Monday, April 2, 2012

A Fresh Take on Universal Health Care: A Jewish Moral Perspective

The Supreme Court concluded their hearings this week on President Obama’s universal health care reform, and the country now awaits the court’s final decisions expected sometime after June.   The court is considering complex jurisprudential questions that the health care plan presents:   The constitutionality of the individual mandate and whether Congress can penalize those who do not buy health insurance.   Further more complicated questions stem from this that reach beyond individual responsibility of the insured to include responsibility of the insurers and of the states.
Mr. Obama’s goal of universal health coverage has its share of legal, political, and public oppositions.      This opinion piece presents a refreshing alternative perspective to these debates.   The author reframes the constitutionality argument using guiding principles from Judaism, calling it a Jewish moral imperative.   The leading question this article presents is whether American society views itself as an ‘American community.’  The author asks, if America is a community then we are faced with two fundamental questions:  Do we believe there is some minimal level of care for physical well-being that every member of that community is entitled?  How do we go about deciding how much that basic level ought to be?   This approach does not offer a solution to the health care reform; rather it is a reframing of the issues using ethical principles that are well established in Judaism.  
The “moral mandate” principle set forth in this article is in sharp contrast to the “individual mandate.”   The concept of a moral mandate relies on the Talmud, a collection of Jewish law and principles, which states that a community must provide, among other things, basic health care and a doctor.   She adds that simply “reducing fees to care of the poor is not sufficient, the community must provide a fund.”   This principle is based on the concept of ‘community’ in the Jewish tradition which stems from the fundamental understanding of the Jewish community, which requires as many as ten people to meet obligations of Jewish religious life.  This understanding is based on the “assumptions of the interdependence of the human family.”
The health care principle in Jewish tradition is not limited to a theory of ethical behavior but has also been put into practice.   The Rabbinical Assembly, an international community of 1600 Conservative rabbis, passed resolutions on health care in 2002 and 2008 and in support of the Patient Protection and Affordable Care Act of 2010.  Affordable health care is not a new concept.   The author of this piece points to the fact that her father-in-law served in the public sector as Commissioner of Health of New York City in 1974 and was the first director of the Medicaid program in New York City fifty years ago.   With his experience in public health, he recognized the “unavoidable need for a system of coverage that would provide health care to all.”   
If we change our perspective from ‘individual’ to that of ‘community,’ it shifts the responsibility to the community, however large you envision a community, and we might then begin to possibly address the “sweeping moral and demographic problem.”   The author stresses there is a moral obligation and a practical urgency in providing health care for all.  But, first, Americans have to “face difficult decisions required to realistically face this problem.”    
We have to recognize that America is a highly individualistic society, based on the theory that individuals can make the best personal choices and that society has no right to interfere in the person’s decision making.   Individualism is in contrast to a collective community.  A negative political view of ‘community’ is often referred to as ‘socialism.’   Accusations of promoting ‘socialism’ have been hurled at the Obama administration and is used to discredit the administration’s vision.  Providing basic health care to the poor, uninsured and every individual according to Mr. Obama‘s vision is consistent with the ethical principles the Talmud calls for.   
Is the concept of a moral mandate limited to Jewish moral principles?   Is it possible to use this principle as a starting point to address why health care should be provided to all?  It may not possible to remove all legal and political implications of health care reform in our society, but it is possible to redirect the conversation currently framed with individual rights to that of a moral mandate and call for the responsibility of the American “community” to provide basic public health care to every individual as a moral responsibility of the nation.

1 comment:

Kyle I. said...

Joyce, I found this post to be quite refreshing in this debate. The debate has often been framed as a obligation to help complete strangers. I appreciated your articulation of a "community" and its members interconnectedness and mutual moral responsibility. To identify others as family rather than strangers is to have a distinct impact on one's moral sympathies and inclinations. I imagine this formation of an American Community would be quite difficult to achieve. Do you think its even possible, given such divisive identity politics and political polemics?