charliehall

A600KiloBear,

Your last posts clearly show you do not know what is going on in the system today. Millions of Americans risk death because they can’t get insurance at any price — including a lot of folks who “work for a living”. Furthermore, private insurers have just as big a problem with fraud as do Medicaid and Medicare — they just don’t have the resources of US Attorneys to investigate it, and in most cases it is not a specific federal crime but simply something that would be dealt with under state commercial or insurance statute. Hence when a provider gets caught it doesn’t make the headlines. And you seem to be as disconnected to reality when you rant and rave about government insurance — the HCR bill that passed the Senate creates no new government insurance program.

I think this thread has reached its natural end; there really is no point in arguing over something that isn’t likely to be part of healthcare reform. I’m signing off.

I could be wrong, but I think the public schools simply confiscate the phone if they catch it.

“it is a strin at best to try and say that the mitzva of Hshovas Aveida require Government Helth care”

Rabbi Tendler never said that. And neither did I. He said we have to provide health care for all. Israel and France do it without a government insurance plan.

“As to why No one replied to Dr. Tendler, well in many Halachic circles he is not taken seriously especially since he tried to abolish metzizah bpeh. “

If you would read what he has published on that issue, you might just want to abolish it as well. It puts the lives of children in danger!

In any case, he is the single most respected expert in medical halachah outside of Israel and most frum physicians follow his Torah.

“we have our networks which ensure that medical care is paid for (RCCS, ROFEH International, the Syrian model organization, etc, etc etc). “

Those networks are too small to ensure that even all Orthodox Jews get care.

“What is needed is less government intervention and more incentives for more such hospitals and care organizations to be formed”

Your ideals are sound. Your arithmetic doesn’t work. To insure every Jew in America would cost billions — more than we spend on Jewish Day Schools! And we can’t even afford all the schools. Shall we tell the rabbis to close all the schools so that we can pay the health care bills, sending our kids to public schools?

People just don’t understand how expensive health care is.

“Sodom, on the other hand”

Sodom was where the poor were not helped by the rich. And in America, if you don’t have health insurance, you aren’t likely to get helped. Private charity funds don’t even begin to cover the needs. People die from lack of insurance, and the bills in Congress are the closest we’ve come to remedying that situation.

‘So sad that defenders of “health care reform” (a misnomer; I would use the term “health care erosion”) have not been able to rebut basic questions challenging this mess. ‘

I’ve rebutted them; it is just that some folks don’t want to admit that the consequences of the current system are that people are dying from lack of access to health care.

“Is the health care bill forcing me to buy an American health insurance that I don’t want nor need?”

You may not want insurance, but unless you are a millionaire, you need health insurance if you live in America. Period.

“CharlieHall, Where did you go? “

I’ve been busy writing a grant proposal. I’m also trying (and failing) to spend less time on the internet on non-work related matters.

baltashchis,

You make a great point about having a rav. A rav is not just someone you ask shilah’s about kashrut! When I was dating I consulted frequently with my rav. My wife and I met on frumster.com with no shadchan, but between the time we connected and the time we met in person we each talked with the others’ rabbis. I would think that a frum person who doesn’t have a decent relationship with at least one rabbi would not be all that frum.

Ben Levi,

My wife paid exactly the amount she was quoted by that company.

I never saw that rebuttal. Have you sent it to Rabbi Tender?

Regarding the past, back then healthcare didn’t cost much. We didn’t have MRIs, cardiac bypass surgery, cancer drugs costing $500/dose, hip replacements….If you want to go back to those days, feel free.

heimesheyid,

“1) the top specialists will look elsewhere for work since it wont be worth it for them with this new healthcare plan?”

Already we see “top specialists” refusing many insurance plans. The new law will not change that (for better or for worse).

“2) Waiting times for specialty doctors will be much longer since the incentive to please will be lost?”

The waiting times will be reduced from forever to finite if today you are one of the millions of uninsurable Americans. But in any case it isn’t clear that the US needs anywhere near the number of specialty physicians it now has. The New York area has far more specialists than do other parts of the US, but it isn’t any healthier than many of those other areas and health outcomes aren’t any better. Other countries have even fewer specialists yet have better outcomes. For all the common serious chronic diseases, a well trained primary care physician can manage patient care just as well as specialists, who really are needed only when the patient does not respond to standard treatment.

Also, it is not clear that how pleased a patient is with his/her physician has any association with health outcomes.

I don’t know what the change will be. I’m not even sure that I will able to be in Eretz Yisrael because even Mashiach won’t repeal torah prohibitions and my wife will still need to pay her medical school debts which she would not be able to do in EY. All I can do is to keep learning and doing mitzvot, and praying that I’ll be part of the generation that finds out what the change will be!

Ben Levi,

You are incorrect regarding the cost of malpractice insurance. In four of the five boroughs of NYC an “occurence” policy for an Ob/Gyn costs $163,269/year. In Manhattan the cost is $137,642/year. It took me less than five minutes of internet searching to get those quotes online, from Medical Liability Mutual Insurance Company. That is still high, but it isn’t a million a year or even close to it. I’ve much prefer a system like Canada where (1) it is almost impossible to win a malpractice case against a physician, and (2) there is no need to go to court for medical treatments because it is all covered by the provinicial health insurance!

You are correct about medical tourism, however; the example I gave of El Paso/Juarez is precisely the effect you mention: Texas has more uninsured citizens than any other state so they go to Mexico for care they can afford. (That also shows that tort reform is inadequate to fix the system; Texas has some of the most draconian limits on medical malpractice cases in the US but it continues to have the most dysfunctional health care system.)

Mom12,

You are correct that people come to America for medical care. One reason is that since it is a large country, there is more likely to be a specialist who is expert in a particular rare diseas. But people also go to other countries. The late Sen. Spark Matasunaga went to Canada for cancer treatment even though he could have received free care anywhere in the US. More recently, Americans have been going to Mexico for medical care. One recent study found that a third of residents of El Paso, TX went to Cuidad Juarez, Mexico, directly across the Rio Grande, for medical care but only 5% of Juarez residents went to El Paso! A major reason for the discrepancy was that only 59.6 percent of El Paso residents were insured but that 82.8 percent of Ciudad Juarez residents were insured.

Americans having to go to Mexico for health care because of lack of insurance! We should be embarassed!!!

First, to be a mentch.

If you aren’t that, nothing else really matters.

A600KiloBear,

“proper moral standards” means taking care of those who are less well off. At least that is what Judaism says. The moral standards of Sedom would leave them to die for lack of health care, which is what is happening now.

Ben Levi,

Your statement of “government takes over” is false and misleading. And you know better. The Senate bill provides for a massive expansion of private health insurance. You know that.

Regarding “proper health care” for someone who is ninety that is a nontrivial question. We don’t usually recommend aggressive cancer treatment, for example, for someone that old, because the improvement in life expectancy is miniscule even if the treatment is successful.

And as I said before, I don’t want people to go into medicine because it makes a “comfortable living” certain. I want students who are dedicated to serving HaShem and their fellow humans. And I am very proud of my students, almost all of whom fit that description. They will make great doctors!

haifagirl,

Taxes and insurance premiums are going up in part because there are so many uninsured Americans getting emergency care. I guarantee you that if you were uninsurable and got sick you would not mind paying higher taxes.

richthefurrydoc,

Rabbi Dr. Moshe Tendler has stated that there is a chiyuv on the community to provide health care for all. I have seen no posek disagree. Israel does so with the total support of the religious parties.

A600KiloBear,

Funny you mention COBRA which is a government subsidized mandate, and Medicaid which is a government run insurance program. I thought you didn’t like government programs?

And “Community assistance” simply does not exist. There is no fund that guarantees the medical bills of any Jew who can’t pay. And the cost of creating such would be greater than the cost of every yeshiva in America put together.

And your choice of Teddy Roosevelt is poignant: He endorsed National Health Insurance 97 years ago. (And his foreign policy was not anything like what the founding fathers would have dreamed of.)

Squeak,

Bare bones policies with high deductables were a Republican alternative that was rejected by the House of Representatives. The plan would have overridden state mandates and would have continued to allow insurers to reject people with pre-existing conditions. The Senate Republicans were too embarassed to bring it up for discussion.

Justin2,

The insurance companies are already raising prices because costs continue to soar. And you are correct that the Senate bill contains no real attempt to control costs: No serious review of coverages, and no public option to serve as a standard of coverage. It was mostly the right wingers who forced these things to be pulled from the measure, because cost control means denial of coverage and the right wingers scream “rationing” or “death panel” anytime there is any attempt to control costs. It is disingenuous to complain about high costs but then to turn around and to oppose the exact things that would control costs.

I post under my real English name because I am less likely to post lashan hara when I have to publicly take responsibility for my comments.

I would not put something inside my body that an individual pharmacist compounded. There is essentially no regulation of their labs for safety, purity, etc.

That said, there actually are a lot of complementary and alternative therapies that do work. Unfortunately there has not been adequate research in part because there is no incentive for the people who market these therapies to do the research and as a result one can not always tell the difference between snake oil and something that can help a condition.

rabbiofberlin,

Anti-Semitism in Europe was a problem before Islam even exited. Europe has done a terrible job at integrating immigrants into its societies even though the numbers are small relative to the US. (3 out of every 8 residents of New York City were born outside the US and the immigrants are making huge contributions to our society as immigrants have for hundreds of years.) Europe’s problem isn’t Islam, it is xenophobia, racism, and good old fashioned anti-Semitism.

Ben Levi,

Have you ever spoken with a posek about abortion? My wife asked one whether it was permissible for her to teach medical residents how to perform an abortion. To her surprise (mine, too) the answer was yes, because some abortions are mandatory under halachah and therefore we must train physicians in how to perform them.

The fact is, the vast majority of poskim do not consider abortion to be murder. (IIRC, Rabbi Moshe Feinstein was a daat yachid here.) For Jews it is not a capital offense even when prohibited. Some poskim even permit aborting a child with a chromosomal defect; Rabbi Eliezer Waldenberg z’tz’l was as prominent a posek in Eretz Yisrael as Rav Moshe and he permitted aborting a Tay-Sachs fetus and recently Rabbi Shlomo Aviner permitted aborting a Down’s syndrome fetus. For non-Jews it can be a capital offense but so too theft of less than a pruta! Our religion does not view abortion the same way as the Catholic church which treats a fertilized ovum as a full human (hence their opposition to the assisted reproductive technologies we frum folks support) not the same way as the mainline Protestants who do not see abortion as inherently evil at all.

Furthermore most administrations of capital punishment in the US would likely be murder because the administration of death penalties here does not meet even the minimum Noachide standards, such as the requirement for an eyewitness. Do you object to your tax dollars going to prosecutions?

Bemused,

You have just made the argument for a single payer system that will cover everyone. There really isn’t any justification to have you slightly above a threshold and getting nothing. But since we aren’t willing to have a single payer system, you are stuck.

gavra_at_work,

You are completely misinformed about the Canadian system. Most physicians in Canada are actually self-employed. My wife and I met a Canadian family physician last winter and the picture he painted of the Canadian system was so favorable we investigated emigrating there. Basically, he NEVER has an insurance company deny coverage for something he recommends, he NEVER has to worry about not getting paid, he NEVER has to worry about his patients being able to afford the treatments he recommends, and he doesn’t have to worry about getting sued, either!

rabbiofberlin,

You clearly were not paying attention. Two days after the minaret vote, the leader of the mainstream conservative party in Switzerland — not the nutty far right People’s Party — proposed banning Jewish and Muslim cemetaries because they were segregated.

And I don’t think Christians should be prohibited from wearing crosses. When I teach medical students I wear a black velvet yarmulke and I am glad that I live in a country that lets me do that.

And Europe is not being Islamicized. No country in Central or Western Europe has more than a 9% Muslim population according to both the Pew Foundation and the CIA World Factbook. When I was in Spain I never found a single Muslim building, or a single Muslim. I did see a beautiful mosque in Ireland but the only Muslim I found was an Jordanian professor who was attending the same conference I was attending.

Regarding Jewish schools accepting non-Jews, that was necessary to continue to receive government funds because the schools are too small to operate with the small number of Jewish students. If you take government funds, you accept government rules — and there would be no Jewish school without those government funds. In Ireland, that would mean Jewish students would have to attend schools run by Christian churches as essentially all schools in that country are run by churches. The community determined that it was better to have a school run by Jews even if non-Jews attended. (And while I was there I met a Christian Irishman who proudly he told me that he went out of his way to send his kids to the Jewish school because he thought Jews would give his children a better education!) I don’t know much about the situation in Spain.

Ben Levi,

Health care for the elderly in the US is almost entirely paid for by a government health insurer and has been for 44 years. This will not change under any plan under consideration. Thus your concern about end of life care is not necessary. And yes, it would be cheaper to replace private health insurance with a government plan, even for congressmen — Medicare is the most efficient health insurer in America and Medicaid is second — but that isn’t going to happen.

tzippi,

Health care is and has been “rationed” ever since the first health insurance plans were created about 70 years ago. The question is, how should it be rationed. Right now, if you don’t have insurance, you have been rationed to almost no care except immediate life threatening emergencies. Private health plans and Medicare deny coverage all the time. (My wife, a family physician, tells me that NY Medicaid has never denied coverage for any treatment she has recommended, so maybe that should be the model for coverage? But NY Medicaid is very costly.) The issue of mammography is about using the best scientific evidence for medical decision making, and unfortunately there has never been any evidence to support mammography screening in the general population for women under the age of 50. The US Preventive Services Task Force should never have recommended it when they did, and they were absolutely correct in changing it to something more sensible. (The best studies don’t even show that mammography screening saves life in women *over* 50; I can post the evidence if there is interest.) The situation for prostate cancer in men is about as disappointing. The situation is very depressing but we can’t allow politics to interfere here as some pro-screening advocates want to do.

Here is my summary of Rabbi Dr. Tendler’s comments, from a shiur given September 10, 2006. The original is online at YU’s Torah site. (YWN does not permit outside links, even to other Torah sites.) Translations from 1917 JPS (in public domain). All errors are mine.

Exodus 21:18-19.

?? ?????-???????? ?????????–????? ???-????? ???-???????, ???????? ??? ?????????; ????? ??????, ??????? ???????????

And if men contend, and one smite the other with a stone, or with his fist, and he die not, but keep his bed;

?? ???-?????? ????????????? ???????, ???-???????????& #1493;?–???????? ?????????: ??? ????????? ??????, ???????? ????????

if he rise again, and walk abroad upon his staff, then shall he that smote him be quit; only he shall pay for the loss of his time, and shall cause him to be thoroughly healed.

— This means that we are supposed to get real healing from real doctors, and not just accept illness as God’s will.

Deuteronomy 22:2

? ?????-??? ?????? ??????? ???????, ????? ??????????–???? ????????, ???-?????? ????????, ??????? ??????? ??? ??????? ??????? ?????, ???????????? ???

And if thy brother be not nigh unto thee, and thou know him not, then thou shalt bring it home to thy house, and it shall be with thee until thy brother require it, and thou shalt restore it to him.

This means that if someone can heal someone else, one must try to do so.

Leviticus 19:16.

?? ???-?????? ?????? ???????????, ??? ??????? ???-???? ??????: ?????, ??????

Thou shalt not go up and down as a talebearer among thy people; neither shalt thou stand idly by the blood of thy neighbour: I am the LORD.

This means that even if you can’t heal the sick person, you must find someone else who can rather than standing idly by — even paying for the healing. In other words, we have to provide healthcare for all!

rabbiofberlin,

The Jewish schools in Spain and Ireland accept non-Jews.

I completely and totally oppose the Swiss vote. Saudi Arabia is not any kind of model for any enlightened community to follow. To the contrary we should be strong supporters of the rights of other minority religions in the diaspora because we are all potential victims of the majority. And this is clearly true in Switzerland, which banned shechita decades ago, and in which there is already a serious proposal to ban Jewish and Muslim cemetaries. We should listen to the European Conference of Rabbis; they know the situation in Europe far better than we do.

I just called a colleague who is a frum neurologist specializing in epilepsy with many frum patients. Unfortunately, she did not think there is any support group for Jews with epilepsy.