As the nation gears up for the coming presidential election, the attacks on “Obamacare” have become extremely ferocious, vitriolic and generally mean-spirited. And even though the Supreme Court has ruled that Obamacare is constitutional, the Republican attacks on it have not abated; to the contrary, they have become even more vehement.
The common theme of these attacks is that Obamacare contributes to the loss of individual rights; it is said that this program mandates people, whether they like it or not, to buy medical insurance. The opponents of this program argue that it is a major threat to the sacred and holy principle of individualism and the freedom of the individual to make his own choices.
The opponents of Obamacare do not deny that many people in the United States do not have access to the medical care they need. Their fear, at least as I understand it, is that Obamacare will introduce socialized medicine.
For a long time, there has been a sizeable contingent of U.S. citizens opposed to any program that could be defined as “social.” Such attacks were directed against Franklin D. Roosevelt’s introduction of Social Security and Lyndon B. Johnson’s program of Medicare and Medicaid.
The most frequently-given reason for why people in this country are vehemently opposed the ideal of collective action is that many people equate anything “social” with Russian or Chinese totalitarianism, in which the individual must submit to the will of the dictator. Perhaps this fear stems from the historic response to British rule when the King of England demanded total submission to his authority; since then, our opposition to totalitarianism has only become stronger, and individualism has become the sine qua non of this country’s ideal.
The American ideal of individualism has its roots in the laissez faire philosophy, a view that advocates that the natural relationship between individuals is the struggle for survival (bellum omnia contra omnes, they would say in Latin). From this perspective, society is nothing more than a collection of individuals who “signed a social contract,” agreeing to have a limited form of government and, most importantly, to set limits on government’s power over the individual.
It is interesting to note that while the Bill of Rights assures and specifies the limits of the collective’s authority over the individual, it does NOT specify our duties to the collective…
The Torah specifies that the court should not honor the rich because of their power; for instance, Samuel cautioned us against appointing a king because in the end the king would use his power for his own benefit. And didn’t Nathan challenge David precisely because he abused his authority?
Judaism realizes that individuals must co-exist with the collective, with society. This coexistence is guided by norms which specify the rights of the individual while at the same time perceiving the society as an independent entity; our values describe the individuals’ duties to the collective and, reciprocally, the duties of the collective towards the individuals.
This is expressed in the term kelal Yisrael; the best description of this view was enunciated by Emile Durkheim, one of the founders of sociology. To him, society is an independent entity, sui generis, and the individual and society are bound not by a business contract, as the English philosophers argued, but rather by a sacred relationship – by a covenant.
G-d, in a sense, is the sacred symbolic representation of the Jewish collective, and we, the individuals and G-d, are bound by the covenant whose terms are laid out in the Torah.
Your Duty, As Well As Mine
Judaism teaches the view that the collective is responsible for the welfare of its people. We are told, kol Yisrael achraim zeh bazeh, basically that all Jews are responsible for each other’s welfare and that this responsibility is carried out through collective action; early examples of this in practice include the Temple’s funds for widows and orphans (the laws of leket and peah, respectively) and the right of the poor to have access to share in the product of harvested fields.
The sages proposed an organic analogy: Society is like a hand with fingers, each representing different social groupings, be they social or economic. And if one finger hurts, does not the whole hand suffer? If any subgroup in a society suffers, because of insufficient medical care, lack of food and clothing, does it not affect the whole society?
To me, the fundamental perspective that should govern man’s relationship to the living world is expressed in the principle of tzar bal chai – that is, not to cause hurt to any living thing – and kol shekeyn, “all the more so,” does this instruction apply to humans. Not only do our laws forbid us to cause pain to living beings (the commandment of lav), but in addition we must alleviate pain (the commandment asseh) wherever there is suffering.
The Meaning of Healing
As I interpret the Torah, the purpose of medicine is two-fold: to alleviate pain and to save lives. Therefore, medicine in Judaism was originally the domain of the priests, the representatives of the world of the sacred, and this made the clear differentiation between medicine and magic, which belonged in the profane world.
Unlike the magicians, who use their craft to serve their own self-interest (that is, for extrinsic purposes), the priest’s role was intrinsic. In contrast to the magicians, when priests heal the sick, they do not ask “how much?”
The priest as the physician makes this profession holy and sacred, for by saving one life, he saves the world. This elevates medicine into a noble profession and the physician into a humanitarian – a saver of the world.
For a long time, this nation struggled with the issue: Do all people have a right to have a share in this nation’s health services? In short, do the poor have a right to have access to life giving skills of physicians and medicines, or should medicine be treated as a business with extrinsic goals?
If we follow the Jewish model, then we propose that all people in society must be given a share in the goods and services that alleviates pain and saves life. In my view, the Hippocratic Oath implicitly supports this.
I hope that we will bring back into medicine the idea that it is a noble profession – one that professes the Jewish view – that medicine should have an intrinsic, humanist aim: the betterment of human life. I wish to propose that gemilath chasodim is not only guiding interpersonal relationships, but also guiding society’s duties toward the individual.
Access to medicine should not be like a nedovoh, a charitable act that reinforces the beneficiary’s self-image as a poverty-stricken individual who must become dependent on other individuals. Instead, medicine should be given as a right, as all individuals are required to pay for the upkeep of the institutions that serve the dispensation of medical help.
In short, let us follow the wisdom of our sages and make medical help a right for all rather than a privilege for the few.
By Eugene Schoenfeld