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Issue Paper: Domestic Access to
Health Care
Caring for Health: Domestic Access to Health Care
RECOMMENDED by the Advisory Committee for
Corporate Social Responsibility, May 20, 2004
ENDORSED by the Division Church Society Board, October 22, 2004
APPROVED by Church Council, November 11, 2004
Background
“God creates human beings as whole persons—each one a dynamic
unity of body, mind, and spirit. Health concerns the proper
functioning and well-being of the whole person” (“Caring for
Health: Our Shared Endeavor” [ELCA 2003], page 3[1]).
“We of the Evangelical Lutheran Church (ELCA) in America have an
enduring commitment to work for and support health care for all
people as a shared endeavor” (page 2). The crisis in health care
today includes rising costs of health care, growing numbers of
people with inadequate health care resources, and the system in
distress. The church is called to be an active participant in
fashioning a just and effective health care system (page 1).
Health care coverage is dwindling, according to the National
Coalition on Health Care, a nonpartisan alliance of business,
labor, and the community. They report over 41 million people
without health care, or 14.6%, with no health insurance in 2001
as reported by the U.S. census bureau.[2]
With costs rising, coverage falling, and more costs being
shifted to employers, the numbers of uninsured are predicted to
reach 52 million by 2006. The hidden fallout they see from this
includes higher risks of developmental delays seen in children
and the impact of families spending upwards of 20% of their
income on health care. In addition, there is lost work
productivity and increasing costs for medical care for the
uninsured, on which the U.S. spent $98.9 billion in 2001.
Families USA reports[3]
that prescription drugs continue to disproportionately
contribute to increases in health care costs due to three
factors: more drugs being prescribed, new and higher-priced
drugs prescribed more frequently, and the cost of all drugs
rising. Specifically, the 50 prescriptions used most frequently
by the elderly rose 3.4 times the rate of inflation in 2002. At
the same time, the Center for Health System Change reports that
one in 12 Medicare beneficiaries reported they could not fill a
prescription in the last year due to its cost. This is
compounded in African American communities, which report the
number to be one in six unable to fill a prescription.[4]
The association of pharmaceutical researchers and
manufacturers, known as PhRMA, also realizes the need for
systemic change. They call for enactment by Congress of a
prescription drug benefit for seniors and the disabled that will
provide full access to innovative medicines that help patients
lead longer, healthier, and more productive lives.[5] The stress on the
overburdened health care system is compounded by
rising liability costs, hospitalization costs, state
fiscal pressures, and concerns about quality assurance.[6]
Other issues fall into this category, including smoking policy,
elimination of toxic chemical compounds in health care, the
development of safer alternatives for toxic compounds, and
overall health and safety policies.
ELCA Social Policy
The ELCA social statement “Caring for Health: Our Shared
Endeavor” (August 2003) develops this church’s vision of health,
illness, and healing. Part of that vision is for equitable
access to health care. An individual’s responsibility for caring
for his or her own health—such as eating well, avoiding tobacco
use, and avoiding alcohol consumption—is cited. In addition, the
church’s ministry in health care is highlighted at both a
congregational and social ministry organization level. A major
component of this social statement is the issue of access for
all. Justice requires health care to be provided on the basis of
need, giving particular attention to those who are
disenfranchised from the system (page 19). At the same time, the
statement says that a combination of individual, market, and
governmental approaches is necessary to begin to provide
equitable access (page 20).
Corporate Response
As the problems above indicate, all privately and
publicly held corporations face issues associated with wellness,
provision of health care, and access to pharmaceuticals. Every
corporation and family business faces decisions about health
insurance for their employees, the health care available to
their employees, and the costs to their employees for such care.
All have to make decisions related to their ability to be part
of the solution to the health crisis. The pharmaceutical
companies in this country have an additional challenge to face
in that they provide some of the basic materials needed for
health and wellness and must address how these goods can be
distributed equitably. In response, many pharmaceutical
companies have developed free access programs that work for some
individuals, but create a patchwork of response that does not
include access for all.
Shareholder Work History
For over 15 years, the community of faith-based shareholders
(mainly through the Interfaith Center on Corporate
Responsibility [ICCR]) has been working with companies on issues
related to health in the United States. In the last 10 years,
the ELCA was an active participant in the resolutions leading to
major changes in national smoking policies. Some of this work
has included smoke-free work places, including eating
establishments. In the late 1990s, much of the work at ICCR
began to focus on access to pharmaceuticals in the United
States. Since that time, dialogues have been conducted with a
variety of pharmaceutical companies about domestic and global
access to pharmaceuticals.
The ELCA has been a dialogue participant for the last three
years with resolutions at pharmaceutical companies about patent
extensions and HIV/AIDS drug accessibility. The ELCA Church
Council has approved resolutions relating to these issues.
Resolution Guidelines for ELCA
- We support resolutions asking for both the development of
ethical criteria for the extension of patents on prescription
drugs and reports on the implications of such criteria.
- We support a report on the company’s initiatives to
create, expand, and implement policies and programs to extend
pharmaceutical accessibility, taking into account the costs
and benefits.
- We support reports disclosing the extent and types of
payments, incentives, or rebates that are made to doctors,
pharmacy benefit managers, and other pharmaceutical purchasers
in order to influence the selection of a particular drug.
- We support policies that phase out the manufacture of PVC-
or phthalate-containing medical supplies where safe
alternatives are available.
- We support reports evaluating the feasibility of removing
dibutyl phthalates, parabens, and mercury from devices and
products.
- We support resolutions asking for warnings on products and
for marketing programs that discourage youth from using
tobacco products.
- We support companies having the same policies in
developing nations restricting marketing of tobacco products
as in the United States.
- We support proposals asking for smoke-free facilities and
expanded smoke-free boundaries around building entrances.
- We support reports to the board about the health risks of
products involved with tobacco sales.
- We support reports on the health impacts on teens that
result from exposure to the portrayal of smoking in (Disney,
Universal, Time Warner, Viacom) movies.
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