Religious Leaders Examine Ethics of Health Care Reform

What would the rabbis of the Talmudic ear have said about Medicaid?

A group of rabbis, Christian ministers and priests, doctors, medical ethicists and public policy experts gathered Sunday and Monday in New York for a conference to explore what the Jewish and Christian religious traditions can bring to bear on the debate about health care reform.

The conference, titled “Health Care: Right or Privilege? Moral and Religious Values in Health Care Reform,” was convened jointly by Columbia University’s School of Public Health; the Protestant, non-denominational Union Theological Seminary; and the Conservative movement’s Jewish Theological Seminary.

The goal of the conference was “to give voice to the liberal religious community on an issue of such transcendent importance as health care,” said Rabbi Ismar Schorsch, JTS chancellor.

Sessions were held at both the Protestant and Jewish seminaries, which are across the street from each other.

The thread woven throughout most of the participants’ presentations was concern that the poor might be abandoned by the federal and state governments as they drastically cut back Medicaid and other forms of public assistance.

Several participants acknowledged the profound complexity of allocating scarce public revenue, the painful task of deciding whether more people should be provided with health insurance or fewer people should have access to the finest quality medical care.

But at the opening session — titled “How Did We Get Here?” — and the morning session of the second day — titled “Am I My Brother’s Keeper?” — speakers did not dwell on the fine points of public policy. They instead focused on what their respective religious traditions have to say about society’s responsibility to aid the needy.

Schorsch, in his presentation, spoke about what he termed “the communitarian ethos of Judaism.”

“Judaism focuses on the welfare of the community rather than the rights of the individual,” he said. The pre-modern European Jewish community applied the Torah and Talmud’s ethical dictates and the result was Jewish communities where “the social contract was very inclusive,” he added.

“Even visitors, students from abroad were taken care of.”

In the United States today, he said, “My deep concern is about the growing exclusionary climate.

“There are more and more outsiders who are not part of the social contract, who are deprived of the blessings of the body politic.”

Schorsch and other speakers pointed to the 41 million Americans who have no health insurance.

And they expressed concern that those numbers could rise as a result of the welfare reform bill President Clinton recently signed into law, which will cut off Medicaid and other social services to immigrants who have not yet become U.S. citizens.

“I find this direction very troublesome, and compare it to Kristallnacht, which was the final consequence of a growing exclusionary policy in Nazi Germany,” said Schorsch.

“We have started down a very dangerous road. From exclusion you move easily to denigration to expulsion and even worse.”

Rabbi Harlan Wechsler, a visiting assistant professor of Jewish philosophy at JTS, said the Jewish requirement to provide health care to the poor dates back to the Middle Ages, if not before.

He cited the Torah’s commandment not to stand by while a neighbor’s life is in danger.

“If he cannot breathe, if he cannot see, if he cannot hear, if his body is ailing, try to save him. Let us cry it from the mountaintop if it has not yet been heard!”

The Rev. James Forbes, senior minister of Manhattan’s Riverside Church, used the biblical story of Cain and Abel, in which one brother kills another, as a metaphor for society’s neglect of the needy.

Forbes called for the religious leaders in the audience of about 200 people to spark a “theological renewal” that he says will be necessary for Americans to cease “stooping to abandoning these most vulnerable” people.

“We, the church, the synagogue, the mosque, must help people recover the sense that we are all privileged,” he said with oratorical fervor hallmarking his training as a Baptist minister.

“We must train leaders in moral and ethical considerations. Health and wellness is divine intentionality, and God will not stop until that promise is fulfilled.”

Medical ethicist Nancy Neveloff Dubler, who runs the division of bioethics at Montefiore Medical Center and is a professor of bioethics at the Albert Einstein College of Medicine, recalled a tradition of doctors and hospitals working pro-bono to provide health care to the indigent.

That practice all but disappeared with the establishment, in 1965, of Medicare and Medicaid, government-supplied health insurance for the elderly and poor, she said.

“We need to make it reappear,” she said.

Schorsch hopes that the success of the conference will lead to the creation of a coalition of Jewish, Protestant and Catholic religious organizations working together to rally their constituents and give voice to liberal religious concerns about health care reform.

One purpose of the as-yet unnamed coalition would be to counter the moral and legislative influence of conservative religio-political groups such as the Christian Coalition, Schorsch said.

The new coalition would be modeled on “the alliance forged between scientists and religionists on environmental issues,” he said, referring to the 3-year-old National Partnership on the Environment.

“That lobby has been extremely effective in bringing environmental concerns to the religious community, and churches and synagogues are the most effective bridge to the masses.”

Schorsch said the interfaith alliance he is proposing would “bring churches and synagogues to be much better informed on issues of health care and take much stronger positions.”