against Dorff's view on universal health care

David Klinghoffer

In the always lively Jewish Journal of Los Angeles, Rabbi Elliot Dorff writes in a cover essay that "support for universal health care is an imperative in Jewish law." Is it now? On health care reform, Rabbi Dorff has his classical sources all lined up -- most having to do with obligations on the community to rescue its needy, the captive, and those otherwise endangered. The communal court system can compel a person to give charity in support of the poor. Proper medical services are a necessity in a Jewish community. And so on. Whether through socialized medicine or government health insurance, something must be done: the fact of there being 40 million uninsured Americans is "intolerable."

Do you notice how many times the words "community" or "communal" appear in the foregoing paragraph? Rabbi Dorff is chairman of the Committee on Jewish Law and Standards of Conservative (i.e., liberal) Judaism. He knows that Jewish laws of the kind he cites are specifically communal laws. They were never envisioned as applying en masse to a non-Jewish country of 300 million people. Liberal Jewish analysts often lose sight of this simple fact. So too in the abortion debate where, simply put, Jewish law for Jews is more liberal on abortion than Jewish law for Gentiles. We are more protective of the unborn non-Jewish life. In Torah, there are separate legal tracks -- the Mosaic and the Noachide, for Jewish and Gentile communities respectively. Yet liberal Jews invariably cite Jewish abortion law, not the Gentile one which makes abortion a death penalty offense. They forget that we live in a non-Jewish country.

Even apart from this, your local Jewish community and the United States of America are incommensurable in many ways. There are three key things about a religious community. It is small in size. It's homogeneous. And it's voluntary. The three together make the provision of welfare benefits to members of the community an affordable proposition. None of these are true in the far, far vaster and incomparably more diverse context of our country. I mean, is this not obvious? Practical considerations like this have led Connecticut's independent senator, Joseph Lieberman, an Orthodox Jew, to call for putting off radical health care reform till we can afford it.

If you object that I myself have extrapolated from Jewish to American law many times here in this blog and in my book How Would God Vote?, my answer is that I always try to take care about making clear it's the philosophical principles behind the laws that can be extrapolated, not the laws themselves. That way lies the road to theocracy.

When it comes to caring for the needy, there are not one but two major Jewish philosophical principles at stake. One is the obligation to provide for the poor. You don't need any detailed presentation of rabbinic statutes to know that this would apply to the area of health care. It's right there in the book of Ezekiel. The prophet chastised Israel's rulers, her "shepherds" for "tending themselves" while ignoring the needs of the flock: "the frail you did not strengthen; the ill you did not cure; the broken you did not blind" (34:2,4).

Counterbalanced with his, however, is the Torah's overwhelming emphasis on personal responsibility. Apart from being beyond our country's current means, one problem with government-run universal health care, which is where ObamaCare would inevitably tend, is that it relieves not only the poor but everyone else of their responsibility to see to their own health needs. Rabbi Dorff mentions the "intolerable" plight of the uninsured. How many? The figures you hear from the Left are deceptive because, among other things, they include people who for whatever reason -- because they are young and healthy, or maybe older and foolish -- think they can get by without insurance.

Truly universal health care would mean mandating that everyone be insured. How else can we all share the burden of paying into the common insurance pool if the healthy or imprudent opt out? In the last election when Democratic candidates were vying with each other to spell out their visions for socialized medicine, John Edwards even wanted to mandate regular medical checkups! Compelling what seems to be common sense, precluding the individual's freedom to take his chances if he prefers, places "universal health care" on the list of those other liberal political notions that foreclose free choice and moral responsibility. I've argued before that the common denominator linking most of the standard liberal policy preferences is a discomfort with the responsibility of an adult to make free choices for himself. (Abortion, of course, is a choice a woman makes for herself but also for the other person in her womb, who if he could speak would likely opt for a pro-life stance.)

The most important word in the Jewish vocabulary is mitzvah, commandment. The idea of a commandment assumes choice -- taking responsibility for yourself. When good choices are compelled, they loose meaning. Supporting the poor is such a choice. When it's forced upon us, the moral significance of the mitzvah is lost.

I wrote earlier about the idea of ritual contamination -- tumah. As Rabbi Samson Raphael Hirsch explains it, tumah comes from experiences that convey the powerful but erroneous impression that we are not free and therefore not responsible. The classic instance is contact with a corpse. Bound by materiality, its spark of divine spirit having fled to rejoin the Creator, a dead body has the power to hypnotize us with the impression that we ourselves are unfree. Nothing could be more morally perilous than taking such an idea to heart.

Hirsch wrote, commenting on Leviticus (11:46-47): "All these [contamination laws] are truths which, in the face of human frailty and the powers of the forces of nature which the appearance of death preaches, are to be brought again and again to the minds of living people, so that they remain conscious of their unique position of freedom in the midst of the physical world, and remain forever armed in proud consciousness of their freedom, armed against the doctrine of materialism."

Any truly Jewish approach to caring for the sick and needy would keep in mind the imperative to avoid conveying tumah to the rest of us while we are at it. On the other hand, market solutions to problems like our health care "crisis" have the virtue of casting citizens not as helpless children but as responsible adults. That's the Torah's way.