Pursuing Justice: One Proof Text Approach to the Health Care Discussion

"I hope this is me in 40 years" Photo by J.B. Hill, via Flickr.com under Creative Commons License
"I hope this is me in 40 years" Photo by J.B. Hill, via Flickr.com under Creative Commons License

We have written in this space before that the issues surrounding what we are calling the “economics of aging” may very well be THE social justice issue for Boomers and, by extenstion our children, in the coming years. Well, that seems to be coming true. The current “debate” on the proposed health care law (which may be voted on very soon in the House of Representatives) has been analyzed a million ways in the media. None of it “fake”. Curious that people from all sides see in this bill certain injustices. From Sen. Cotten to John Oliver (now that is a swing of opinion) and the Budget “score”, we seem to be looking at a bill that will impact the very people who can least afford it and the “block grants” proposal for Medicaid should trouble many unless you live in a state that has huge surpluses of cash. Mine does not!
We have begun to look at the Jewish approach to this issue through texts. Indeed, at a recent weekend, the rabbi agreed to focus the Sunday morning program on a look at a variety of ways modern Jewish thinkers have approached this issue. (Thank you Gates of Prayer in Metarie, LA). We will return to this issue, I am sure, a lot in upcoming weeks. Yet, let us begin with an interesting approach from a 1991 article in the Kennedey Institute of Ethics by Dr Aaron Mackler. He wrote an essay called “Judaism, Justice and Access to Health Care.” (Kennedy Inst of Ethics. Vol. 1. No. 2. 1991). He argued that society has an obligation to provide care to restore what is lacking to its citizens. He used the concept of “tzedakah” (justice) as his base. Mackler cites a Responsa from Rabbi Waldenberg: “the requirements of the Jewish understanding of justice for health care can be met in a variety of ways. These might include direct provision of care in public hospitals and clinics, an expansion of Medicaid, universal health insurance, a system involving vouchers and market competition, government contracting with medical providers or some combination of the above….Still, some requirements are clearly implied by the “tzedakah” model. Access to all health care needed by any individual must be assured. Those individuals with greater needs must assuredly be provided with greater health care, through available insurance or direct provision of resources.”
Mackler points to the issue of what a person may be lacking. “The key to the understanding of need seems to e the idea of lack, or that which is missing”. He cites Talmud “Sufficient for his lack–you are commanded to support him, and you are not commanded to enrich him” (Ketubot 67b) as well as Maimonides “according to that which is lacking for the poor person you are commanded to give him..You are commanded to fill in for his lack, and oyu are not commanded to enrich him”. Mackler also makes the point that “Access to health care should be provided in a manner consistent with personal dignity and self-respect” This belief, common to our tradition, on the dignity of a human being is a subject sorely lacking in much of the current discussion.
I wanted to begin this conversation with you from this traditional scholar’s point of view, a point of view that sees the concept of “justice” as key. Society has a moral duty, in a just society, to provide people what they “lack”. Mackler’s approach, is an interesting one. As Jews looking at this debate, it is noteworthy to allow ourselves to see this through the prism of a traditional concept of “tzedek”. What is justice and just for all people? And what is society’s obligation to walk in this path while maintaining the dignity of each human being?
Rabbi Richard F Address

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