Tuesday, July 18, 2017

Do the rich need to pay for the healthcare of the poor?

In a recent Huffington Post article, Rabbi Shmuly Yanklowitz criticized the Republican health care plan and puts forth what he asserts is the Jewish perspective.
Today, Senate Republicans unveiled their so-called healthcare plan—the Better Care Reconciliation Act—conceived in secret and designed to deprive millions of people access to affordable health care, while cynically giving tax breaks to the wealthiest Americans. These Senate Republicans, who so-often like to flaunt their spiritual credentials, would do well to remember the obligation to pay for the cure of a person who has a life-threatening illness: “From the straightforward reading of Sanhedrin 73a, we see that one is obligated to do everything to save him, and if not, one transgresses the negative commandment: ‘Do not stand idly by the blood of your neighbor’” (R. Shlomo Zalman Auerbach, Minchat Shlomo, V.2, 86:4).

Personally, I am not entirely convinced that Rav Auerbach is correct, that the obligation mentioned in Sanhedrin 73a of hiring others to save, in cases of external acute threat to life (such as drowning, mauled by beasts, attacked by robbers), would extend even to internal and chronic conditions*.  Or that Rav Auerbach's position is widely accepted.

Regardless, I always encourage people to look up the sources, because people on the religious or political right or left -- that is, a lot of authors out there -- can be tempted to take sources out of context. Here is what Rav Shlomo Zalman Auerbach actually writes:


"4: The obligation regarding expending money to save a sick person:
Regarding the obligation to finance the costs to save the life of a dangerously ill person, from the straightforward reading of the gemara in Sanhedrin 73a we see that he is obligated to do everything to save him, and if not, he violates the prohibition of 'Do not stand idly over the blood of your fellow. (In my humble opinion, it is obvious that the sick person himself is obligated afterwards to repay him.)  
And if it be said that upon this prohibition, which requires an action, there is no obligation to despoil all his wealth, still, a tenth or fifth he is still obligated. And in this particular case, it seems more logical that this prohibition is much more severe, and indeed he should be required to despoil all his wealth..."

And it continues, but I am going to stop here.

Since Rav Auerbach writes that obviously the sick person must pay back, the idea seems to be that if these medical expenditures are holding up the procedure, that the wealthy (or really, anyone who can provide the money) must provide it to save the life. But that does not mean that the poor sick person is not on the hook for the expense. Rather, 'it is obvious that the sick person himself is obligated afterwards to repay him'.

Therefore, I am not sure that this would be a convincing argument to those wicked corrupt Senate Republicans who really want to oppress the poor, but on the other hand want to listen to Gedolim.

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Footnotes:
* While we don't make such distinctions nowadays, there is a tension between 'verapo yerapei', you shall surely heal him', and the criticism of King Asa for going to doctors, and a distinction is made between internal vs. external. See Ramban, Ibn Ezra, Rabbenu Bachya.

Monday, July 17, 2017

Praising those with whom you disagree (Bava Basra 176)

Today we finish Bava Batra. The Mishna (on the previous page) recorded a dispute, in a practical case, between Rabbi Yishmael and Shimon ben Nanas. After Ben Nanas presented his argument, Rabbi Yishmael praised Ben Nanas to the heavens:

To become a Chacham, one should study monetary laws. It is the greatest field in Torah; To learn monetary laws, one should study under Ben Nanas.

With such high praise, one might think that Rabbi Yishmael retracted. However, the gemara reports (via Rabba bar bar Chana) that not only did Rabbi Yishmael still hold firm in his position, the halacha is like him. And it turns out that even in the case of promise of repayment to save the borrower from choking, which was the comparison Ben Nanas offered, and which Rabbi Yishmael praised -- even there, Rabbi Yishmael disagrees, and the halacha is like Rabbi Yishmael.

This is a nice way to end a masechta, and is fitting for the three weeks. We can learn from Rabbi Yishmael's example. Even when we believe someone's halachic positions are wrong, we can still be polite to them, and even praise their character or thought process. All the while, holding true to what we believe is the correct halacha. And such niceness does not mean that we will lose the day.

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Some thoughts about Rav Papa, especially after seeing the Rif and the Rosh. We saw on the previous daf that the Amoraim of Bavel were all aligned to say that Shibud is not Biblical, while all the Amoraim of Eretz Yisrael were aligned to say that it was Biblical. And when, for a moment, it seemed that a statement of Rabba indicated the opposite, the gemara explained that he was explaining it according to what the Amoraim of Eretz Yisrael held.

Then, we have Rav Pappa. He is the fifth generation, is thus Batrai, the halacha is like him, and he employs the word hilchesa. With whom does he align? Like Ulla that it is Biblical, or like Rabba that it is Rabbinic? The text of Rav Pappa in our gemara appears in the chart below, on the left hand side.

He stakes out a practical position regarding inheritors and purchasers, and the words he uses for each match exactly to what the gemara offers ("mai taama") to explain Rabba. And he is an Amora of Bavel. So it makes sense to place him as Shibud being Rabbinic. That is why a reason needs to be given to collect from the inheritors, of not closing the door before borrowers. If it were Biblical, then there would be no need to give a justification.

But the gemara in Kiddushin 13b has a different version of Rav Pappa, where his reason for inheritors is that Shibuda deOraysa, is Biblical! 

Rif and Rosh harmonize, and say it is not a dispute. Rather, Shibud is Biblical, but the reason the Rabbis didn't nullify it (as they did by purchasers, in the sefa) is the reason given, of not shutting the door before borrowers. This works. And there is a general trend of harmonizing sources to arrive at a globally optimal explanation.

There is a different derech halimud (IIRC popular in Spain before the expulsion) in which we identify the primary sugya where something is discussed and follow that. And look to a locally optimal explanation. And reasoning or interpretations from elsewhere, where it is brought it, are left there as interpretations brought to make things work.

In Kiddushin 13b, it definitely is a haavara, a transfer. The gemara introduces it that they hold (and are teaching here) that Shibud is Biblical, and then asks that they have taught this already once. Then it goes on to cite the foreign sugya, and ends with a slightly different version of Rav Pappa.

אלמא קסבר שיעבודא הוה דאורייתא והא פליגי בה חדא זימנא דרב ושמואל דאמרי תרוייהו מלוה על פה אינה גובה מן היורשין ולא מן הלקוחות ור' יוחנן ור"ל דאמרי תרוייהו מלוה על פה גובה בין מן היורשין בין מן הלקוחות צריכא דאי איתמר בהא בהך קאמר שמואל משום דלא מלוה כתובה בתורה היא אבל בהך אימא מודה להו לרבי יוחנן ולר"ל ואי אשמעינן בהא בהא קאמר ר' יוחנן דמלוה כתובה בתורה ככתובה בשטר דמיא אבל בהך אימא מודה ליה לשמואל צריכא אמר רב פפא הילכתא מלוה על פה גובה מן היורשין ואינו גובה מן הלקוחות גובה מן היורשין שיעבודא דאורייתא ואינו גובה מן הלקוחות דלית ליה קלא:

Also of interest is Tosafot there, who ask that Rav Pappa is different in Kiddushin and Bava Batra. But Tosafot's version of Bava Batra is different from ours:

Tosafot, Kiddushin 13b


Namely, they have explicitly in the sefa of Rav Pappa that Shibud is not Biblical. This is a quote from Tosafot, not an explanation by Tosafot. And they harmonize, but that is not our interest.

I would suggest further that, as in the case of Rabba, the primary statement by Rabba is positional, what to do in each case, as stated always in Hebrew. And the explanation (with mai taama for Rabba and bald for Rav Pappa) is the explanation by a setama, and that can be be more fluid across texts.


Monday, July 10, 2017

Sefer Bemidbar: Fairness vs. Morality

A while back, people were discussing a study which concluded that conservatives and liberals viewed the world in different ways*. Roughly, liberals think in terms of fairness while conservatives think in terms of morality. And, as Scott Adams suggested, that might be one reason one side cannot persuade the other -- they are speaking different languages, and what one side would consider a strong argument, the other would consider irrelevant.

Fairness and equality, as opposed to adherence to God-given rules, seems a recurring theme in Chumash Bemidbar. We have three separate instances in which the rules were set up, ordained by God, but in which some people, through no fault of their own, end up in an unequal situation. And in each instance, they complain to Moshe with למה נגרע, "Why should we be worse off?"

1) For Korban Pesach, people with ritual impurity contracted from a corpse may not eat of it. That is the Divine rule that applies equally to all people, that ritual impurity invalidates people from partaking in a korban in general. And some years, people miss out, and other years, they may partake. But the impure complain that it isn't fair to them, because they get left out. As they said in Bemidbar 9:7, lama nigara:

  • פסוק ז: וַיֹּאמְרוּ הָאֲנָשִׁים הָהֵמָּה, אֵלָיו, אֲנַחְנוּ טְמֵאִים, לְנֶפֶשׁ אָדָם; לָמָּה נִגָּרַע, לְבִלְתִּי הַקְרִיב אֶת-קָרְבַּן יְהוָה בְּמֹעֲדוֹ, בְּתוֹךְ, בְּנֵי יִשְׂרָאֵל. 
Rather than dismissing their complaint and saying that they have lost out, Moshe takes their complaint seriously. Since he has a direct connection to God, he revisits the topic and asks what can be done for these folks. And God tells him about Pesach Sheni, a second chance. But adds a protection that people don't use this to be derelict in the first korban Pesach.

2) The inheritance of Israel is based on males. The daughters of Tzelophchad complain that, because their father died in his own sin and only had daughters, they have been left out, and their father has no share in the land. Their situation wasn't the origin intent of the Divine decree, but it has that unfortunate effect. It is not fair.  As they say, in Bemidbar 27:4, lama yigara:

  • פסוק ד: לָמָּה יִגָּרַע שֵׁם-אָבִינוּ מִתּוֹךְ מִשְׁפַּחְתּוֹ, כִּי אֵין לוֹ בֵּן; תְּנָה-לָּנוּ אֲחֻזָּה, בְּתוֹךְ אֲחֵי אָבִינוּ. 

Rather than dismiss their claim, he tells them to wait while he asks God directly. And he gets a revision, that in such a case, the daughters will inherit.

3) Even revisions can have unintended effects. The tribe of Menasheh complains that when the daughters of Tzelophchad marry, they will take their inheritance with them to another tribe, and so Menasheh's portion will shrink. That is not fair. As they say, in Bemidbar 36:3, venigraah:


במדבר פרק לו
  • פסוק ג: וְהָיוּ לְאֶחָד מִבְּנֵי שִׁבְטֵי בְנֵי-יִשְׂרָאֵל, לְנָשִׁים, וְנִגְרְעָה נַחֲלָתָן מִנַּחֲלַת אֲבֹתֵינוּ, וְנוֹסַף עַל נַחֲלַת הַמַּטֶּה אֲשֶׁר תִּהְיֶינָה לָהֶם; וּמִגֹּרַל נַחֲלָתֵנוּ, יִגָּרֵעַ. 
Moshe consults Hashem and revises the law once again, to require women, in such a situation, to only marry into their own tribe.

Is such a situation sustainable? Any time someone is adversely affected by the law, should they complain and the law will be revised? Maybe that was the intent, if we understand going to the shofet in a given era in that light. But having the law in such a constant state of flux does not seem sustainable to me. Eventually, the law is the law, and some people fall through the cracks, and it isn't fair.


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* I would treat all such studies with skepticism, because I think that the researchers' political views will influence the design of the study or the interpretation of the results.



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