High Holiday Healthcare
Maimonides, a revered Jewish scholar, listed health care first on his list of the ten most important communal services that a city had to offer to its residents (Mishneh Torah, Hilchot De’ot IV: 23). Almost all self-governing Jewish communities throughout history set up systems to ensure that all their citizens had access to health care. Doctors were required to reduce their rates for poor patients, and when that was not sufficient, communal subsidies were established (Shulchan Aruch, Yoreh Deah 249:16; Responsa Ramat Rahel of Rabbi Eliezer Waldernberg, sections 24-25.)
Source:
Some of the most stressed out people in the
United States this month are Conservative and Reform Rabbis. While most of us spend our last Sundays of summer enjoying the sun, they are busy preparing their High Holiday sermons trying to find words to inspire Jews (and some non Jewish spouses) who only seek this spiritual guidance one to two days a year.
Their mission is difficult. Before the 19th and 20th centuries, the Rabbi was most likely the wisest person in his small community. Today Rabbis have to intellectually, emotionally and spiritually stimulate attorneys, teachers, scientists, writers, politicians, CEOs, and physicians in a 20 to 30 minute speech that relates to their 21st century lives and incorporates the values of a books of laws and ethics that are a couple of thousand years old.
Sometimes the Rabbi does a great job and his/her words are remembered for years to come and requests are made for the sermons to be published online. Other times, Mrs. Cohen’s 40 day bout with insomnia is cured in three minutes and Tammy’s right contact pops out because she rolls her eyes when she hears about how she should get more involved at her synagogue. Less frequently, the Rabbi gives a controversial sermon that causes an uproar and either he/she leaves the synagogue or the congregants may even start their own synagogue.
The High Holiday speech that I want
America ’s Rabbis to deliver might lead to angry congregants, cancelled memberships, new synagogues. But it doesn’t have to. If it’s done right, perhaps the results could lead to real progress in this area without needing to bring out the guillotine.
The title: Why Universal Healthcare is a Jewish Value
No scratch that. I already see people walking out angry.
The title: Is Universal Healthcare a Jewish Value?
Much better.
Yes, you are correct. I did just see Michael Moore’s “Sicko.” The film makes the compelling argument if every country in the Western world provides universal health care, why doesn’t the
United States ?
Moore provided anecdote, after anecdote, after anecdote, of poor or middle class people unable to afford adequate health care leading to their great physical, psychological, and economic suffering or even death.
You cannot help but leave that movie feeling embarrassed by our health care system and how we treat our poorest people.
The difficulty is how do you dismantle a system in which so many people make so much money off of? As a capitalist country, and given the years and years of school that doctors complete, how can we limit the salaries of our greatest resource?
I don’t have the answers to these questions. What I want is for the Rabbis of America to mandate their congregants to works towards fixing
America ’s health care system. There are numerous Jewish sources that support universal healthcare. The speech should write itself. The difficulty will be writing it in a way that motivates congregants, and especially Jewish physicians and policy makers, to work for change. The following responses, “you’ll have to wait for hours in line, you’ll have to wait for months for surgery, you receive substandard treatment,” are refuted by Moore, but also are irrelevant when so many poor and working and middle class people experience the above problems because they do not have insurance or their insurance companies have denied them funding for treatment.
If the
United States ever offers Universal Health Care, it will be because of the private sector, not the Congress. Rabbis must ask their medically insured congregants and physician members, “What are you going to do to help fix this broken system?” They must explain why Universal Healthcare is a Jewish Value and that as leaders in the community they must commit to reforming it before the "book is closed and sealed. "
February 1st, 2008 at 11:56 pm
Hi Sharna,
Great blog post. Even though things are very bad now for a sizable segment of the population, I don’t think we’ll see universal health care in any form for at least another 10 years or so. Unfortunately, I think the situation needs to get even worse before there’s enough pressure to force a change. Also, the public needs to realize that if we can fix other areas of our health care system that contribute to the problem of uninsurance, it will be easier to achieve the goal of universal coverage while improving quality and affordability for everyone.
There are so many problems with the current (non-)system:
- undertreatment for those who are underinsured or without insurance
- overtreatment for those with insurance
- failure to establish and practice evidence-based medicne
- regional variations in capacity of hospitals and physician supply that dramatically affects treatment decisions, costs, and clinical outcomes.
- fee-for-service medicine that encourages overtreatment and small solo/group physician practices that hinder coordination of care (the doctors who work for large west coast prepaid practices like Kaiser in California and Group Health in Puget Sound are salaried and make a little less money, but provide more coordinated care and produce outcomes).
- an insurance industry that seeks to insure only the healthy while leaving everyone else to fend for themselves (effectively shattering the protective effect of risk pooling).
- industry-funded studies from pharmaceutical or medical device manufacturers that are biased, withheld from publication (b/c they produce unfavorable results), or are done only on products/treatments that will yield the highest profit and not necessarily the greatest health benefit.
- excessively high prices for heath care products and services (i.e. greed).
- the list goes on and on.
Real reform would mean that many of the medical subspecialties would take a modest pay cut (though primary care pay would probably increase), and doctors would likely lose some of their autonomy. In addition, fewer physicians-in-training would be permitted to enter the more lucrative subspecialties where there’s already an oversupply. But it isn’t just doctors who would be economically affected. For instance, highly-paid lawyers, consultants and marketers who represent the big insurance firms, pharmaceutical companies and hospitals would see their revenue shrink as some health care entities are eliminated or forced to become more efficient.
So will the Jewish community, which is economically better off than the general population and over-represented in well-paying health care sector jobs, be at the forefront of pushing for a more just health care system? Doing so would mean taking an economic risk that goes far beyond donating money, providing occasional charity care or paying lip service to the importance of insuring everyone. At this point it’s difficult for me to envision the Jewish community advocating more forcefully for health care reform than it would for any other socially progressive cause. Locally here in Chicago, I don’t see much enthusiasm among my peers.
- J
p.s. A really good book published in the last year on problems in the health care system is “Overtreated,” by Shannon Brownlee.