Rabbi Michael Knopf came to the attention of Faith in Healthcare through a March, 2017 article he wrote for the legendary Jewish publication The Forward. In “Would Judaism Want Us to Repeal and Replace Obamacare?”, the rabbi of Temple Beth-El in Richmond, Virginia, considered the assault on the Affordable Care Act then being waged by the President and Republicans in the U.S. Congress. “Does our ancient tradition offer any wisdom that might shed some light on this complicated subject?” he asked. “Do Jewish values point us in one direction or the other?”
Citing the commandment not to “stand idly by the blood of our fellow” (Leviticus 19:16) and the preeminence of Jewish law’s pikuah nefesh mandate to preserve life, Rabbi Knopf concluded that Jewish tradition definitely takes a stand on the healthcare debates. “Helping those in need is not merely a matter for private charity, laudable though such deeds may be,” he wrote. “Rather, it is a shared responsibility, incumbent upon a community charged by its most sacred text with caring for all its members and striving toward an eradication of poverty (Deuteronomy 15:4).”
Rabbi Knopf’s 2017 article played a role in that year’s inspiring interfaith defense of the Affordable Care Act. That campaign culminated in dozens of faith leaders helping to lead a 24-hour vigil on the grounds of the U.S. Capitol, a display organized in part by Nathan Bennett of the Religious Action Center of Reform Judaism, interviewed in Faith in Healthcare in January. The interfaith moral call to action was successful, and the ACA survived the legislative attack.
But, did that advocacy discharge our obligation as persons of faith? The ACA has made a huge impact, but there are still 27 million persons in the U.S. without health insurance and millions more technically have coverage but face such high deductibles and copays that they are forced to go without the care they need. So, more than two years after his eloquent case for preserving the ACA, Faith in Healthcare reached out to Rabbi Knopf to ask what Jewish tradition has to say about today’s U.S. healthcare situation.
“I think the Jewish tradition is at odds with the current system and the deficiencies of the private health insurance market, where people struggle with high deductibles and care is still prohibitively expensive,” he told us. “It’s crazy that in the moments when people are at their most vulnerable, and are suffering, they have to battle insurance companies and a tangle of red tape, and even die while waiting for care.”
As he did in his Forward article, Rabbi Knopf cited the Jewish obligations under the principle of tzedakah. “Tzedakah is sometimes translated today as charity, but it’s not charity,” he said. “The analogy is to our current tax system. People had obligations to give to tzedakah in a graduated way—people who had more had to give more, people who had less were required to give less. And there were priorities for how it should be used, chief among them providing for the physical well-being of persons in the community who were in need.”
Modern healthcare systems were not contemplated in scripture or rabbinical tradition, Rabbi Knopf said, so specific policy proposals were not included. “Healthcare is far more complicated, and society is bigger, today than in sixth century Babylonia, when the Talmud was written,” he said. “But the principles remain, and the standards we are to meet are clear.”
Those standards call for a community obligation to ensure the health and well-being of all its members. “My understanding of the Jewish tradition is that healthcare is a human right, and that people have a right to as much healthcare as they need to thrive,” he said. “The term ‘human rights’ does not appear in the Bible or in rabbinic literature. But when you distill down to the essence what a community has an obligation to provide people, and the claim people can make on the community, it boils down to rights by another name.”
"Jewish Law is Clear: Healthcare is a Communal Obligation"
Rabbi Knopf says there is a 21st century model for fulfillment of those rights: the state of Israel’s universal healthcare system, inspired in significant part by the tzedakah tradition. “We form communities so that we can turn to others for things I cannot do, and others can turn to me for the same,” he said. “Jewish law is clear that healthcare is a communal obligation.”
But, Rabbi Knopf points out, it is an obligation we are not fully meeting in the U.S., and our sisters and brothers are paying the price. Insulin prices are so high that one in four Americans with Type 1 diabetes are rationing their supplies, leading to multiple reported deaths of young persons who could not afford the medicine. Our emergency rooms are often filled with people in crisis because they could not afford asthma inhalers or blood pressure medicines. A recent Harvard University School of Medicine study showed that over 45,000 Americans each year die because they cannot afford medicines or other forms of care. (See Faith in Healthcare co-founder Jessie Wise’s article, “Why Jews Are Called to Respond to Big Pharma ‘Price—Gouging’” )
“We are living in the most wealthy country in the history of the world, and the most technologically advanced country in the history of the world, and there are so many ways we can save a life through good care,” Rabbi Knopf concludes. “Yet if you are not wealthy, your ability to access care goes down, your life expectancy goes down. People go bankrupt, people even die because they cannot afford care. As a rabbi, I see this first-hand in our community.
“There should be social correctives in place so that no one is locked out of access to healthcare because they cannot afford it, no one is unable to buy the drugs they need to live, no one is unable to pay for the surgery they need to live. Our current market approach to healthcare, which inevitably causes healthcare to be something the wealthy can access but the poor often cannot, is unconscionable under the Jewish tradition.
“The poor have as much right to life as the rich.”
Faith and Healthcare Notes
“Health Insurance Companies Are Useless. Get Rid of Them.” Article in Monday’s Los Angeles Times by Michael Hiltzik: “The truth is that private health insurers have contributed nothing of value to the American healthcare system. Instead, they have raised costs and created an entitled class of administrators and executives who are fighting for their livelihoods, using customers’ premium dollars to do so.”
Taxpayers Paid to Discover a Potential Cure for Sickle Cell Disease—Will We Be Able to Afford the Drug Company Price? Patients for Affordable Drugs points out that the National Institutes for Health paid $300 million to develop a gene therapy called LentiGlobin BB305 that could cure sickle cell. But will the for-profit corporation the U.S. gave a patent to use the opportunity to price gouge? It is time for NIH to finally put limits on the price of medicines it develops.
Doctors Say Insurers Increasingly Interfere with Patient Care. “Some are finding that they need more approvals from insurance companies for routine things like medical scans or some prescriptions, which can postpone care for a few days or even weeks, per the Associated Press . Still worried about government interference in care under Medicare for All?