Is there a basic human right to health care? Or is health care a “privilege” that applies only to those who can afford it? And what is the Judaic perspective on this controversial issue, so much in the news these days?
Rabbi Elliot Dorff, a pre-eminent authority on Jewish medical ethics, has noted that Jewish sources on distributing and paying for health care are “sparse.” In general, rabbinical texts regarding communal services usually deal with providing for the needy or rescuing someone from captivity (Matters of Life and Death, p. 281). However, Dorff notes that the “…moral problems and their suggested solutions are often similar to those associated with scarcity and cost in modern medical care.” (p. 281). Of special importance is the Talmudic requirement that every city fit for a Jewish scholar must have a physician available. Since every Jewish community needed a rabbi, Dorff concludes that the requirement to have a local physician “…effectively makes it every Jewish community’s responsibility to provide medical services.” (p. 281).
But who will pay for such services? The Jewish tradition divides responsibility among the physician, the individual, family members, and the community. The physician is without question permitted to charge a fee for medical services, while at the same time being admonished to ensure that the poor have access to medical care. This need was met, traditionally, via the physician’s personal acts of charity, when faced with sick and indigent patients. However, Dorff notes one 19th century rabbinical ruling requiring that the communal court “…should force physicians to give free services to the poor if they did not do so voluntarily.” (Dorff, p. 299) Arguably, one can find in this ruling the implicit assertion of a “right” to receive health care. Indeed, while rabbinical sources are clear that those who can afford to pay for their medical care are expected to do so, Dorff concludes that,
“…with donations from, or taxes on, its members, the community as a whole has the duty to pay for the health care of those who cannot afford it themselves…even the synagogue’s needs must give way to the requirements of the indigent sick.” (Dorff, op cit, pp. 302-303.)
With respect to the particular problems endemic to the U.S health care system, Rabbi Dorff is very clear as regards both the moral and financial implications:
“…the fact that more than forty million Americans have no health insurance whatsoever is, from a Jewish point of view, an intolerable dereliction of society’s moral duty. And the fact that some of those people will ultimately get health care in the most expensive way possible—in the emergency room, usually when they are sickest—means that as a society we are also currently neglecting our fiduciary responsibility to one another to spend our communal resources wisely.” (Dorff, op cit, p. 308).
There is little question that taxes for the purpose of providing health care services to the indigent is fully consistent with Judaic and rabbinical tradition. This was abundantly clear from a survey of rabbis from various Jewish denominations, published recently in Moment. As Reform rabbi, Laura Novak Winer, put it,
“In the Babylonian Talmud, we are taught, “The law of the state is law.”…Taxes are also a moral duty…From the Torah, we learn that we are each responsible for giving one-tenth of our earnings toward helping those in need…Our taxes go toward social services, education, health care and other services…we have a civic responsibility to pay them.” (March/April 2011, pp. 28-29).
Similarly, the Commission on Social Action and Public Policy of the United Synagogue of Conservative Judaism [http://www.uscj.org/Judaism_and_Health_C5336.html] stated in 1993 that
“Jewish values demand that we work to create a society where no one is denied proper medical care. We are all created b’tzelem Elohim — in the image of God — health is not a luxury, and it should not be the sole possession of a privileged few. Elderly people should not be required to impoverish themselves in order to receive medical coverage.”
A fair synopsis of rabbinical opinion on health care rights is represented in this comment from Rabbi Dorff:
“While the specific form of health care system may vary, Jewish ethics definitely demands that American Jews work to ensure that the United States, as a society, provides health care to everyone in some way….conversely, that society has the duty to balance this obligation with the other services it must provide…” (p. 309).
When will our country do the right thing, and institute a plan for universal health care coverage? For those who want to read more, and do more, please go to the website for Physicians for a National Health Program (PNHP).
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