As the nation waits for President Clinton to present his proposal on national health care reform, Jewish groups are staking out their positions on what promises to be one of the coming year’s most consuming domestic concerns.
Jewish groups’ proposals span a wide range of concerns, from halachic to social, from prenatal and pediatric care to care for the elderly.
Nobody knows how many Jews are included in the more than 37 million Americans who are uninsured or underinsured. But according to one official at a Jewish organization, anecdotal evidence suggests that “it is a problem that appears to be present and growing” within the Jewish community.
So Jewish organizations, like countless other religious, ethnic, business and special-interest groups, are weighing in with their proposals and suggestions for what would be this country’s best method of health care delivery.
“On this issue the Jewish community is responding as individual Jews and is not monolithic,” said Rabbi Lynne Landsberg, associate director of the Reform movement’s Religious Action Center.
There are some hard-and-fast demographic facts about the Jewish community that have led organizations to emphasize the needs of the elderly, pregnant women and young children.
The Jewish community is among the oldest ethnic groups in the country, with a mean age of 44 compared to the average American’s mean age of 33, and with nearly one-third more elderly members than the general population.
Nursing home care is not an affordable option for 80 percent of elderly Americans, according to a position paper published by the United Synagogue of Conservative Judaism, the movement’s congregational arm.
Another demographic fact of Jewish life is that religious Jews are among the most prolific of Americans, with a high birthrate being the rule rather than the exception. For them, prenatal and pediatric care are major concerns.
The fervently Orthodox community may also have the largest proportion of lower-middle-class and blue-collar Jews — those who are least able to afford the health care they need, according to David Zwiebel, legal counsel and director of government affairs for Agudath Israel of America, which represents that community.
NJCRAC PUTS FORWARD COMPREHENSIVE PLAN
Of the several Jewish groups that have weighed in with proposals for health care reform, only the National Jewish Community Relations Advisory Council has put forward a comprehensive plan.
It has endorsed a “single payer” system, which is supported largely by liberal groups.
A single payer, or publicly financed system, would allow consumers to choose their health care providers. Payment would be administered by the government, which would collect all the money being spent on health care and distribute it to the providers.
This system would provide universal coverage and would, say proponents, reduce the percentage of the gross national product now devoted to health care.
This fall, President Clinton is expected to propose what is seen as a more centrist plan, known as “managed competition.”
With this approach, new government structures would be formed to buy insurance through approved health plans which would agree to provide all mandated care. Consumers would choose among health plans.
Conservative suggestions have been along the lines of insurance company reform and government-provided tax credits to encourage uninsured people to buy from private insurance companies.
The central elements of NJCRAC’s sweeping proposal include: universal access, comprehensive care and a choice of health care providers.
NJCRAC’s members would like to see a national health care plan serving everyone in the country, for it not to be tied to employment and for it not to exclude prior medical conditions.
They want it to include comprehensive benefits including pre- and post-natal care, immunizations and epidemiological services, dental, eye, hearing and mental health care.
Their proposed national health plan would also provide reproductive health services for men and women, and long-term care and rehabilitation in home settings, hospitals, clinics, specialized nursing homes, group homes and hospices.
CONSERVATIVE ETHICIST ON CLINTON PANEL
Other groups, like the Conservative movement’s United Synagogue, have not taken a position on a specific plan but rather have outlined basic principles which they feel should be included in the plan ultimately adopted.
The Conservative movement’s most prominent medical ethicist, Rabbi Elliot Dorff, provost of the University of Judaism in Los Angeles, wrote a paper on the distribution of scarce medical resources for the movement’s Committee on Jewish Law and Standards.
Dorff was also a member of Hillary Rodham Clinton’s Task Force on National Health Care Reform, which met earlier this year.
In his paper, Dorff advocated making more services available to more people by not extending aggressive, expensive treatments to the terminally ill.
Dorff urged “a recognition of the reality that allocation of resources for expensive and often futile treatment for the terminally ill in preference to providing basic health care, food, clothing and shelter for the viable is a direct threat to the latter’s lives.”
The halachic implications, or implications under Jewish law, of this same issue — what to sacrifice in order to broaden the health care system so more people are covered — have also been considered by Agudath Israel.
In contradistinction to Dorff’s position, Agudah is opposed to what it describes as the “rationing” of treatment. This system would deem certain treatments outside the list of those which are insured, because they are too expensive and affect a tiny portion of the population.
“In an era of scarce medical resources we’ll be faced with a lot of religious problems where a rabbi says halachah demands you do certain things, and the insurance company and government say that’s a course of treatment that will not be covered in any way and if you want it you have to pay for it yourself,” said Zwiebel.
“These questions will come crashing down on our community with crushing force in coming years,” he said.
The Archive of the Jewish Telegraphic Agency includes articles published from 1923 to 2008. Archive stories reflect the journalistic standards and practices of the time they were published.
