Jessie Wise is a co-founder of Faith in Healthcare, an attorney, and a member of the Jewish community in Indianapolis.
Progressive American Jews like me are called by our faith to focus on this country’s healthcare crisis, particularly the ever-increasing cost of life-saving medicines that is killing people both in the United States and abroad.
We all remember the story of Martin Shkreli, also known as the “Pharma Bro.” In September 2015, Shrekli rose to notoriety as chief executive for Turing Pharmaceuticals, which purchased the marketing rights for the drug Daraprim. It is a story that illustrates the fundamental injustice at the heart of our modern pharmaceutical industry.
Daraprim is a drug that treats life-threatening parasitic infections. Once Turing purchased the marketing rights to Daraprim, the company increased the price from $13.50 a pill to nearly $750.00. That’s a price increase of more than 5,000%. The news of this price increase went viral. The public outcry prompted a Congressional Hearing at which Shkreli smirked, mocked, and asserted his Fifth Amendment right to not speak. Meanwhile, U.S. citizens watched and grew outraged that there were no genuine answers as to why this company could hike up the price of such a necessary medicine.
Shrekli is now serving time in the federal prison for securities fraud. But his conviction is unrelated to the outrageous price increase of Daraprim. It turns out that what Shkreli and Turing did was a perfectly legal business practice in the United States.
Shrekli’s defense of the price hikes echoed the arguments that other pharma companies use to this day. He said that price increases were necessary in order to cover the exhaustive costs of research and development—a line frequently touted by leading pharmaceutical companies to explain the hefty price tag of many life-saving medicines.
But, while the country focused their outrage on the ‘Pharma Bro’ and his antics, other larger pharmaceutical companies sighed in relief, because Shrekli largely took the blows for these industry-wide practices. The subsequent imprisonment of Shrekli soothed the public outrage for a time. Meanwhile, other pharmaceutical companies continued substantially increasing the price of life-saving medications.
Nothing has changed except for the ever-increasing list of medicines that are becoming too expensive for Americans to afford. Case in point, the EpiPen. This price for this life saving medical device rose to as much as $608—which represents an increase of almost 500% in the past seven years. Humalog insulin has experienced a price increase of 1123% since 1996; currently, one vial of insulin costs approximately $300.
One for Ten Thousand
In the Talmud, we consider the case of a large army that surrounds a small town of 10,000 people. The enemy army demands that the Jewish people living in the town hand over one unidentified person. The army warns that if they do not hand over the person, the army will kill the whole town. The Tosefta states that the Jewish people should refuse to turn the person over to die, and instead the 10,000 should hand themselves over to murder before allowing this one unidentified person to die.
This story teaches us the importance of each individual life. If we choose the death of one innocent person to save 10,000, we could logically justify the death of one person to save two or three people because the value of life has become quantifiable. Humans should not assign a relative value to a single life. Once one commits to ascribing a relative value to a human life, it is much easier to sacrifice that life for other values as well. History has demonstrated what terrible things can result when we begin to value one life over another.
The lesson derived from this Talmudic story is very important and relevant to the fight against price gouging for life-saving medicine. Pharmaceutical companies are forcing us to not just place a relative value on lives, but a very literal monetary value on life. In today’s society, we stand side-by-side with shareholders as the townspeople, and we are allowing the lives of those who cannot afford essential medicines to be sacrificed for the sake of higher profitability (not even the sake of our lives!).
The Talmud tells us what we must do in this situation. The whole weight of the Halaka supports what we must do. We the “9,999” must stand together with the one, and let the army do its worst against us. Although the army (pharmaceutical companies and their lobbyists) may seem formidable, there are things we can do.
B’Tzelem Elohim: In G-d’s Image
We know from the Torah that all humans are made in the likeness of G-d. Central to the understanding of Tikkun Olam is the partnership between man and G-d to rid the world of evil. B’Tzelem Elohim requires us to tap into the characteristics of G-d within us to help aid the world. Every single human being on this earth carries G-d inside of them, and with G-d inside them, each person carries the power, moral obligation, and responsibility of G-d. We fulfill our duty as being made in G-d’s image by fulfilling to our moral potential.
We turn further to the Torah to interpret and understand what B’Tzelem Elohim truly means in thinking about our responsibility to provide life-saving medicines to those in need. While many facets of G-d are unknown, there are certain aspects of G-d that have been made explicitly clear. For example, in Exodus 15:26, G-d approaches Moses and says, “I am your healer.” This identity of G-d as healer is a repetitive theme throughout the Torah.
When B’Tzelem Elohim is understood to contain power and responsibility, it becomes the obvious answer that we have a moral and ethical obligation to promote the healing of others—rich and poor. While it is not wrong to profit while healing others, the pursuit of outsized profit should not be undertaken at the expense of an innocent person’s life. Once we cross the threshold of denying someone lifesaving medicine only because they cannot afford treatment, we fall away from our identity under B’Tzelem Elohim.
Therefore, in order to utilize and fulfill the concept of B’Tzelem Elohim, we must tap into our own identity of healer. Everyone has the ability to tap into their identity of healer and use their voice to fight for equal access to medicines.
The major pharmaceutical company business model is broken. Too many people are dying because they cannot afford their medicines, and the fix is easy. Economic analysts have shown that it is possible to conduct research and development and provide life-saving medicine at affordable prices, while still returning normal profits to companies and dividends to shareholders. We as advocates must rally for price transparency and a return to a business model that promotes both life and innovation. It is time we reclaim our pharmaceutical industry as a place for healing.
Faith and Healthcare Notes
Action Opportunity: Local Resolutions for Medicare for All. A coalition of organizations, including Public Citizen, National Nurses United, and our own Faith in Healthcare, are committed to push local resolutions in support of healthcare as a human right, and Medicare for All as the path to making that right a reality. Here is a link to tools to help you pass a resolution in your community.
Living Scared—and We Don’t Have To. A new Gallup survey found that nearly half of Americans fear bankruptcy in the event of a health emergency—a legitimate fear given that the same survey found that Americans borrowed $88 billion to pay for healthcare over the last year. This scenario is unheard of in other countries like ours, where universal healthcare is considered a right, not a privilege.
Email Newsletters as the Remedy for Social Media Overload. Struggling to manage the unending flood of information coming your way on social and traditional media? Gizmodo reporter Patrick Howell O’Neill writes, “An email newsletter avoids most of the pitfalls of Twitter hell while still delivering on many of value points.” Seems about right to those of us at Faith in Healthcare.