“The marginalization of creation”

Fretheim in his introduction to God and World in the Old Testament begins with:

The importance of creation has often been underestimated by church and academcy. Indeed, we can speak of the “marginalization of creation” in biblical and theological student over the course of muich of the twentieth century (and before). [p. ix]

This indicates part of Fretheim’s purpose in this book, to articulate a creation theology that can serve as the foundation for understanding the rest of hte Old Testament (and, implicitly, a creation theology that is not rife with fundamentalist attitudes toward the Creation narratives, as there have been creation theologies provided, though more focused upon battles with science than actual theology). Salvation history has gotten the bulk of the attention and focus in theology. Later, Fretheim goes on to give a list of historical trajectories for the marginalization of creation theology, such as the focus on salvation history, the focus of the creation narratives with Canaanite mythology, etc, all of which I think are valid to some degree. However, I think there are causes that reach to the root of the situation that explain many of the reasons Fretheim gives for creations lack of respect in the church and academy.

There are few things that contribute heavily to the way we have concieved of theology at the cost of creational thinking. First is the structure of our Biblical canons as Christians. Words such as salvation, redemption has a much more central role in the New Testament texts than words that relate to creation. Given the normative nature of religious texts and of the New Testament for Christians, greater exposure to certain words naturally lead to greater emhpasis on the ideas and theologies related to those words. Furthermore, the association of Christ with redemption, with relative little direct associaton to creation, serves to only create a further disparity as “Jesus texts” will naturally play a great theological role for Christians. Creation, just by looking at the number of direct references, can be said to be on the margins of thought in the Bible, especially in the New Testament (though, by margins, I am refering to human cognitions, not the framework for Biblical theology “behind the text.”). So while creation may be the first thing in the Biblical canon, and by doing so provides a framework to understand what follows, creation thought works in the background. In other words, it might be essential for Biblical understand, but it is not easy to get from reading the Bible.

Furthermore, there is also a sociological trend that biases us away from aspects of creation and nature. In an agricultural world where many people directly work the land, ideas about the world itself plays a more central role in individual thought. But as there are fewer individuals needed to work the land and more needed to organize people and things, or to developed a general understanding of all the experiences in this world, we move away from more earthly and concrete thought, towards the more abstract and “heavenly.” Hence, Gnosticism rooted in the Hellenistic philosophical world, which was a major influence in cities and not rural, agricultural areas, disparged the natural world and moved towards the heavenly and abstract. In the present day world, having excised itself of pagan thought that was somewhat latent in Gnosticism (though perhaps less so than the polytheistic culture it resided in), still retains the same principle. Salvation for many Christians is abut getting into heaven, concieved of a spiritual paradise. Science focuses upon natural laws that are not experienced or seen. While I am not saying that abstract thinking is bad (if I did, I would be speaking against myself!), it does create a bias towards broad, unexperienced principles or ideas (notice the Platonic influence with the word “idea”) and away from tangible experiences that would be majorly agricultural to a society that has to focus more time upon that. Early civilization (including Isreal) was more agricultural, whereas later civilization became more urban. With Christianity becomingas a urban movement with Paul’s mission to the Gentiles, it itself would think in the same way, and thus affect language and reason. This is not to say that the New Testament is in error with its emphasis, only that it would speak less of tangible creation and Gods’ relation to it, and more of futuristic and spiritual salvation and redemption and God’s role in that.

Our bias is more systematic from the Scriptures we considered as normative and our own societal life. For a more agricultural society, they could perhaps more naturally see the creation aspects of Biblical theology and taken Genesis 1-2 as a framework for what follows in the narrative, whereas a more urbanized society will be more apt to pass over it. Thus us Biblical interpreters have to be more cognizant of this “bias” (though not to say this bias must lead to error) in the Biblical canon as a whole and our own life experiences, which we use to interpret the Bible.

Medical care: A right or privilege?

In the medical reform debate in the US, part of the rhetoric used in describing the differing sides based upon who should recieve health care classifies viewing health care as a right or as a privilege. Frequently this form of rhetoric is more “liberal” in usage as it the word privledge, because of its negative connotations, is associated with upper class, and thus is wrong. But to frame the discussion in such a way is a quick and easy heuristic to determine a basic approach to health care (all or not all), but it fundamentally misses differing rationales.

It is important to note that health care doesn’t work like most other sectors work. In most sectors, price will affect demand significantly. However, in medical care, price is not a major factor in demand when it comes to issues of death and extreme suffering, because most people value their life more than all their possessions. As such, there is little price people won’t pay in order to live and in order to avoid extreme suffering. This contrasts with the majority of goods where there is a negative correlation between price and demand.

Secondly, as demand increases for medical care, so does supply. Everytime you save the life of someone, there will be another time where they will risk death. Saving someone’s life leads to them having to run into the risk of losing their life down the road. Death is not escapable by any human means. So giving medical care only leads to more necessary medical care down the road.

In addition, the more health problems one has, the more likely they will have health problems in the future, so as medical care supply increases, there is also a near exponential increase in future demand.

The only major restriction of health care demand is population and the ages of that population. But population also affects the potential supply of medical care as it requires labor in providing medical care, and labor in obtaining knowledge to practice medical care, and labor to obtain more knowledge that can be taught to those who would provide medical care and create instruments to use in taking care of the ill. Since only a select portion can work in field of medical care, and yet everyone needs it (at the very least in any society, some labor has to be dedicated to provide food, clothing, and shelter), you can plausibly reach a point where demand exceeds supply. In more practical terms, the number of patients overwhelm health care providers to the point that they either can not serve some people or they have to ration their time and services and reduce the quality of care for every individual for every new person that needs medical help.

I use the word ration purposefully because that is an idea that has been used in the current medical reform discussions. Rationing of health care will become an eventual necessity in any society where there is a major reliance upon medical specialists. The demand exceeds supply.

So in reality, with the usage of the rhetoric of rights vs priviledge, what is in reality being talked about is a method of rationing health care. To say medical care is a right in reality is to say that medical care should be rationed equally among all the people. Privlege is in reality saying that equal rationing among all the people is not the preferential option. But the latter is not necessary an acceptance of the rationing system as it is, but merely a rejection of the form of rationing being espoused under the premise of medical care as a right. There are multiple ways to conceivably ration health care, not just two (government regulation vs. current market rationing).

A very general concept of rationing is based upon what is appropriate, both for the individual and the society as a whole. In other words, a combination of need and merit.

Here is a hypothertical circumstance to illustrate: There are two people who are sick. One person is one we might refer to as upper class. He made his money providing some service that people paid for and providing many benefits to his customers, and the customers as a whole felt the price was well worth what they got (in other words, this man didn’t exploit his customers). The other person would be classified as lower class and never worked a day in his life. The rich person also has a serious medical problem that requires more medical care to treat, wheras the poor person as an illness at the moment that is threatening to his life or quality of life, but other than that, he would be considered healthy.

If there was not enough medical care to be provided to both of those people, then rationing has to occur. Do you split health care amongst them equally? Then the poor person would survive, and the rich person wouldn’t. But then the service the rich person provided would be affected, and thus many other people would be affected because of his passing. You may have done something according to the principle of equality, but you have turned around and in fact hurt more people.

Now this example isn’t meant to be representative of all rich people and all poor people. There are many rich people who are good and who are bad, and there are many poor people who are good and who are bad. Nor is this meant to be determinative of a specific principled stance towards health care. However, it shows a potential dilemma of equality in health care. Equality sounds good, but it isn’t in all circumstances the best option for everyone (including those not recieving care).

Now one might try to create government regulations to take into consideration cases such as this. To a degree, they could create some leeway in the rationing system. However, because government regulation relies upon everyone acting according to similiar standards, the distinctions that are to be used to determine how to ration are restricted by the available vocabulary and the ease of understanding the  particular words chosen.

However, that is not easy to do. It would be near impossible to give articulate a principle that is by an large based upon equality, but yet consider that one exception, in one basic clause. Thus, it would require mutiple sentences to explain how to handle varying cases. But that is not the only situation where equality may not be beneficial. For other circumstances, it would require further exceptions be articulated. However, the more and more you add to a certain set of principles and codes, the harder it is to retain and remember all of them (just look at the IRS tax code!). So for those who implement policies that have been laid down, they would either be more prone to making mistakes or having to spend more time looking up regulations, and thus requiring more time and labor to actually implement the policies (the problem of beauracracy, in other words). As you try to take into consideration more and more exceptions to a general principle, knowledge costs rise dramatically.

So while in theory, government regulation could adapt their principles for medical care rationing to consider what is beneficial also for the entire population, including those not receiving medical care, in practice the costs become prohibitive for efficient implementation. Also, the less efficiency there is from beauracracy means there is less available resources available for actual medical care, thus reducing how much medical care can be rationed (or it requires use of tax funds either by pulling from so other programs which could hurt other segments of society, or increasing taxes which could hurt the economy).

Another option would be to give policy implementers allowance for exception based upon their judgment. However, people do not actually make decisions based upon actual future outcomes, but upon principles they have been taught that may or may not relate to future outcomes. For instance, a person may not recognize the rich person given in the example above will not be able provide those helpful services if he dies (after all, medical care does not need to know what you in order to treat you). Or, the person may feel that all rich people are evil and all poor people are innocent and make a decision that favors the poor person. Or, the person may not be concerned about society as a whole, but purely and only with the individuals. Etc. Etc.

So in consideration of whether health care should be a right or a privilege, the idea that it should be a right, while it might sound good, is not necessary the best route to go to benefit everyone. That is not to say that I personally think that the current way the market operates to dole out health care is the best way (at least best theoretical option) to do it. However, for all the injustice that is latent in the current system, it does allow for individual need and merit to a degree (as money can be said to correspond with the services provided to society, although there are other factors involved such as luck, greed, etc.). Without the ability to actually articulate a rationing system in such a way that is simple, considers all the possible different scenarios, provides health care to those who have nocapacity on their own to provide (whether due to infancy, being elderly, mental handicap, etc), is efficient, and does not allow for great potential to be used corruptly for personal power by a few individuals, the current system is preferable to a overhaul in my opinion. That is not to say the current system doesn’t need tweaks to improve health care, but there is no tweaking of the system that can provide everything that is being demanded of health care in my opinion. The human limitations of knowledge and time bear heavily upon us. To be ignorant of said human limitations while in the pursuit of justice can lead to some of the greatest forms of injustice.