An editorial in today's Wall Street Journal highlights the savings Rhode Island has seen the past few years in its Medicaid expenditures as a result of negotiating from the Feds some small liberties to decide for themselves how to fund healthcare for their poor. At the time Rhode Island received this privilege from the Feds, one of every five of its citizens were on Medicaid, a quarter of the state's budget was going to Medicaid payments, and the state's Medicaid expenditures were growing 7.6% per year. More recently, though, from 2009-2012 Rhode Island has reduced its growth in Medicaid expenditures to 1.3% per year as the other 49 states' expenditures increased 4.6% per year.
States rights is not only an ordering principle of our nation's Constitution, but also the necessary method of protecting our solvency. Return decisions concerning spending of Medicaid funds to Rhode Island magistrates and, that very minute, accountability returns and expenditures begin to decline.
How did they do it?
Two major reforms in particular saved money. The first reduced costly emergency room visits by Medicaid recipients for routine medical needs, and the second reduced admissions to pricey nursing homes by offering home-care subsidies and promoting assisted living arrangements, which seniors generally prefer.
Whether ecclesiastical or civil, that government is best which is most decentralized and exercises authority over the smallest group of people. In Presbyterian government, the session (for church members) and presbytery (for pastors) are the courts of original jurisdiction; and that should be the end of it in everything but the most extreme cases.
If a humdinger of a controversy arises in... {C}
Antioch, the remedy of seeking counsel from the Church of Jerusalem has Biblical precedent. But let everyone understand that Acts 15 is the exception. It's no annual occurrence.
Subsidiarity (that government should occur at the lowest level possible, only rising to higher levels when absolutely necessary) should be burned into the minds of Americans and Presbyterians today—not nationalism and its ecclesiastical twin, denomi-nationalism.
It is the nature of proud men to build very large stages on which to swagger and preen, and thus we've arrived at Washington D.C.—as well as MNA, RUF, and Covenant Seminary.
Think about the revolution that would occur in the government of these United States if no one inside the Beltway were allowed to exercise authority over any state until he'd first proven himself by good results there at home in Washington D.C. Say, for instance, the Department of Education were barred from passing any law or administering any taxpayers' dollars in any state until it had succeeded in passing laws and administering taxpayers' dollars in Washington D.C. with the result that the Presidents of these United States put their own children in D.C.'s public schools, rather than Sidwell Friends School.
This is merely the application of Scripture's command concerning an elder, that
He must be one who manages his own household well, keeping his children under control with all dignity (but if a man does not know how to manage his own household, how will he take care of the church of God?)... (1 Timothy 3:4, 5).
The neglect of this command has left us with elders and pastors who can't say "no" to their children and wives at home, yet they are under the obligation of saying "no" to their brothers and sisters in the Household of Faith; pastors and elders who can't say "no" to their brothers and sisters in their congregation, yet they are under the obligation to say "no" to their fellow elders and fellow pastors in presbytery; and pastors and elders who can't say "no" to their fellow elders and pastors in their own presbytery, yet they preen themselves over their "no's" on General Assembly's national stage.
Lawlessness starts locally; at home. Undisciplined there, it metasticizes upward until we're left (say, in the PCA) with Covenant Seminary profs seeking the repeal of sodomy laws, RUF planting churches within presbyteries, the national franchise of Manhattan's Redeemer promoting woman officers, General Assembly's Standing Judicial Commission bypassing its fiduciary obligations by means of fake technicalities; and all with perfect impunity.
We're left with tall-steeple pastors on General Assembly's national stage making loud speeches and passing vehement condemnations of Federal-Vision theology, then going home and failing to find any particular man guilty of that doctrinal crime.
Lawlessness starts in a man's own spirit; then it spreads, corrupting his marriage and household. Allowed to become an officer of the church, the man's lawlessness spreads until it corrupts his congregation. Then it corrupts his presbytery and general assembly.
The reason we have wickedness in high places is the wickedness in our own hearts, households, churches, and presbyteries. MTW, MNA, Covenant, RUF, GA, SJC, and Washington D.C. merely point back to the abdication of Christian fathers in our marriages, households, pulpits, session meetings, and town squares.
For it is time for judgment to begin with the household of God; and if it begins with us first, what will be the outcome for those who do not obey the gospel of God? (1Peter 4:17)
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CORRECTION: Originally, this post said the WSJ piece was an "oped." It has been corrected to say an "editorial."
Tim serves Clearnote Church, Bloomington, Indiana. He and Mary Lee have five children and big lots of grandchildren.
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