Reform of the Health Care System

Two central ideas underlie the abiding Jewish commitment to provide health care to all of God's children. The first is Judaism's teaching that an individual human life is of infinite value and that the preservation of life supersedes almost all other considerations. We are constantly commanded "not to stand idly by the blood of our neighbors." The second is the belief that God has endowed us with the understanding and ability to become partners with God in making a better world. The use of that wisdom to cure illnesses has been a central theme in Jewish thought and history.

Three health care obligations flow from these core values:

  1. First, physicians have an obligation to heal. As Moses Maimonides concluded in Commentary on Mishnah Nedarim 4:4: "It is obligatory from the Torah for the physician to heal the sick and this is included in the explanation of the phrase: 'and you shall restore it to him' meaning to heal the body." So honored a profession was that of physician that during the Middle Ages as many as half of the best known rabbinic authors and scholars were also physicians.
  2. Second, patients have an obligation to obtain health care. Our bodies and souls belong to God, and we have to ensure that they are cared for. The verse in Deuteronomy (4:15) "You shall indeed guard your souls," has traditionally been interpreted as commanding us to protect our health. Furthermore, based on the passage in the Talmud, "Whoever is in pain, lead him to the physician," (Baba Kamma 46B), the rabbis concluded that Jew should live in cities where doctors live, in order to have access to health care.
  3. Third, providing health care was not just an obligation for the patient and the doctor, but for the society as well. It is for this reason that health care is listed first by Maimonides on his list of the ten most important communal services that had to be offered by a city to its residents. (Mishneh Torah, Sefer Hamadda IV:23). During the long history of the self-governing Jewish community, almost all such communities set up societies to ensure that all their citizens had access to health care. Doctors were required to reduce their rates for poor patients and, where that was not sufficient, communal subsidies were established (Shulchan Aruch, Yoreh Deah 249:16; Responsa Ramat Rahel of Rabbi Eliezer Waldernberg sections 24-25).

From these themes, we must conclude that when members of a society at large are ill, our responsibility - not only of the medical profession but of all of us - expands to ensure that medical resources are available at an affordable cost to those who need them. This principle is also embodied in the concept of mipnei tikkun ha-olam - what we are obliged to do in order to repair the world in which we find ourselves.

The provision of more affordable and more easily accessed health care in America has become a pressing matter for Reform Jews, who operate with a prophetic mandate to "do justly" and to provide for those in need. Our resolutions on "social insurance" for adequate health care date back to 1948, and on a single-payer approach to national health care, to 1975. In the current crisis of health care coverage and access, our commitment to health care leads us and our constituencies to adopt a set of principles regarding health care and to work in coalition with other groups seeking similar goals.

President Clinton and the Administration have proposed a national health care plan, the Health Security Act, that features many important improvements over the current health care system. Among these are the provision of comprehensive coverage to the uninsured and underinsured, prevention of denial of coverage based on pre-existing conditions, and emphasis on preventative and primary care.

It is from a position of strong support for the goals of the President's plan that the UAHC hopes to contribute to the health care debate, and make further improvements to an already strong plan.

THEREFORE , the Union of American Hebrew Congregations resolves to:

  1. Commend President Clinton for proposing and the First Lady Hillary Rodham Clinton for shaping, the Health Security Act, a strong, national health care reform plan whose stated goal is to extend access to affordable quality health care to every American, a program which shares so many goals of the UAHC on this issue.
  2. Continue its support of the Interreligious Health Care Access Campaign, and reaffirm its support for the UAHC principles for health care reform, as summarized in the following paragraph:
    "We seek a national health care plan which grants universal access to health care benefits, including access to primary and acute health care, immunization services, early diagnostic and treatment programs, provider and consumer education, programs of extended care and rehabilitation, mental health, and health and wellness promotion. Such a program should provide for education, training, and re-training of health care workers as well as just compensation and affirmative action in hiring. An effective plan will provide for cost containment, equitable financing and assure quality of services." IHAC Statement of Principles, Opening Paragraph).
  3. Advocate a single-payer system as the most likely means of fulfilling the principles articulated in past UAHC and CCAR resolutions on health care reform and the principles of the Interreligious Health Care Access Campaign.
  4. Encourage congregations to continue their educational effort on the issue of health care, with a special focus on promoting advocacy by our congregations, their members, and UAHC affiliates of reform of the health care system embodying the principles of this resolution on both state and national levels.
  5. Urge our government to institute a health maintenance tax on tobacco and alcohol products to generate revenues to substantially contribute to the projected costs of initiating such a health care system.