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Health Care: Who is Responsible? Akiva Institute, 1998

It must be noted at the outset that Judaism tends in general not to focus on government and the ethics of government but of people.  The question is what lesson is to be learnt from that? Does it mean that there is no separate ethic for a government, and a government is as obligated to care for the poor as the individual or does it mean that there are no rules, guidelines, or moral obligations for a government as such, and that all ethics are left for the individual?  

However, even if we were to maintain that “the government” is not a distinct ethical entity, wouldn’t anyone in a position to help others by virtue of being in government be obligated to do what they could from their seat of responsibility? 

To be more accurate, there are some guidelines for public health which are outlined in the Talmud. The mishna in Talmud Moed Katan 5a states, Metaknim et hamekulkalot bamoed,  the community can fix a road, even during the quasi holidays of the intermediate days of the holidays of Pesach and Succoth. If they don’t fix the road, says the Talmud, vehyaah alecha damim, the verse in  Deut. 19 is interpreted to mean that the blood would fall in the hands of the community.  

Actually, Maimonides counts as one of the 613 commandments to remove all danger from the community. 

However, one might argue that this very question as to whether government is party to all ethical obligations or whether it is somehow non entity of sorts, is actually a dispute in the Talmud. “Kol haamur beparashat melech, melech mutar bo, asur bo.  In Sanhedrin 20b, the Talmud cites all the horrible things Samuel said a king  might do to the people, such as take their children as a tax, take their fields and the like. There is a Talmudic dispute as to whether the prophet Samuel was telling them that ultimately the king is above the law or that this is just the way kings often wrongfully act.

Jewish law has decided in favor of those who say that the government does have extra legal rights. However, this does not exempt the individual leaders  as individuals from the wrath of the prophets such as Isaiah who complained that the judgement of the widow never came to the leaders presumably because there was no money in it. The individual cannot hide behind the title government and exempt himself from moral obligations.

However, in terms of allotting resources, there are often limits, for instance generally government would try to extricate a captive, cuz as maim. Says, he is among the “Hungry and thirsty and in danger of life, one who lifts his eyes from them violates “save those taken to death and love thy neighbor.

There is a communal obligation of pidyosh”,  but not yeter al dmeyhen, mipniei tikkun haolam.

The idea that the community should as  part of being an all service community, have health care is stated in Talmud, Sanhedrin 17: A person should not live in a city that doesn’t have a doctor, a synagogue, a charity fund, a court, a school, but it doesn’t; state who will  pay for it. It assumes that the community will pay for the doc, but that the community should see to it that there is a doctor. 

Finally, in a strange mix of religion and medicine, one could argue that the institution of Taanit is a form of health care…If many people in a city come down with a disease then it is a public sorrow and the community must fast. An ancient and still effective form of health care is to pray for the ill. This is an obligation of the communty. 

Who should provide? Individuals are obligated in charity,not governments, but whatever an official can do he must do as far as health care as far as charity health care, this would seem to devolve mostly on the individual.  But if it is not a great loss, the community would have to take it on, otherwise be obligated as spilling blood, but since it is of a great loss, I would say it is primarily a community responsibility.