Archive for the 'medical' Category

Saturday, November 23rd, 2013

Village Missions and the Affordable Care Act or ObamaCare

Background:  When I became Executive Director in November 2000, Village Missions had a self-funded health insurance plan, in other words, we were our own insurance carrier.  We collected premiums from the churches we served and used a T.P.A. (Third Party Administrator) to administrate medical bills.  We carried stop-loss insurance to cover major medical expenses.  Over the years, various consultants advised us on the best structuring of our plan.  One particular challenge was finding P.P.O.’s (Preferred Provider Organizations) for missionaries serving in diverse and often extremely rural locations.

At the time I became Director, the premium charged was insufficient to meet the medical costs.  I worked with the Village Missions Employee Benefit Board to eliminate the deficit through a premium increase.  Although some churches ended their relationship with Village Missions because of this increase, the plan was balanced and the deficit eventually erased.

For a period of three years prior to 2012, we were able to maintain our premium at $950 a month, in spite of double-digit health care cost increases.  Unfortunately, one of the ways we lowered costs was by raising our stop-loss level to $160,000.  Although this lowered premiums, when six of our missionaries became seriously ill, the plan began to go into serious deficit in 2011.  The Board voted to increase the premium to $1,025 per month in January 2012, but this amount was too little, too late. By July 2012 our plan had experienced a $750,000 deficit.  The Benefit Board made the decision to switch to Regence Blue Cross, a group plan, in August 2012.  This required a premium increase to $1,216 per month for a couple or family.

We learned two things from our experience that are relevant for the national health care debate.  First, the margin of profit for health insurance companies is small.  Our self-funded plan ended with a significant loss.  Second, only a small group of seriously ill people in a plan accounts for most of the cost.  Some within this group may have chronic, long-term conditions.  Others may have serious health issues that are temporary, such as treatable cancer.  But together, they are the significant cost drivers in any plan.

So, with that background in mind, this is the announcement and explanation I recently sent to our missionaries and churches.

Re: No Increase in Village Missions Benefit Plan Premium in 2014

I am happy to report that no increase in the premium for health insurance, disability, and life insurance (the Village Missions Employee Benefit Plan), will occur in 2014.  I am thanking the Lord for this unexpected development.

 If you don’t want to read all the details which follow below, here are the summaries:

  • Several aspects of the ACA (Affordable Care Act/ObamaCare) put upward pressure on our premium.
  • In negotiations, Regence Blue Cross went from a 9.3% increase in premium for 2014 to no increase.
  • Changes in our plan will not have a significant impact on most missionaries.
  • At this point, Village Missions is required to provide health insurance under the ACA.
  • Other options continue to be explored, but for now, the Village Missions Employee Benefit Board believes we should stay with Regence Blue Cross as our health insurance provider.

Upward Pressure on Plan  As you know, ObamaCare or the Affordable Care Act (ACA) has been much in the news.  One underreported aspect of the ACA is the fees charged employer provided insurance plans to help pay for the exchanges.  We are being charged the “carrier tax” (2.3% of previous year premium) and the “reinsurance fee” (1.6% of previous year premium) in 2014 as well as a 3.47% fee to help pay for the Oregon Health Exchange.[1]  We are being charged this fee because we are headquartered in Oregon.  Recently, the Obama administration indicated that they would exempt unions from the reinsurance fee but other employers such as Village Missions are required to pay it.[2]  In addition, mandated changes in coverage under ACA put upward pressure on our plan as well as the estimated 6% increase in medical costs.

Negotiations Eliminate Increase    Initially, Regence Blue Cross (our health insurance provider) wanted to increase our premium by 9.3%, an increase of $112 per month.  Our Benefit Board told our consultants that this increase was unacceptable.  Our consultants were able to find some cost savings in their proposal and some relatively minor changes in coverage resulted in a small decrease in the premium.  The changes in coverage actually brought us more in line with the ACA, avoiding the future Excise Tax (40%) in 2018 for having a so-called “Cadillac” plan. [3]  This Excise Tax for “Cadillac” plans is another little known aspect of the ACA that affects employer provided plans.

Changes in the Plan  Changes in the new plan are relatively minor.  The deductible increases from $750 per person and $1500 per family to $1,000 per person and $2500 per family.  Yet, now office visits as well as prescription costs will count towards the deductible (they didn’t before) and the co-pays for physicians and specialists are the same at $25 per visit.  Maximum out of pocket expenses have been raised from $1500 to $2,500 individual and $3,000 Family to $7,500 to comply with ACA.  Of the 709 Village Missionaries and dependents in our plan, 87% did not even reach the $750 deductible in 2013.  The Helping Fund will be available for the seriously ill Village Missionaries most affected by the changes in our plan.

Village Missions Required to Provide Coverage  Village Missions as an employer with over fifty employees is currently required under the ACA to provide health insurance or otherwise face the “Sledge Hammer Penalty.”  This is an annual tax of $2,000 for each full-time employee, disregarding the first 30 full-time employees.[4]  Village Missions, however, is different from a regular employer in that our Village Missionaries have, in effect, a dual-status employment between the local church and us.  The United Methodist Church is similar in that their local districts provide health insurance, which is paid for by each church in the district.  Interestingly, the United Methodist Church, a big advocate for the ACA, has now petitioned the IRS (yes, the IRS) to be exempted from the requirement to provide insurance. [5]  [6]  They believe that each local pastor could obtain cheaper insurance through the exchanges.  Of course, the appeal came before the exchange disaster that is now occurring. At this time, our consultants believe Village Missions is required to provide coverage, pending the outcome of this appeal.

Other Options Considered  The Benefit Board considered other options such as going back to a self-funded plan or obtaining coverage through a Christian sharing plan.  Three factors caused the Benefit Board to stay with Regence Blue Cross at this time.  First, Blue Cross could cover almost all of our Village Missionaries in their various and often remote locations.  The care received by missionaries has been excellent and we have received virtually no complaints in the office.  This is especially important considering the turmoil currently existing in health care caused by the ACA.  Second, when we switched to Regence Blue Cross we received a one-month premium holiday of $213,935.  As part of our agreement, we would have to refund this premium if we leave Regence Blue Cross before 2015.  Third, we have some missionaries that are severely ill with chronic conditions.  Stop loss policies under a different carrier would start over again.  We are not sure how Christian sharing plans would treat such individuals, as most Christian sharing plans do not cover pre-existing conditions.  Interestingly, somehow Christian sharing plans were exempted from the requirements of the ACA such as covering pre-existing conditions.

Summary  The Village Missions Employee Benefit Board will continue to monitor the rapidly changing health care environment.  They are committed to providing good health care for our missionaries at a cost that our churches can afford.  The increases in insurance in recent years have affected Village Missionaries, the churches we serve, and Village Missions.  Yet we have seen God provide and the fact that we don’t have to increase our premium this year is a wonderful answer to prayer.  Please keep praying!


[1] http://www.thelundreport.org/resource/oregon%E2%80%99s_health_insurance_exchange_leads_the_nation

[2] http://thehill.com/blogs/healthwatch/health-reform-implementation/189413-labor-unions-may-get-tax-wish-on-obamacare

[3] http://www.uhc.com/united_for_reform_resource_center/health_reform_provisions/excise_tax_on_high_cost_coverage.htm

[4] http://hrhorizons.nacubo.org/newsletter/past-issues/volume-8-issue-1/countdown-to-health-care-reform.html

[5] http://www.umc.org/site/apps/nlnet/content3.aspx?c=lwL4KnN1LtH&b=5259669&ct=13195933

[6] http://church-alliance.org/sites/default/files/images/u2/Church_Alliance__Comment_Letter_on_Employer_Shared_Responsibility_NPRM_AQH.pdf


Thursday, June 21st, 2012

Village Missions Changes Health Care Coverage

Summary: Village Missions has chosen to suspend its self-funded health plan and purchase a fully-insured group plan from Regence BlueCross.

History of Self-Funded Plan Nearly two decades ago, because of rising health insurance costs, Village Missions decided to develop a self-funded health plan.  This plan succeeded in providing adequate coverage for our missionaries serving in a number of diverse and sometimes remote locations.  In spite of rising health care costs averaging 15% a year, we were able to limit increases and keep costs to the churches under control.  From 2009 – 2011 we were able to hold our premium at the same level and still end each fiscal year with a balanced budget. 

Included within our plan were not only health coverage but also disability insurance and a life insurance policy.  In addition, we employed the services of a case management company, Medical Rehabilitation Consultants, that did a wonderful job in assuring that our missionaries with serious health issues received the best care.

Explanation of Rising Costs In an effort to contain cost over the years, we have allowed our stop-loss claims level to rise.  This is the amount at which Village Missions can recover claims cost from a reinsurance policy. In the early years, this amount was set as low as $60,000 per individual.  In order to save premium dollars, it has risen to the current level of $160,000 per individual.  This stop-loss level is sufficient if the plan has only two or three large claims per year.  This year we have had an exceptional number of large claims. In addition, we have had a number of large claims that do not approach the stop–loss level, yet still have had a costly impact.  Six cases accounted for 45% of our medical bills.  Nineteen claims amounted to $907,899 or 83% of our medical bills.  In spite of a premium increase of $75 starting last January, our plan was in a $724,547 deficit at the end of May.  General Fund reserves were used to cover these overages.  Our self-funded plan became unsustainable.

Exploration of Options I instructed our C.F.O., Jim Cross, to begin to explore other options.  A possibility was one of the Christian medical sharing ministries.  We investigated the three major groups but only one, Christian Healthcare Ministries, was willing to cover pre-existing conditions.  Yet even with the large hurdle of pre-existing conditions overcome, this option would represent a significant change in how missionaries access health care.

Missionaries would be considered “self-pay” patients, needing to negotiate up-front with providers, pay for services out-of-pocket, and wait for reimbursement.  There would be no wellness care, no coverage for doctor’s visits or lab work, and no prescription coverage.  Even though the financial structure of this option would include the use of health savings accounts, there is a real concern that missionaries would delay care, not see the doctor when needed and not fill prescriptions, thus causing more serious health problems and greater expense later on.

We could have possibly overcome these obstacles but, ultimately, it would represent a significant transfer of cost and work to Village Missionaries.  We want missionaries to be able to access health care easily when they need it, without concern about cost, or trying to manage a deluge of bills when they are sick.  We want them to be focused on “Preaching the Word and loving the people.”

The second option, chosen unanimously by the Benefit Board, was to purchase a group plan from Regence BlueCross.  Their bid, although higher than our current premium, was much lower than the premium we would have to charge churches to balance our plan.  The cost will be $430 for a single (some spouses are on Medicare) and $1220 for a couple or family.  The coverage will be virtually unchanged from what we have now and the change should be quite easy.  We have an effective start date of August 1.  Regence BlueCross has guaranteed this premium for 17 months.

Recognition of Hardship We recognize that this change will present financial hardship to both the churches we serve and to Village Missions.  For Village Missions we estimate that it will require an additional $18,000 a month as we cover the additional costs for our poorer churches and administrative staff.  In addition, it will slow the progress a church makes toward becoming self-supporting, because so much is required to provide health coverage.  It is disturbing that health care has become such a large part of our budget and the budget of churches we serve.  Of course, we are not alone in experiencing this problem.

Village Missions will also face a few difficult months, as claims that have already been incurred under our self-funded plan will need to be covered.  We estimate that $500,000 in bills or more will be out there when the plan ends on July 31.  As we have with the deficit, we will use our reserves to cover these expenses.

Objections Some have asked, “Why not just pray for healing?”  We have prayed for healing and continue to trust God that He will heal.  We are optimistic for many of our seriously ill Village Missionaries.  However, we also believe that God uses the health care we have in this country and that He would have us pay our bills.

Some have advocated letting our missionaries be on their own in finding and paying for their health insurance.  One mission leader told me that he was glad that his mission had made the decision years ago to “get out of providing health insurance.”  Yet I believe that God has used Village Missions precisely because we do care for and support our missionaries.  The salary support and health coverage we provide has enabled our missionaries to go throughout this country to rural communities and dedicate themselves to reaching people for Christ.  We couldn’t do this without the support of our larger churches (once not self-supporting) as well as the many people who sacrificially give to support the work of reaching rural America for Christ.  God has used this approach to win untold numbers of people to Christ, send out a huge number of Christian workers and pastors, and strengthen the thousand or more churches served by Village Missions since 1948.

Conclusion I believe that God has opened this door to enable Village Missions to continue developing spiritually vital churches in rural North America.


Monday, December 10th, 2007

Home from the Hospital

It is hard to believe that a week ago I was having prostate cancer surgery.  Time flies when you are having fun!  The surgery went well but I did have some problems with my catheter which involved an extra day in the hospital.  I came home Thursday.

Today, Dec. 10, I just got back from having my staples removed.  The pathology report indicated only a small area of cancer with the same Gleason score of 6 that I had at my biposy.  No cancer was observed in the outside area of the prostate.  My PSA level should begin dropping and remain very low if indeed the cancer has been completely removed.

I praise the Lord for these good results and am very grateful for so many who prayed.


Friday, December 7th, 2007

Christmas and Cancer

I wrote this post on December 2, before my surgery on Dec. 3.  Didn’t post it until after the surgery. 

The words “Christmas” and “cancer” don’t seem to go together.  The word “Christmas” generates mental images of family gatherings, Christmas trees, quaint snow-covered villages and churches, Sunday School pageants, wreaths, and, of course, presents.  Cancer generates images of hospitals, doctors, bald heads, and perhaps even death.  Cancer should not even be mentioned in the same sentence as Christmas!

Yet for me, with my prostate cancer surgery tomorrow at the start of the Christmas season, my thoughts naturally connect the two.  And I wouldn’t have it any other way!

At Christmas, we should be thinking most of all about why Jesus came.  The reasons for His coming directly relate to cancer, to suffering, to all that is most difficult about our lives.  I could refer to many passages of Scripture but the passage that means the most to me now, one day before surgery, is Hebrews 2:14-18.

He came to help me and all who share in flesh and blood.  And what a help it was!  Through His death He rendered Satan ineffective, for He conquered death.  If I die from surgery or from cancer, I go to be with Him.  He came to become a merciful and faithful high priest.  He satisfied the wrath of God for my sins, so I will enter the hospital room basking in the undeserved favor and grace of God.  He came so that He would experience all the temptations involved with suffering so that He could provide the best of help to me.  What great reminders Christmas brings!

During this season we will hear of the depression that occurs during holiday seasons.  Although actually it is a myth that more suicides occur around Christmas, still many feel stress, loneliness, and despair during the holidays.  How I wish they could understand the relationship between Christmas and cancer.  How I wish they could have the joy that underlies all the Christmas celebrations-the joy I have as I anticipate surgery during the Christmas season.


Tuesday, November 6th, 2007

On Having Cancer– Strength through Weakness

 As word of my cancer has spread, many people have come up to me and expressed their loving concern.  Several have told me that they are praying for me and asked me how I was doing and how I was feeling.  This has been especially true at Stonecroft Ministries where the staff takes very seriously the ministry of prayer.  I am extremely thankful for your concern and the tremendous missionary family I have the privilege of serving.

                                      

Physically, I am feeling better than I have felt in a long time because I have lost some weight.  My prostate cancer was not diagnosed because of the presence of symptoms.  Instead, my annual blood work indicated an increasing P.S.A. level that led to a biopsy.  Actually, it is very serious if you have symptoms with prostate cancer, as symptoms are an indication that it hasn’t been detected early enough.  Men, please have your annual blood work done!

As I write this, it is exactly one month until my surgery on Dec. 3.  I am doing well emotionally and spiritually now but it is conceivable that as surgery draws near I won’t be doing as well.  I can imagine that the closer the day is, the higher my anxiety will be.  Could it be that the day of the surgery, as I pull into a parking space at the hospital, my hands will freeze fast to the steering wheel?  Will they drag me kicking and screaming into surgery with me only becoming calm when they give me the “La-La” juice?

The possibility of my becoming a basket case brings me to another way that God is strengthening me.  God has strengthened me through the knowledge that no matter how weak I become God will not forsake me.  His staying with me through any trial has nothing to do with my strength but everything to do with His strength and the completeness of what He has done for me in Christ.  Are not the fantastic (virtually unbelievable, but completely believable because they are from God) promises of Romans 8:31-39 perfectly appropriate for minor trials such as mine as well as the severest trial?

I can be weak, fearful, full of anxiety about the surgery or its outcome without ever worrying that my weakness will separate me from God.  He has promised me it will not!

Of course, it would not be good public relations for the Executive Director of Village Missions to be screaming as he enters the hospital!  Neither is it good for a Village Missionary to scream in panic when encountering a trial!  Unfortunately, many of us maintain the appearance of strength on the outside while inwardly we are screaming.  After all, we have to maintain the image of the pastor or the director who is in control!  That is nothing but hypocrisy and such false spirituality does no one any good.  Yet total weakness in the face of adversity would undercut everything we have ever preached about the sufficiency of Christ!  It would certainly undercut everything I have written in this blog thus far about my cancer.

What is the answer?  In my weakness, knowing that God has not forsaken me, I must cling to God’s strength.  It is good to come to the end of our resources and it is even necessary to come to the end of our resources so that we turn to the strength of God.  We must turn to God in the midst of our anxiety and panic.

Paul identifies and illustrates what we must do in 2 Corinthians 12:7-10.  He came to God in his weakness caused by the “thorn in the flesh.”  God kept reminding Paul of the sufficiency of His grace.  He informed Paul of a spiritual growth process in which power was “perfected in weakness.”  I think the process was a weaning away in Paul his reliance on his own strength in favor of a developing reliance on God’s strength.  He came to the place where he even relished weakness because of the opportunity for the display of God’s power in him.

I have entered the school of weakness.  It has a curriculum that can be learned in no other way.  I am strengthened in this trial by knowing of an unending love that does its greatest work of grace in the times I am the weakest.  How am I doing?  I am actually doing better by having this opportunity for the display of God’s power than I was doing before I had cancer.

May we embrace every trial we encounter as part of the rich and thoughtful design of God to display His power in our life!


Wednesday, October 10th, 2007

On Having Cancer- Part 2

David learned that his home base had been burned and all the inhabitants taken captive (1 Samuel 30:1-6).  Further, when he realized his men were questioning his leadership and discussing stoning him, Scripture says that David “strengthened himself in the Lord his God.”  It is something we should learn to do whenever we experience difficult circumstances.  Strengthening occurs when we bring the truth of Scripture to bear on the difficult circumstance we are encountering.

My prostate cancer has been an opportunity to strengthen myself in Christ.  In my last article, I mentioned the foremost reality that was strengthening me—the grace and mercy of God that far overwhelms whatever negative circumstance I might encounter.  The second reality that strengthens me in this trial is the reality that God’s purpose for me in this life is to make me more like Christ.

Some passages that reveal this are:

Rom 8:29: For whom He foreknew, He also predestined to become conformed to the image of His Son, that He might be the first-born among many brethren; Eph 4:13: until we all attain to the unity of the faith, and of the knowledge of the Son of God, to a mature man, to the measure of the stature which belongs to the fullness of Christ.  Col 1:28 And we proclaim Him, admonishing every man and teaching every man with all wisdom, that we may present every man complete in Christ.  NASB 

God’s purpose for me is not to make me prosperous or happy.  He does not intend that I lead a trouble free existence.  He does not promise that every thing that happens to me will seem fair.  He may give me long life or He may not.  He doesn’t even promise that my particular surgery will be successful and without complications.

Instead, He promises that He is interested in making me more like His Son.  Suffering is the chisel that God expertly wields to chip away parts of my life that are not like Christ.

How does suffering make us more like Christ?  Suffering causes us to examine whether we are aligned with His great purpose in making us like Christ.  Am I rebelling at this particular turn of events?  Am I angry with God?  Do I wonder, “Why me?”  If so then I am out of alignment with the intent of all that happens in my life.

Suffering also moves us toward deeper fellowship with Christ.  Scripture tells us that suffering better qualified Jesus to come to our aid (Hebrews 2:18).  We are encouraged to draw near to Jesus in part because His suffering has qualified him to “sympathize with our weaknesses” (Hebrews 4:15).  When we are tempted to give up because of the difficulty facing us, we are to fix our eyes on Jesus and “consider Him who has endured such hostility by sinners against Himself” (Hebrews 12:2-3).  In the deepening of our fellowship with Jesus, a deepening that only suffering can bring, we grow at His feet and become more like Him.

I know that my Savior will use His chisel wisely.  He will only chip away that which detracts from His image in my life.  No stroke will be by mistake nor will any stroke be too deep.  May I embrace the necessary cuts!

I would also like to update the Mission family on the decision we have made and the process involved in coming to this decision.  Out of many different options, Carole and I have decided that I will have prostate cancer surgery.  The surgery has been scheduled for December 3.

The decision process first involved prayer for God’s wisdom, a prayer that he promises to answer in James 1:5.  Our decision also involved information gathering.  I found some good articles on the web, especially from the National Cancer Institute.  You have to be wise about information sources on the web and select reputable sources.  On the National Cancer Institute site, I found a very helpful list of questions to ask the doctor as well as a thorough discussion of the various treatment options.  We would have never thought of many of these questions, which ended up being quite beneficial in making our decision.

We then met with our doctor.  He met with us for over an hour, patiently and thoroughly answering our questions.  We asked him what his rate of complication was and how many prostate cancer surgeries he did each month.  His willingness to answer questions and take time with us were big factors in deciding both to have surgery and to have him do our surgery.

At the end of our meeting he gave us a book called, not surprisingly, The Prostate: A Guide for Men and the Women Who Love Them by Dr. Patrick C. Walsh and Janet Farrar Worthington.  Dr. Walsh has written another book, called Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer, Second Edition, which is more recent.  This book was very thorough and very helpful, although not what you would call gripping reading.

We also talked to others.  Carole’s sister has a friend who is an urologist in Grand Rapids, MI and he was extremely helpful.  We talked to other individuals who have had prostate cancer.  Scripture commends the use of many counselors (Proverbs 11:14; Proverbs 15:22; Proverbs 24:6).  We just have to remember that the greatest counselor of all is Scripture itself.  The Psalmist writes, “Thy testimonies also are my delight; They are my counselors” (Psalm 119:24 NASB).

Village Missionaries have two additional resources that are invaluable.  Dr. Larry is always available and willing to discuss a medical situation with you.  Medical Rehabilitation Consultants, the company that does our pre-certification, will also help you walk through the maze of medical care.  I know of several instances where they have called Village Missionaries almost every day to make sure they are getting the proper treatment.  I talked at length with Steve at MRC.

Why do I go into such detail about what is a very private matter?  First, perhaps my experience will help someone else make greater sense of health care today.  In today’s world, we have to take charge and inform ourselves about our medical care. 

Second, with our self-funded plan, whatever we can do in prevention and in early, proper treatment will help ourselves, help the churches we serve, and ultimately help Village Missions.  Our self-funded plan is in the forefront of what Christian and non-profit organizations can do to manage health costs.  Our monthly premium is lower than most similar insurance and self-funded plans.  Our Benefit Board keeps working at ways to provide better medical care and lower costs.  Their efforts directly affect our ability to provide leadership to churches with limited financial resources.  Yet, they will not succeed without our cooperation.  I have tried to work with them in developing an excellent plan and now, hopefully, will model how to further the Benefit Plan when ill.

Next month I will continue the series on strengthening and keep folks posted on further developments.  Carole and I are very grateful for the many who have indicated that they are praying for us.


Wednesday, September 19th, 2007

Wonderful Encouragement

This blog is under construction so that soon people will be able to post comments directly. I received this wonderful e-mail from retired Village Missionary Jim Scanlon. Jim and Delores will soon be serving in Friant, CA as Associates.  Our Associate Program allows retired missionaries or even layman to serve our churches on an interim basis while the church waits for permanent leadership. To learn more http://www.village-missions.org/serve/ministry-associate.php

Here is the e-mail:

My Dear Brother
Read you comments in Country Matters with great interest. As another who has been blessed with prostate cancer, your comments were great.

You, as was I, are very fortunate to have your cancer found early. That is the most important part of detection, getting it early. Seems to me that, as you  said, far too many of our missionaries are neglecting their health. Some are just suffering from some “macho” attitude about going to a doctor. Some may have a form of thinking that says they are too busy to get a physical and neglect their duties, even for a few hours. I suspect that many of these are the ones who never take a day off and are reluctant to take vacation. I know, Brian, that you can’t force them, only encourage. However, they need to get it done before it is too late.

When my cancer was detected my urologist, Dr. Fawcett if that isn’t a hoot, gave me some good recommendations. The first one was not to worry. I wasn’t worried, concerned, but knew the whole thing was in the Lord’s hands. He also told me to get as many second opinions as I needed. I spent nearly two hours with a cancer specialist who was part of the team that developed the seed treatment. His advice to me, based on my age and the size of the cancer, was to have the prostate removed. He reasoned that if I had the seeds and the cancer returned the surgery would be complicated by the burning the seeds do.

It has been seven years since my surgery and the PSA reading at my most recent blood test, last Friday, was still >.1. Doesn’t get any lower than  that.

I was fortunate in that I never had any incontinence or other problems. The hardest part was wearing a catheter for several weeks. Of, course, you have Mike in the office next to you who is a great source for information on the latest methods.

Brian, in any cancer, you suffer alone. Yes, Carole your children, family and friends are there with you and hurting for you. However, it is Brian that faces the treatments and the future as a cancer survivor. As you well know, the LORD is your strength and your shield, and HE will see you through this trial, as he has others in the past. The difference is that this time it is something that was beyond your control and HE can use it to bring Glory to Himself as you turn your cancer in to a positive event for His use and glory. If you haven’t read it yet, John Piper wrote a wonderful short essay when he found he had prostate cancer. I believe it is on his web site.

In the time prior to my surgery Delores and our family and friends were a great support to me. No one dwelt on the issue, but the concern and love was very evident. After the surgery De was my number one nurse, physical therapist and guide in my life. Without her at my side it would have been very difficult. I don’t think I have ever prayed as much as I did in those months and continue to give thanks to our Loving Father for His watch care over me and His showering De with His love.

We are anticipating a good report concerning the decision you make for treatment and for the eradication of the cancer, no matter what form of treatment you follow.
We will be praying for you and Carole during this trying time.

In HIS Love
Jim & De Scanlon


Monday, September 17th, 2007

On Having Cancer

I am writing this article while on vacation at Russ Wayland’s wonderful cabin in northern Washington called the “Refuge.”  Two days ago, I learned that I have prostate cancer.  I have not met with the doctor in person yet.  He told me on the phone that it was a small, non-aggressive form of cancer.  I still do not know what type of treatment will be necessary.

In writing about my cancer, I certainly do not want to over-dramatize it in any way.  Prostate cancer is one of the most treatable forms of cancer and mine has been detected very early.  Years ago, I visited a young farmer in his thirties named Ellis in the hospital.  He was the sole worker on his farm, he had several children, and he had been diagnosed with stomach cancer.  His diagnosis and prognosis was so much more threatening than mine was.  Ellis bore striking testimony to God’s grace until several months later when he was ushered into heaven.  I think of others I have known and ministered to who died of more serious forms of cancer and throughout gave testimony to the sufficiency of Christ.  Many of our own Village Missionaries have battled and are battling truly serious forms of cancer.  No, my form of cancer is a very small this and I would not have you think otherwise.

In addition, if you would label this a tragedy, which for many reasons it is not, it is a small tragedy indeed.  I think of Gayle Warner from our church in Red Feather Lakes, CO.  Her husband Charlie pulled out in front of oncoming traffic.  Charlie was killed instantly and Gayle was severely hurt.  I arrived at the hospital just as Gayle was being wheeled to the x-ray room.  The nurse stopped the gurney for me and I had prayer.  Then Gayle said to me, in her pain and in her sorrow, “God doesn’t make mistakes!”  Gayle responded with faith and grace in a hugely bigger trial than my own.

Having any form of cancer, however, has caused me to reflect, especially on the reality of Jesus Christ.  I have dug deeper into several truths about Him that perhaps would not be quite as meaningful for me in a time of health.  It says of David after receiving news of Ziklag that “David strengthened himself in the Lord His God.”  I would like to share some of the ways God has strengthened me in the hopes that they might help someone.

Before I do so, I do want to remind the mission family of the importance of regular physicals.  My elevated P.S.A. level was discovered through the blood work done at staff conference.  Having a regular physical has made the difference between detecting my cancer at a very early stage and perhaps not detecting it at all until it had spread outside the prostate.  Occasionally I hear of missionaries (sometimes from upset and frightened wives) that they refuse to have a physical.  I cannot begin to grasp the thinking behind this or the danger inherent in this.  If Paul warned Timothy to take precautions about his frequent stomach ailments, certainly there is wisdom in taking precautions about our health.  God has given doctors today the ability to address problems before they become too serious.  If we love those around us, we ought to be wisely taking care of our health.

Well, I only have space for one spiritual strengthening.  For me, it is by far the strongest.  It is that God has already shown me unbelievable mercy and grace by saving me.  We think of many passages of Scripture that express this truth but perhaps one of the clearest is Ephesians 2:4-6: 


4 But God, being rich in mercy, because of His great love with which He loved us, even when we were dead in our transgressions, made us alive together with Christ (by grace you have been saved), and raised us up with Him, and seated us with Him in the heavenly places, in Christ Jesus, in order that in the ages to come He might show the surpassing riches of His grace in kindness toward us in Christ Jesus.  (NASB)
 

By any measure, God could have justifiably regarded me with holy wrath for my sin. I more than deserved it.  Instead, He chose to expend that holy wrath for my transgressions on His Son.  He did so that He could justly justify me (Rom. 3:26).  However, God did so much more than merely forgive my sin.  He made me alive with Christ and He seated me with Him in the heavenly places.  He made me a forever object of the surpassing riches of His grace.

Doing what He has done for us in Christ is so much more than we deserve.  If, after trusting Christ as Savior in 1972, my life was nothing but disaster and disease piled upon disaster and disease, that still would not in any way detract from God’s extravagant grace.  It is just too extravagant—too amazing—too bountiful!  To be mad at God or question God now would be like a son who received a $5,000,000 inheritance questioning why he also didn’t receive an old shoe!

The joy of trials like these is that in some ways they provide the black backdrop that makes God’s extravagant grace shine even brighter.

More spiritual strengthening next time.


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