Medical Care is not healthcare

In his commentary "How S'prore can ride the coming healthcare revolution (Today 14^th May 2015). Dr. Jeremy Lim has rightly highlighted the problem of healthcare that is marketed  with a fee-for-service payment model.  We do indeed need a healthcare revolution if we want our citizens to enjoy good health to a ripe old age.

Dr. Lim had also pointed out that insurers are becoming more concerned about improving health and health promotion than about only sickness cure. Unfortunately, if the incomes of medical care providers are dependent on the sickness behavior of the patients, such providers will tend to pay lip service to health promotion. In fact, the training of doctors is directed towards diagnosing and treating diseases rather than health promotion.

We need to recognize that medical care does not lead to health - it is a misrepresentation to see our medical services as health care.  Our increasing need for medical care means that we are an unhealthy nation.  

True health does not lie in the hands of doctors. Indeed, the present Ministry of Health should be renamed the Ministry of Medical Services. 

The real Ministry of Health lies in the Ministry of the Environment and Water Resources, Health Promotion Board, the family service centres and all the other agencies involved in promoting ahealthy lifestyle.

The healthcare revolution must also change Singaporeans attitude towards suffering, death and dying. We must overcome our fear of suffering and death, which will come to each of us sooner or later, by learning to love ourselves and our fellow human beings. Perfect love casts out fear.

We must make hospice and palliative care the cornerstone of our medical education and imbue our healthcare providers with the spirit of hospice care enunciated by the founder, Dame Cicely Saunders:

“You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.”

Unless we learn how to die, we cannot truly live. When we live fully, we will not be afraid of death or suffering and will not seek to add years to our lives, but rather to add life to our years. 

In doing so,  we will bring down the cost of medical care and enjoy good health in our old age.

(Published in Voices, Today, 23 May 2015)

Behold The Lamb!

The Lunar New Year in 2015 is the year of the Goat or Sheep. Many traditional Chinese celebrate the year of the Goat rather than the Sheep. However, this Lunar New Year is a special one as Ash Wednesday falls on the eve of Chinese New Year. This means the year of the Goat or Sheep marks the beginning of the season of Lent. For the Christian, the year of the goat this year carries a special meaning when we are reminded in the season of Lent to “Behold the Lamb of God that takes away the sins of the world.” In fact, the Chinese character for “righteousness” is depicted by the word picture of a “lamb” over “me.”

Goat and sheep are used by Jesus in the description of the Last Judgment in the gospel of Matthew 25:31-46. We read that the people will be divided as a shepherd separates the sheep from the goats. The righteous ones are the sheep who have shown mercy to the poor, the sick and the oppressed. The unrighteous ones are the goats who have failed to show mercy to the poor, the sick, and the oppressed. The most striking point of the parable is that the sheep were not aware of the good deeds that they have done and the goats were not aware of their failure to do the good deeds.

The parable of the goat and sheep is to teach us that what is in our hearts is the most important thing. The goats represent those who are living only for themselves and who are trying to be the Greatest Of All Time (G.O.A.T). The sheep, on the other hand, are those who are living beyond themselves, seeking the good of others and the Kingdom of God. They are the people who Sees Heaven Everyday in Every Person (S.H.E.E.P.)

The feasting of the Lunar New Year may also appear to be in stark contradiction to the discipline of fasting in the season of Lent. But the prophet Isaiah warns us against the ritualistic practice of fasting as a way to please God. We read of God’s judgment against Israel in Isaiah 58:3-4:

“’We have fasted before you!’ they say Why aren’t you impressed? We have been very hard on ourselves, and you don’t even notice it!’ ‘I will tell you why! I respond. ‘It’s because you are fasting to please yourselves. Even while you fast, you keep oppressing your workers. What good is fasting when you keep on fighting and quarreling? This kind of fasting will never get you anywhere with me. “

True fasting that God wants is described in Isaiah 58:6-7. It is to overcome oppression and injustice and to care for the poor and needy. But these are not things that we have to do - they are the marks of those who are a new creation in Christ Jesus. The good news is that we have been set free from the bondage of sin and from living by the letter of the law. We are to live by the Spirit in the truth that Christ is in us. As we do so, our lives will bear the fruit of our loving God with all our hearts, our souls and minds and loving others as ourselves.

Jesus gave us the Last Supper so that we can turn our feasting into times of remembrance of His sacrificial death on the cross for us. The eyes of Cleopas and his friend were suddenly opened when Jesus broke bread with them in their walk to Emmaus (Luke 24:13-34). It has been said that sometimes the greatest miracle is just a perspective change. We are spiritually blind by the things of this world and by the desires of our flesh.

Let us change our perspective from looking at the world to beholding the Lamb of God, from living under the sun to living with the Son of God. In this special season of Lent in the Lunar New Year of the Sheep, let us pray that we may be healed of our spiritual blindness caused by the spiritual cataracts of   G.O.A.T. (Greatest Of All Time). May we be S.H.E.E.P – seeing heaven every day in every person by cultivating the discipline of waiting on God and paying attention to our Shepherd as we prepare our hearts to celebrate the wonder of Easter.

LIVING BEYOND OURSELVES

The most important legacy of Mr. Lee Kuan Yew, our first Prime Minister is his inspiration to live beyond ourselves. It has been said that “if we don’t find something greater than ourselves to serve, we end up serving ourselves.” But the more important challenge for me as a Christian is “what is the something that is beyond myself” that I am serving?

We can give our lives for many causes that is greater than ourselves but King Solomon in the book of Ecclesiastes remind us of the futility of giving our lives for any cause that is lesser than God. When we do so, we fall into idolatry and deprive ourselves of the true wisdom that comes from the fear of God. 

The fear of God is not to make us afraid of going to hell when we die but to draw us to the agape love of God so that we can live the life of zoe in the here and now. Without the fear of God we are condemned to live a life of fear, frustration and futility. We will live lives of quiet desperation in seeking pleasure and avoiding pain. 

In the face of suffering and loss without God, we will echo the cry of King Solomon in Ecclesiastes – “everything is meaningless, completely meaningless” for we are only chasing after the wind. And in Ecclesiastes 7:1-4, we read:

“A good reputation is more valuable than costly perfume. And the day you die is better than the day you are born. Better to spend your time at funerals than at parties. After all, everyone dies – so the living should take this to heart. Sorrow is better than laughter, for sadness has a refining influence on us. A wise person thinks a lot about death, while a fool thinks only about having a good time.”

Standing in the rain with the crowd for the funeral procession of LKY on Palm Sunday, I was moved to see the tears of some in the crowd and by the cries of many chanting, “Lee Kuan Yew” as his cortege drove by. I was reminded of the cries of “Hosanna to the Son of David!” on Palm Sunday more than two thousand years ago when Jesus rode into Jerusalem on a donkey as well as the tears of the grief stricken women when Jesus was being led to his crucifixion on Good Friday.

In this season of Lent, I am challenged by the following insight of Rob Bell in his book, “Jesus wants to save Christians”:

“Our destiny, our future, and our joy are in the Eucharist, using whatever blessing we’ve received, whatever resources, talents, skills, and passions God has given us, to make the world a better place. Disconnection from the suffering of the world, isolation from the cry of the oppressed, indifference to the poverty around us will always lead to despair. We were made for so much more………. The Eucharist is about people with power empowering the powerless to make a better life for themselves.”

The bad news is that when we live only for ourselves, our families, a political party, a social cause, a church or anything other than God, we are only chasing after the wind. In times of loss, pain and sorrow we will face despair and meaninglessness no matter how rich or poor we are, how wise or foolish we are.  It will be “vanities of vanities, all is vanity.”

The good news is that Jesus Christ died and rose from the dead to give us the resurrection power so that we can live the abundant life – even in poverty, sickness and in the face of death. As the children of the God of love we are to infect the world with our joy of salvation. 

In Christ, we are empowered to rejoice in all circumstances – to be glad, happy and thankful. We are not called to live lives of quiet resignation to fate but to live by the power of the Holy Spirit with joyful acceptance and anticipation. For we are called to be witnesses that the Kingdom of God is in the here and now as we live in this world of darkness, suffering and pain. Let us die to ourselves so that we may truly live for God in Christ.

SHEEP OR GOAT

The Lunar New Year in 2015 is the year of the Goat or Sheep. Many traditional Chinese celebrate the year of the Goat rather than the Sheep. However, this Lunar New Year is a special one as Ash Wednesday falls on the eve of Chinese New Year. This means the year of the Goat or Sheep marks the beginning of the season of Lent. For the Christian, the year of the goat this year carries a special meaning when we are reminded in the season of Lent to “Behold the Lamb of God that takes away the sins of the world.” In fact, the Chinese character for “righteousness” is depicted by the word picture of a “lamb” over “me.”

Goat and sheep are used by Jesus in the description of the Last Judgment in the gospel of Matthew 25:31-46. We read that the people will be divided as a shepherd separates the sheep from the goats. The righteous ones are the sheep who have shown mercy to the poor, the sick and the oppressed. The unrighteous ones are the goats who have failed to show mercy to the poor, the sick, and the oppressed. The most striking point of the parable is that the sheep were not aware of the good deeds that they have done and the goats were not aware of their failure to do the good deeds.

The parable of the goat and sheep is to teach us that what is in our hearts is the most important thing. The goats represent those who are living only for themselves and who are trying to be the Greatest Of All Time (G.O.A.T). The sheep, on the other hand, are those who are living beyond themselves, seeking the good of others and the Kingdom of God. They are the people who Sees Heaven Everyday in Every Person (S.H.E.E.P.)

The feasting of the Lunar New Year may also appear to be in stark contradiction to the discipline of fasting in the season of Lent. But the prophet Isaiah warns us against the ritualistic practice of fasting as a way to please God. We read of God’s judgment against Israel in Isaiah 58:3-4:

“’We have fasted before you!’ they say. Why aren’t you impressed? We have been very hard on ourselves, and you don’t even notice it!’ ‘I will tell you why! I respond. ‘It’s because you are fasting to please yourselves. Even while you fast, you keep oppressing your workers. What good is fasting when you keep on fighting and quarreling? This kind of fasting will never get you anywhere with me. “

True fasting that God wants is described in Isaiah 58:6-7. It is to overcome oppression and injustice and to care for the poor and needy. But these are not things that we have to do - they are the marks of those who are a new creation in Christ Jesus. The good news is that we have been set free from the bondage of sin and from living by the letter of the law. We are to live by the Spirit in the truth that Christ is in us. As we do so, our lives will bear the fruit of our loving God with all our hearts, our souls and minds and loving others as ourselves.

Jesus gave us the Last Supper so that we can turn our feasting into times of remembrance of His sacrificial death on the cross for us. The eyes of Cleopas and his friend were suddenly opened when Jesus broke bread with them in their walk to Emmaus (Luke 24:13-34). It has been said that sometimes the greatest miracle is just a perspective change. We are spiritually blind by the things of this world and by the desires of our flesh.

Let us change our perspective from looking at the world to beholding the Lamb of God, from living under the sun to living with the Son of God. In this special season of Lent in the Lunar New Year of the Sheep, let us pray that we may be healed of our spiritual blindness caused by the spiritual cataracts of   G.O.A.T. (Greatest Of All Time). May we be S.H.E.E.P – seeing heaven every day in every person by cultivating the discipline of waiting on God and paying attention to our Shepherd as we prepare our hearts to celebrate the wonder of Easter.

How To Improve Our Qualtiy of lLife

Letter to the Forum Page of Straits Times on 17th Feb 2015

LAST Saturday’s articles (“Dying shouldn’t be so brutal” and “Rise of the frugal economy”) draw attention to two important issues that we need to address – the reality of death and money, for they affect our approach to health care.

Firstly, we need to come to terms with our mortality. It has been said that it is better to die a meaningful death than to live a meaningless life. Facing death will help us to make better and more informed decisions about medical care and avoid futile treatments that may add years to our lives but diminishe the quality of our remaining life. 

As the writer Ira Byock rightly pointed out, there is a lot we can do to make the process of dying safer as the end of life approaches, whether death is welcomed or feared. We can also improve the quality of life, as well as extending survival and saving money.

Secondly, we need to change our attitude towards money. In the second article’s writers Navi Radjou and Jaideep Prabhu have drawn attention to a very important truth – a self-organising frugal economy could generate millions of dollars in value and create millions of jobs. 

As they pointed out, the Internet, mobile technologies and social media have eliminated the intangible costs associated with search, bargaining, decision-making, and enforcement in many sectors. We also need to recognise the very important difference between a welfare state and a cooperative society. 

In a welfare state, taxes are collected from the rich to help the poor. In a cooperative society, rich and poor pool their financial resources for the common good. When everyone gives their “small change” to make a big change in our nation, there will be more than enough to provide basic, essential and universal medical care, as well as to reduce the cost of education, transport and other essential services.

We need to encourage our citizens to pay their taxes as an expression of gratitude for the opportunities for them to earn their living. Taxes should not be seen as a burden, but as a responsibility for those of us who are doing well to ensure that their fellow citizens are well taken care of. 

We urgently need to transform our selfish and competitive society into a cooperative and compassionate nation.