Jews, Judaism, and Obamacare

The following is an opinion piece, and it should not be construed to reflect the ideas or position of GTJ as an organization.

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Stephen Richer is the President of Gather the Jews. 

In honor of today’s ruling on the constitutionality of the Affordable Care Act (“Obamacare”) by one of our local courts (The U.S. Supreme Court found the law constitutional, 5-4), I thought it might be fun to ask a couple community members to assess Obamacare through the lens of Judaism.  But almost as soon as I sent the email request for papers I recognized the request as fruitless, inconsistent, and inappropriate.

Fruitless:  Rabbi Shira of Sixth & I mentioned to me the other day that Jewish religious text can be used to support or evince seemingly anything.  I agree.  Completely.  I’m always astounded by the number of seemingly incongruent arguments raised through religious text.  Jewish text is especially guilty of this because there is simply so much of it (Talmud).   You don’t even have to step outside this healthcare debate to see how Jewish text can allegedly support both sides of the argument:  Here’s Julie Schonfeld (Washington Post) and Elliot Dorff (JewishJounal.com) writing in support of Obamacare, and here’s David Klinghoffer (Beliefnet) writing in opposition to universal health care.

Inconsisent:  If we locate text that seemingly speaks to health care, what of it?  Non-fundamentalists (and here I stand) reject the idea that religious text is 100% true.  The Torah also says that the world was created in seven days — we’ve dismissed that pretty summarily.  Why shouldn’t we similarly dismiss any text that speaks to health care?  And even Jewish fundamentalists — those who take the text as gospel — are able to dance around seemingly straightforward text such as “stoning a wayward/disobedient son,” a line that has seemingly been overturned by the oral law.   How do we know if the Jewish text on health care is a time when we’re supposed to dance?  And if we dance, which commentator or interpreter determines how we dance (problem 1)?

Inappropriate:  Even if we are able to discern Judaism’s ruling on Obamacare, what does this matter?  The laws of Judaism have no place in the governance of our society — bacon is still widely enjoyed in America.  And the idea of invoking religion to support a political position is an idea that, if transferred to another religion, is distasteful (to say the least) to most of us Jews.  American society would not take well to anyone trying to shape society according to Islamic law.  And we Jews are especially hostile to any seeming blurring between zealous Christianity and civic law.

Since any straightforward application of Jewish text to Obamcare is seemingly pointless, a better approach is perhaps an application of the general Jewish ethos toward health care.  I’ve spent the past few days reading as much as I can on this subject, but, again, I failed to find any sort of straightforward answer.   The Talmud very clearly states that Jews have the responsibility of attending to the sick and the poor in their community, and this mentality has been a hallmark of Jewish communities since Jewish history began (see, e.g., the Dorff article).  But this philosophy does not help us answer the questions:  How do we define the community?  Is the American public of 300+ million Jews and gentiles the same type of community that was envisioned in the Talmud? (Klinghoffer argues that it’s not).  And what about the individual mandate?  The Talmud might be seemingly clear that we’re supposed to help the poor and the sick, but are we supposed to force seemingly healthy people to plan for the future?

Then there’s the thoroughly Jewish notion of self-determination and free will — the Jewish individual is free to make good decisions and bad decisions.  And through this model, the measure of the man’s righteousness is measured.  If his life is controlled by God, and his hands bound (the only Biblical instance of which I know of is when God compels the action of Pharoah in Exodus), then he has no agency and cannot take credit for being good.   Similarly, can man take credit for making a wise personal decision (buying healthcare) or a magnanimous decision (helping others buy healthcare) if he is compelled?

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If it’s hard to discern what Jewish text says about Obamacare, it’s not hard to uncover what the Jewish people think about Obamcare:  They overwhelmingly support it.

In the most recent major poll of Jewish political beliefs, 72% of Jews said they prefer Obama’s healthcare vision to Romney’s; 19% prefer Romney’s; 9% undecided.  (American Jewish Committee — April 30, 2012).  Multiple umbrella Jewish organizations (including, e.g., United Synagogue of Conservative Judaism, Union for Reform Judaism, and Religious Action Center of Reform Judaism) have signed letters in support of universal healthcare or Obamacare.

But this is hardly surprising given the liberal bent of American Jews and their oft cited interest in issues of “social justice.”

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To close this little report on Jews, Judaism, and Obamacare, I’ve pasted (below) articles written by two community members on the topic.  If you want still further reading, I suggest the articles I linked above, or else go to this page to get a Reform, Conservative, and Orthodox opinion on whether “Jewish law mandates universal health care?” (Jewish Values Online)

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Affordable Care Act Reflects Jewish Values

Madison Arent is an Eisendrath Legislative Assistant at the Religious Action Center of Reform Judaism, the social justice and public policy arm of the Reform Movement. This post originally appeared on RACblog.

Jewish tradition has long advocated broad access to health services. Maimonides, the revered medieval Jewish physician and scholar, listed health care first on his list of the 10 most important communal services that a city should offer 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).

Guided by our tradition and these texts, the Reform Jewish Movement has long advocated for more accessible health coverage and passed numerous resolutions on the importance of an affordable and inclusive health care system.  The Religious Action Center of Reform Judaism was a leading voice in the faith community advocating for the passage of the Affordable Care Act; in the two years since it was passed, we have worked to educate our community about the new law and defend it against legislative attacks. In advance of the Supreme Court’s consideration of the law, the Union for Reform Judaism proudly signed on to two briefs: one arguing for the constitutionality of the individual mandate and another arguing in favor of the law’s expansion of Medicaid, which helps more low-income individuals get the health care they deserve and speaks directly to the practice of reducing rates for the poor and providing communal subsidies for health care when necessary. Moreover, the bold efforts of our congregations around the country have demonstrated solidarity around the improvements the Affordable Care Act can make to our health care system.

Access to affordable health care, including preventative and emergency care, is a fundamental human right. A mother should not have to choose between preventative health services and rent payment. A senior should not have to pay for costly prescription drugs and worry about depleting his or her savings. Lack of insurance should not prevent a child from maturing into a healthy adult. The Affordable Care Act helps ensure that 32 million fewer Americans will have to sacrifice their health because of circumstances out of their control. We acknowledge that this expansion of coverage is not universal, but it is a significant improvement over the system we have now, where insurers and money too often dictate the care we receive.

Our tradition teaches us that human life is of infinite value and that the preservation of life supersedes almost all other considerations. We, as Jews, believe that God endowed humanity with the understanding and ability to become partners with God in improving our world. The use of our wisdom to cure illnesses and formulate policies to provide health care has always been a central theme in Jewish thought and history, and the Affordable Care Act is a modern expression of that theme.

When I recall the words of the preamble to the U.S. Constitution, the Founding Fathers made very clear that one of the primary purposes of government is to promote the general welfare of its citizens. The Affordable Care Act is a law that does just that, serving the best interests of all by ensuring that no one has to suffer or go bankrupt because of lack of insurance. Not only is promoting the general welfare the responsibility of a government to its people, but it is also a moral imperative grounded in Jewish tradition.

The Reform Movement remains steadfast in its support of the Affordable Care Act and all of its provisions. Regardless of Thursday’s Supreme Court decision, we will continue to advocate for further improvements to our nation’s health care system to transform it into one that reflects the Jewish values that guide our advocacy—preserving life and caring for all people, including the most vulnerable.

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Honest Weights, Honest Measures and Obamacare

Noah Silverman is the Republican Jewish Coalition’s Congressional Affairs Director.  This piece first appeared at the RJC blog.

It surely goes against the grain of the prevailing stereotype, but in the health-care-reform debate, the “Religious Left” — supporters of a government takeover of health care — are far more likely than religious conservatives to cite Scripture in making their case.  This is especially evident in the Jewish sector of American religious life, where most public advocacy is heavily tilted toward the left. (In fact, RJC is the only national Jewish organization standing with the majority of Americans who oppose the Obama health care plan.)

Have a look at this speech featuring a bullet-pointed list of “words of the Jewish tradition on health care,” delivered by Rabbi David Saperstein, Director of the Religious Action Center of Reform Judaism (RAC), and a leading voice of the Jewish Left, at a “progressive faith groups” rally for Obamacare Tuesday on Capitol Hill:

To those who would say that religion has no place in the health care reform debate, that this has become too much a partisan political issue, we insist that this is a quintessentially religious issue. The failure to provide universal health care coverage challenges the simplest and clearest biblical command expressed by Ezekiel, that “Every living thing shall be healed.”

As uncompromising as this prophetic mandate sounds when marshaled to indict our current health-care arrangements, it mellows into something much more accommodating when it comes to assessing congressional Democrat reform proposals.

Every version of the Obama plan congressional Democrats put forth leaves millions of Americans uninsured.  Yet this does not prevent Rabbi Saperstein from enthusiastically urging the Senate to pass it.  In doing so, he and his allies decline the option of holding out for a straightforward (presumably government-run) universal health care program – while maintaining that such a program would be the most direct way to fulfill the alleged biblical mandate to provide universal health care coverage.

This is not necessarily evidence of hypocrisy or even proof that RAC’s official position in favor of mandatory universal government-run health care is insincerely held.  Religious Left advocates who mobilize for the Massachusetts-like mandate-plus-taxes/subsidy scheme that Obamacare has evolved into can rationalize acceptance of a watered-down compromise as morally justified. Prudence and pragmatism are both virtues for anyone pursuing a political venture, at least some of the time.

If only Religious Left folk would be as understanding when someone else’s prudent and pragmatic attempt to apply his faith’s ethical principles to a contemporary dilemma leads him to adopt a different policy preference.

Here’s a Torah principle that seems to me to pose a rather stark challenge to current Democrat health legislation: it’s from the Book of Leviticus, Chapter 19 [a chapter known as the "Holiness Code"], verses 35 and 36: “You shall not falsify measures of length, weight, or capacity. You shall have an honest balance, an honest weight, an honest ephah, and an honest hin.”

Talmudic and modern commentaries on these verses rightly emphasize their application to private-sector business ethics.  But is there anyone prepared to disagree that the imperative for honest measurement surely applies to the business of government as much as to other businesses?

How well do the current Democrat health-care-reform bills affirm the spirit of the commandment to use honest measures?  Not very well.

A persistent temptation to which governments at every level have fallen prey is the tendency to use funds deemed to apply to a different fiscal year’s budget to pay for current expenditures.  But usually such budgetary gimmicks are acknowledged by policymakers to be a necessary evil.

By contrast, Obamacare relies on such gimmickry to game the scorekeeping process.  In other words, the White House and its congressional partners are using gimmicks with the specific aim of rendering the official cost assessments provided to Congress by the Congressional Budget Office dishonest measures.

At a time when public concern about the risks associated with a burgeoning national debt is intense, Obamacare’s backers feel an acute need to be able to claim that their bill does not worsen the problem.  Most famously, President Obama included this line in his September address to Congress: “I will not sign [a health-care bill] if it adds one dime to the deficit now or in the future. Period.”

The Reid bill pays cynical respect to Americans’ fiscal concerns by delaying the onset of benefits while immediately instituting tax hikes.  Because of this fiscal sleight of hand, the CBO’s determination that the bill will not add to the deficit over the ten-year period covered by its cost assessment obscures, rather than clarifies, the bill’s true fiscal impact.

The practical result is a bill that collects revenues in the first four years after enactment — before paying out almost all the benefits in the remaining years.

Wednesday, the Senate debated — and Senate Democrats (Ben Nelson and Evan Bayh excepted) defeated – an amendment to make the effective date for benefits provisions the same as the effective date for taxing provisions.

This tactic of making Americans wait to enjoy the bill’s benefits to get a better CBO score looks particularly indefensible when subjected to the unforgiving terms of the biblical mandate Rabbi Saperstein delineated -  obeying Ezekiel’s “simplest and clearest biblical command” by requiring that every uninsured American get coverage.  Now we’re not just employing dishonest measures to ease passage of a health-reform bill; we’re leaving people uninsured for years for no better reason than to facilitate the dishonesty.

Another gimmick to front-load revenues and deprive the American people of an honest measure of proposed expenditures’ cost is the inclusion of a new entitlement program for long-term care that will collect more in revenues during the years that fall within the parameters of the ten-year CBO score than it expends in benefits — only to become a huge unfunded liability in later years.

And yet another: Cato Institute researcher Michael Cannon demonstrates how the architects of Obamacare learned from the failures of the 1993-4 Hillarycare how to ensure that the costs of universal coverage will not be reflected as federal expenditures in the CBO score.

Can someone please explain how anyone claiming to hew to a tradition that includes Lev. 19: 35-36 could support this bill now that its backers have specifically rejected an amendment to bring it into alignment with the commandment to use honest measures?