Living Our Jewish Values: Health Care

Rabbi Joel Fleekop

Friday, December 8, 2006

The carefully guarded list of those who have stayed on the ninth floor is a veritable whose who of Hollywood. And alongside the names of actors and producers are those of famous politicians--American and foreign, the global economy’s most successful CEOs, and even royalty. They come to the ninth floor for its unparalleled privacy and confidentiality, but above all for the services available. Services so good that they make the room’s nightly rate, higher than almost any hotel in the world, worth paying.

The 9th floor is not, as you might be imagining, a section in a super-swank hotel. The 9th floor is part of the UCLA Medical Center and those who stay on it have more than wealth in common, they are all dealing with serious illness.

They come to UCLA Medical Center, just like they come to Stanford, UCSF, and a handful of other American hospitals, from around the globe to receive the most cutting edge and comprehensive care. They come to the leading hospitals in the United States because it is at these American hospitals that the world’s best health care is available. And that is what they receive.

One summer during seminary, I worked as a chaplain intern at UCLA and it was my job to visit with patients on the ninth floor, though unlike all other floors in the hospital, I visited there only by request. I remember one afternoon when, as I was finishing up a visit in one of the floor’s private rooms, I was paged to the emergency’s waiting room.

There are only eight levels between the exclusive ninth floor and the hospital’s emergency room but they seemed worlds apart. Making my way into the emergency room’s waiting area I was struck by the number of people waiting to be helped. I was also struck by how many of them were children.

Despite the room’s title, those waiting weren’t all there with emergencies. They mostly had runny noses and bad coughs.

The woman I had been paged to see was there with her teenage daughter. She had brought her daughter, I’d guess about 14 years old, in because of a persistent infection under her nail. We had a brief visit during which I learned the mother was very involved in her Pentecostal church. I also learned that they had been waiting to see a doctor for 3 hours. I thought the length of their wait appalling, but, as the mom explained, they came to UCLA because the wait at other hospitals tended to be much longer.

They, like so many others in the waiting room, were there not because they had an acute emergency but because for them, a family without insurance, the emergency room was the only door through which they could enter the American health care system.

Unable to call up a doctor and make an appointment, it is likely that the mother and daughter I met with waited longer than most before deciding to have an infected nail examined. It is also likely that they aren’t getting annual physicals, having their blood work done, or getting other tests that can provide early detection of cancers, heart conditions, and diabetes. The fact that the family is uninsured and only able to see a doctor in the emergency room is coming at a great cost to their health.

It is coming at great cost to their health but it is also coming at a great cost to the health care system and local governments.

As California State Senator Sheila James Kuehl explains in the current issue of Tikkun magazine, “hospitals bear the brunt of this over-reliance on ERs, not only because facilities are overused and patients have to wait to be seen, but also because many of the patients treated in ERs are not insured and cannot afford to pay for the care they get.” The absorption of these costs jeopardizes the sustainability of hospitals and, as Kuehl suggests, contributes to the growing number of hospitals closing their doors; a trend that puts at risk the health of all Californians, insured and uninsured alike.

Legally obligated to care for the indigent, county government coffers are also being pushed toward the breaking point by medical costs. As noted in the Mercury News on November 24th, last year Santa Clara County spent $184 million dollars providing care to the uninsured. Adding insult to the injury of this astronomical sum is the reality that many of these dollars were spent treating acute illnesses and conditions that could have been avoided at a fraction of the cost if people had received proper preventative care.

Recognizing the costs -- financial, medical, and emotional -- of having so many American citizens unemployed, the UAHC, at both its 1987 and 1993 Biennial Conventions called for state and federal legislation to be enacted that would guarantee all Americans essential-health care coverage and insurance. Though a national or California wide program still seem a long ways off, proposals for bringing health care to the uninsured are gaining momentum on the local and county level.

One such program, which has caught the attention of the Shir Hadash Organizing Committee, is a three payer system designed to bring health coverage to low-income workers. We believe that the implementation of this plan, predicted to bring coverage to 5,000 uninsured adults in the first year, will not only strengthen our county but will help us live according to the teachings of the Jewish tradition.

The Talmud teaches, “Whoever is in pain, lead him to a physician.” Based on this passage, the rabbis teach that people should live close to a doctor in case they are ever in need of medical attention. Santa Clara County has some of the best doctors in the world, but for those without insurance, the distance to the doctor across town or across the street is seemingly unbridgeable. We are obligated, Maimonides’ Mishneh Torah teaches, to eliminate whatever barriers, whatever distance exists between our neighbors and the care they need; care Maimonides clearly understands to include both emergency treatments and preventative checkups.

The three payer system promises to do just that. By combining the voluntary contributions of workers and small business owners with public funds already being spent on health care, it will offer our neighbors affordable access to the care they need without increasing the county’s financial burden. Because of this, a November 16th Mercury News editorial, copies of which are available in the lobby, called the creation of the program “the no-brainer of all no-brainers.” But as we know, things are never that simple when politics are involved. On February 12th Shir Hadash will be holding an action to rally support for the program and I hope you will be able to join us.

A few summers back, a brief elevator ride at the UCLA medical center highlighted for me the two sides of our health care system. On one end, the 9th floor, I saw doctors and nurses, as well as new technologies and innovative procedures all coming together to make our health care system the best in the world. And on the other end, just eight floors below, I saw people who live without preventative care, people who when they need medical attention have to wait hours to see a doctor.

Every American deserves the best the U.S. health care system has to offer and we have a role to play in making that a reality. Let us raise our political voices to proclaim the values of our tradition and let us work to bring the blessing of good healthcare to all of our neighbors.