The Silence of Religious Voices in the Health Care Debates

At the end of August, our nation witnessed the first full public conversation about health care reform and the Gospel of the Poor. In the celebration of Senator Kennedy’s life and accomplishments, clergy and laity joined in acknowledging that the Senator had made access to health care for all—regardless of wealth or station—his life’s work based on his understanding of the Gospels, his Roman Catholic faith, and his love for humanity. It was a very different conversation than those we have generally heard on the broadcast media or read in print, because it was about health care for real people in real need. It was a conversation about faith, morality, and compassion.

As a scholar of comparative religions, I was struck by the silence of other religious voices in our national conversation about health care. Where are the American Jews, the American Muslims, and all the other Christians? It is not that those traditions do not have doctrines and theologies about the poor. In Judaism, for example, there is the concept of tsedakah, mistranslated as “charity,” the rich giving to the poor. It really means “righteousness, justice, and piety” and is an obligation on every Jew, whether rich or poor. It is often linked with the notion of Tikun Olam, perfecting the world; that is, bringing about the righteousness, justice, and piety associated with tsedakah. It is said that one who does not perform tsedakah is the same as a worshiper of idols.

In Judaism, there are degrees of giving. The famous sage and scholar, Moses Maimonides, said that the lowest form of giving was to give reluctantly and grudgingly, not giving as much as one should, and giving so that the recipient knows that you are giving. The highest form is giving so that the recipient is self-sustaining. This is, of course, based on the tradition of the Hebrew prophets, such as when Isaiah says, “Cease to do evil; learn to do good; seek justice, rescue the oppressed, defend the orphan, plead for the widow.” (Isaiah 1:17)

In Islam, there are two kinds of giving to the poor, sadaqah (related to the Hebrew tsedakah) and zakat. The first is voluntary, and the second is required of all individuals by Islamic religious law, regardless of monetary circumstance. As in Judaism, charitable giving in Islam is meant to better the community as well as the individual recipients, and to share justly the bounties that have been given by God to the fortunate. In Islam, if you have more than what you need for your own sustenance and that of your family, you must share the excess with those less fortunate in the community. Muhammad said, “Whoever wakes up secure among his people, physically healthy, and has food for his day, it is as if the whole world had been gathered for him.” It is also an obligation incumbent on everyone, as Muhammad said, “Each one of you is a shepherd, and each one of you will be asked about your flock. A ruler also is a shepherd and he will be asked about his flock.”

For all Christians it is the same. Jesus’ admonitions to the rich and defense of the poor are values that Christians share with Judaism and Islam. So where are the American religious voices? President Obama has called on religious leaders and progressives to join the conversation—but what about the other religious, who may not identify as “progressive?” They may be silent because we are having the wrong conversation. We are talking about insurance, money, the economy, freedom of choice, and letting those already fortunate to have insurance keep what they have. We are forgetting that there is a distinction between health care and health insurance, between the economy and the health of the nation.

Children in America are twenty-five percent of the population but are thirty-five percent of the poor, and over thirty-five million individuals live below the poverty line. Many of those who have jobs are subsisting on poverty wages. Even before the collapse of the economy, more than twenty-eight percent of American families with one or both parents employed were living in poverty. This has a direct impact on health care. One in six adult Americans do not have insured health care, and over eighteen percent of children are without it as well.

Some argue that taking care of the large numbers of Americans in need of good health care will bankrupt the nation. In the ethics of both Judaism and Islam, it is wrong to give so much that one becomes a charity case oneself. For Islam, charitable giving is from the surplus of what one has. But even in these times, we are a wealthy nation and will become more so as the economy improves. What is needed is a national conversation about our moral priorities as a nation, even as we discuss our financial future. From the heritage of Christianity, Judaism, and Islam, it is wrong to leave so many in poverty and need.