By EZEKIEL J. EMANUEL, M.D.
PHILADELPHIA (JTA) — “My son, the doctor.” Why does every Jewish mother have to have a doctor in the family? It might be because the immigrant mentality desperately desires a secure and well-paid profession, but in fact, there is a deeper reason why Jewish mothers want a doctor son.
The value of health care is throughout our tradition. Our greatest rabbi, Maimonides, was a medical doctor, and doctors even have the authority to break the Sabbath strictures to care for the sick. We’re taught that “whoever saves a life, it is considered as if he saved the world.” How much greater nachas can a Jewish mother get?
The duty to heal the sick and provide for the poor are deep moral imperatives in the Jewish tradition. Combined with the biblical command to treat the stranger as yourself because you were once a stranger in a strange land, this duty transforms our obligations beyond the worthy interest in promoting the health and well-being of our own community. Our mothers can’t just want their children to be doctors to Jewish people, they must heal whomever is sick — Jew and non-Jew.
This element of Jewish philosophy makes the Jews’ stake in health care reform enormous. It is not just about providing insurance to millions of uninsured Americans — caring for children who might not get the vaccinations or the checkups they need, or diagnosing cancer or other diseases early, or making sure people don’t have to choose between bankruptcy and having a needed surgical procedure. For Jews it is about more; it is about holding true to our tradition.
After 100 years of trying to achieve comprehensive health care reform — an effort that started with Teddy Roosevelt and continued with FDR, Harry Truman and Bill Clinton — Congress finally passed the Affordable Care Act and President Obama signed it into law on March 23, 2010. Once and for all, the Supreme Court affirmed that the law, particularly the individual mandate, is constitutional.
That would appear to be the end of the discussion and, in most instances, it would be. But not today. Not in the age of 24-hour news cycles. Not during a divisive presidential election.
Yet in the midst of the chatter and the punditry, it’s important to focus on what matters most. As the president said after the Supreme Court’s ruling, “Whatever the politics, today’s decision was a victory for people all over this country whose lives will be more secure because of this law.”
Let’s be clear, the law has already produced significant benefits for average Americans. More than 5 million seniors have received an average of $600 in reimbursement for their drug payments because of the partial closing of the “doughnut hole.” More than 6 million young adults — many of them our children or grandchildren — are on their parents’ insurance because of this health care reform. Tens of millions of Americans have received preventive services — whether mammograms or other tests — without a co-pay because of health care reform. Millions of Americans have received checks from their insurers because they spent too much on administrative costs rather than on health services.
Because of this health care reform, children can no longer be denied care due to pre-existing conditions. Patients can’t lose coverage when they get sick. Insurance companies can’t impose lifetime caps on care or raise premiums without reason. Medical research will proceed faster, as insurers must cover the cost of participation on clinical trials. And all of this reform comes while still allowing preserving the traditional physician-patient relationship.
And 2014, the launch of the insurance exchanges, promises even more. No American will face denial of coverage or exorbitant premiums because of a pre-existing condition. Women will not have to pay more than men for the same insurance. And most important for Jews, 30 million Americans will gain access to health insurance.
These changes will save lives. They will perfect our union and help repair our world. Yet Republican leaders want to reverse course.
Since the Supreme Court’s decision, we’ve heard presumptive Republican presidential candidate Mitt Romney call for full repeal of the law. Senate Republican leader Mitch McConnell said that extending coverage to 30 million uninsured Americans is “not the issue.” Leading Republican governors have pledged to refuse additional funding for Medicaid — funds to secure medical care for working families, low-income workers, children and seniors.
Republicans claim they want to repeal and replace the Affordable Care Act. The fact is they have never once offered a coherent “replacement” alternative plan to the ACA that controls costs, provides care to the uninsured and incentivizes better quality care. “Repeal and replace” may be good rhetoric, but unfortunately it is not backed up by any real substance. As Jews, can we really accept living in a country that denies tens of millions of our citizens access to health care insurance? Can we in good conscience let our children — and our neighbors’ children — go without vaccinations, checkups and care for the simplest of ailments?
President Obama courageously championed health care reform. He understood the moral imperative.
Because he led, millions of families will now be part of the health care system and Jewish doctors will better be able to fulfill their obligations to help save the world. And Jewish mothers can be prouder still that their sons — and daughters — can care for all Americans.
(Dr. Ezekiel J. Emanuel chairs the Department of Medical Ethics and Health Policy at the University of Pennsylvania.)