By Joshua Ratner, RA Public Policy Fellow
Halakha Calls Upon Us to Provide Access to Health Care
“Is there no balm in Gilead? Is there no physician there? Why then has the health of my poor people not been restored?” (Jeremiah 8:22)
Therefore only one person was created to teach you that whosoever kills a single soul the Bible considers to have killed a complete world. And whosoever sustains and saves a single soul, it is as if that person sustained a whole world. (Mishnah Sanhedrin 4:5)
A Torah scholar should not live in a community unless that community has available medical care. (PT Kiddushin 4:12 [66b] and BT Sanhedrin 17b).
The duty to return a lost object to another (in Deut. 22:1-3) includes returning “a person’s body, for if one sees him dying and can save him, one should save him, whether physically or with money or with knowledge.” (Rambam, Comment to Mishnah Nedarim 4).
God created food and water; we must use them in staving off hunger and thirst. God created drugs and compounds and gave us the intelligence necessary to discover their medicinal properties; we must use them in warding off illness and disease. (Rambam, Commentary on Mishnah Pesahim 4:9)
“Doctors are required to reduce their fees for the poor. Where that is still not sufficient the community should subsidize the patient.” (Shulhan Arukh, Yoreh De’ah, 249).
“One who has medications, and another person is sick and needs them, it is forbidden to raise their prices beyond what is appropriate.” (Shulchan Aruch, Yoreh De’ah 336:3).
“It has been enacted that in every place in which Jews live, the community sets aside a fund for care of the sick. When poor people are ill and who cannot afford medical expenses, the community sends them a doctor to visit them, and the medicine is paid for by the communal fund.” (Rabbi Eliezer Waldenberg (a 20th century Israeli posek), Tzitz Eliezer 5:4).
In relation to the obligation to pay the costs of saving the life of a sick person who is in danger of dying: From the straightforward reading of Sanhedrin 73a, we see that one is obligated to do everything to save him, and if not, one transgresses the negative commandment: “Do not stand idly by the blood of your neighbor.” (R. Shlomo Zalman Auerbach (a 20th century Israeli posek), Minkhat Shlomo, V.2, 86:4).
“The community clearly has an obligation to provide for the medical needs of the indigent. This establishment of a fund to defray medical expenses represents both a needed social amenity as well as a charitable obligation, and the community is fully empowered to levy a tax for either purpose.” (Rabbi J. David Bleich, Tradition 31:3)
The Mandate To Health Care Access Applies To All Members of Society
“Our Rabbis taught: ‘We support the non-Jewish poor along with the poor of Israel, and visit the non-Jewish sick along with the sick of Israel, and bury the non-Jewish poor along with the dead of Israel, for the sake of peace.’” (BT Gittin 61a).
“In a city where non-Jews and Jews live, the tzedakah collectors collect from Jews and non-Jews and support Jewish and non-Jewish poor; visit Jewish and non-Jewish sick and bury Jewish and non-Jewish dead, and comfort Jewish and non-Jewish mourners, and return lost goods of non-Jews and Jews, to promote the ways of peace.” (PT Demai 4:1).
Rabbi Nissim ben Reuven of Gerona (the Ran) ruled that funds dedicated for medical care may not be re-appropriated for needy students and that such funds are for the “needy of the world,” not just the “needy of the town.” Ran, She’elot U’tshuvot 1, Dibbur hamatchil “V’haben hayoresh.”
“The government may not excuse itself from its responsibility toward the sick, since the government — and not the doctors — is responsible for the health of the people.” (Rabbi Shlomo Goren, former Ashkenazi Chief Rabbi of Israel, Sh’vitat haRofeh L’or HaHalachah, Assia 21).
“If an individual cannot afford to pay for needed health care, the obligation to provide for that care devolves on the community as a whole. … Preferred ways to meet this communal responsibility for the care of the poor include a societal health payment program, perhaps analogous to Medicare or national health insurance, or direct government provision of medical care.” (“Responsibilities For The Provision Of Health Care,” by Rabbis Elliott Dorff and Aaron Mackler (approved by CJLS on Sep. 9, 1998), pp. 330-31.