Saturday, July 7, 2012

Health Care Reform

In Dan Brown’s “The Lost Symbol,” the third book in the trilogy that also includes “Angels and Demons” and “The DaVinci Code,” protagonist Robert Langdon quips that he is on his way to take part in a blood-drinking ritual while kneeling at the foot of an ancient torture device.  He refers to his weekly communion.

Symbols fascinate me.  I am often entertained to learn the origins of a society’s symbol or the meaning behind symbols I thought I understood.  One of the more common symbols of modern medicine actually is derived from this week’s Torah portion.  We read in Numbers 21:5-9:

The people spoke against God and against Moses, "Why did you make us leave Egypt to die in the wilderness? There is no bread and no water, and we have come to loathe this miserable food."  6 Adonai sent venomous serpents against the people. They bit the people and many of the Israelites died.  7 The people came to Moses and said; "We sinned by speaking against Adonai and against you. Intercede with Adonai to take away the serpents from us!" And Moses interceded for the people.  8 Then Adonai said to Moses, "Make a seraph figure and mount it on a standard. And if anyone who is bitten looks at it, he shall recover."  9 Moses made a copper serpent and mounted it on a standard; and when anyone was bitten by a serpent, he would look at the copper serpent and recover.

The serpent has long served as a symbol of healing.  It is thought that the serpent-pole described in our parashah influenced the Rod of Asclepius, held by the Greek deity associated with healing and medicine.  Perhaps this is because many antidotes for snakebites are made with a small amount of the venom from said snake.  A lesson from nature that the very same medicine that can hurt can also heal.

We are hearing a great deal about the Supreme Court decision to uphold most of the Patient Protection and Affordable Care Act, colloquially known as Obamacare (which I can't decide if it is a pejorative or a compliment).  Allow me a brief summary:

This act, signed into law in March 2010, provides a great deal of support to lower income families and individuals who are seeking and using health insurance.  Some highlights:

·         Insurance companies are now required to offer the same premium to all applicants of the same age and geographical location without regard to most pre-existing conditions

·         An individual mandate has been established, requiring everyone to be a part of an insurance program, choose a program, or pay a penalty.  

·         Medicaid eligibility has been expanded.

·         Insurance exchanges will be established, and individuals purchasing insurance at these exchanges will receive federal subsidies.

·         Minimum standards for health insurance policies will be established and coverage caps will be banned.

·         Firms employing 50 or more people but not offering health insurance will pay if the government has had to subsidize an employee's health care.

·         Co-payments, co-insurance, and deductibles will be eliminated for preventative care.

·         Chain restaurants with 20 or more stores will be required to post calories, fat content, and other health information on their menus.

But how do we fund such wide-spread generosity of our government?  Well, a series of taxes are also written into the bill.  High income taxpayers have a larger Medicare rate.  There is an annual fee for health insurance providers.  People with excessively high health insurance policies will pay extra taxes on the higher coverage.  There are also fees and tax increases on other entities such as drug manufacturers and medical device producers, as well as a raised floor on medical expenses deductions.  (**This is why we have been hearing anti-PPACA commercials that claim the law will raise taxes.  They will, but not on most people, and certainly not on much of the middle class.)

So there are good things on the bill and bad things on the bill.  Money that people don’t want to pay and health care that people previously couldn’t pay for.  It makes sense that the way we have chosen to symbolize health care is with the serpent.  That which can heal can also harm, apparently.

In reading through the Patient Protection and Affordable Care Act, it is really difficult for me to understand what the problem is with this bill.  Perhaps that is because I read it from a Jewish perspective.  According to Maimonides’ Mishneh Torah, health care is first on his list of the ten most important communal services that a city should offer its residents.  According to Joseph Caro, the writer of the Shulchan Orech, a health care provider who withholds services should be perceived as shedding blood.  And in the Talmud, six of the ten things listed as necessary for a town to provide its residents have to do with health care.  To the Jewish people, providing health care to the community is of primary concern, and is the responsibility of the entire community.

Rabbi Eric Yoffie wrote in the Huffington Post, “We are seeing the end of a pitifully inadequate health insurance system that caused horrors every day so tragic that they could rip the heart out of a stone. The American people no longer need to fear that every one of us could lose our health insurance at any time.”  With Rabbi Yoffie, I say, thank God for the wisdom of the Supreme Court of the United States of America.  Thank God for their echoing of Jewish values and American ideals.

May we be able to hold back the serpents who will bite at the heels of this law in the coming months and years.

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