An open church understands that the church speaks most effectively when the people who are the church do the speaking, and leaders speak most believably when they speak with the informed consent of those whom they would lead. Sometimes leaders can and should disagree with the views of the majority. To disagree, however, is not to disregard the views of others. Leadership in an open church is marked by candor and never by contempt for the convictions of those with whom we differ. In these ways, an open church becomes a zone of truth-telling in a world of mendacity [falsehoods and lies]." ("Christianity and Democracy," Institute on Religion and Democracy booklet, pp. 2-3, emphasis added)

During the keynote address, the following assumptions -- written and edited by Herring, Montaperto, and Stallsworth -- were presented. Perhaps they can help us in thinking through the current health care debate and its associated politics.

Medical Assumptions:

(1) The provision of health care involves knowledge of the medical arts as much as knowledge of the medical sciences. Nurses, doctors, surgeons, and other practitioners are required to sacrifice years of their lives to study and practice medicine. Only when such sacrifices are made can such people properly prepare to provide the highest quality health care to others.

(2) Health care in America -- especially its medical knowledge, innovation, and technology -- is generally excellent, but far from perfect. That is confirmed by the flow of patients, from around the world, toward (not away from) American medicine.

(3) Health care, at its best, should "Do no harm" (Hippocratic Oath) to patients -- especially to those who cannot speak for or defend themselves.

(4) Decreasing the likelihood that health-care providers will face malpractice lawsuits, involving large costs, will enhance the quality of health care. Unfortunately, such lawsuits cause wary providers to practice defensive medicine.

Political Assumptions:

(1) Legislative reform of health care in America is a very large and complex task. While most generally agree that some kind of health-care reform is needed, exactly what kind of reform is needed is a matter about which reasonable citizens can and should reasonably disagree. Indeed, civility in the discussion of this issue will help lead to optimal legislative outcomes; likewise, incivility will help lead to less than optimal outcomes.

(2) Health care is not a constitutional right. On this, consult the United States Constitution. Even so, health care is a societal or moral good.

(3) Health-care legislative reform should aim at a system of checks and balances. That is, the goal of reform should be a balance of power between the health-care sector, the health-care insurance industry, the government, the legal profession, and the American people, in which the patient is best and most efficiently served. Allowing any one of these centers of power to gain too much power throws the entire health-care system into imbalance; in that case, the patient's care and the common good are not advanced.

(4) Health-care legislative reforms are best achieved when they advance the common good, are well considered by all concerned (politicians and the public), are relatively simple to understand, and are consistent with American political tradition and practice.

Economic Assumptions:

(1) The goal of health-care reform is to make health care, without sacrificing quality, accessible to more people (especially the working poor) and built upon a sustainable fiscal foundation.

(2) Individuals and families must be involved in sustaining all aspects of their health and health care, including the financial dimension.

(3) Market mechanisms are consistent with American tradition and practice, but some forms of government regulation -- clearly articulated and decided by democratic processes -- are probably necessary to advance the common good.

(4) Competition among health-care providers (including drug companies) and among health-care insurance companies is desirable and should be increased.

The Church is a zone of truth-telling in a world of mendacity. It is a privilege. And a challenge.