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Mina's Musings: Hukkat 2015

Hukkat, the Brass Serpent, and Health Care – 2015 (revised dramatically from 2012)

We have been hearing for months now that by the end of this month the Supreme Court will determine the fate – again – of the Patient Protection and Affordable Care Act, also known for better or worse as Obamacare.  Earlier this weeks, the Supreme Court made it  decision and Obamacare will stand.  Thus, whether or not one is “for” or “against” Obamacare has to a certain extent become irrelevant.  Moreover, it is undeniable that caring for the health of those in our community is something of importance to each of us, not only as Americans, but as Jews.

Indeed, as the Supreme Court gets ready to hand down its ruling within the next week it is kind of amazing that the portion refers to health and healing.  Of course, it always seems to be that the portion matches what is happening in our lives.  Thus we read this morning (Numbers 21:5-9) of what happened when the Israelites “spoke out against God and Moses,” saying, "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 bread/food." 6 The Lord sent seraph (fiery) 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 the Lord and against you. Intercede with the Lord to take away the serpents from us!" And Moses interceded for the people. 8 Then the Lord said to Moses, "aseh l’chah seraf - Make yourself a fiery serpent 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.”

It is a fascinating little story, and its conclusion in the Torah is the source of the nehushtan, sometimes called the Rod of Asclepius, the symbol of the physician’s healing power, a serpent coiled around a staff.  This symbol is so associated with medicine and healing that over 62% of medical associations use the nehushtan – or Rod of Asclepius – as their symbol.

That in itself is interesting, but questions about the text are also interesting, and over the centuries rabbis have asked many such questions.  The first is simple:  Why did God send snakes to attack the Israelites in retaliation for speaking out against Moses and God?  An answer provided in Midrash Numbers Rabbah (19:22) is that because the serpent was the first to speak slander and was cursed for it, the Israelites should have learned not to engage in slander.  Since they didn’t, God said to Himself, ‘Let the serpent, who was the first to introduce slander, come and punish those who speak slander.’ 

Kli Yakar and R. Yehoshua Leib Diskin asked another question.  Why in one part of the story does it say fiery (seraf) serpents, and in another place it simply says serpents?  The answer is that God sent the snakes in retaliation for two sins – speaking against God and speaking against Moses.  Therefore two varieties of snakes were unleashed against them, nehashim and seraphim.  The nehashim came to punish them for the slander against Moses and were more toxic and potent, whereas the seraphim burn because lashon hara – slander (especially against God) burns.

Now, in the Torah Moses staff was used to stop the plague that God sent in his anger at the Israelites.  However, since the text says “anyone that is bitten” rather than anyone bitten by a snake, is used, the rabbis of the Midrash [Numbers Rabbah 19:23] theorized that anyone bitten by anything – spider, dog, scorpion, wild beast, could look at the brass serpent and be healed.  From there it was easy for people to jump to a general association of the staff with healing.

Since we are talking about healing let’s spend a moment reminding ourselves of what our tradition says about healing those in our community now that we do not have Moses’ staff.  It is fairly easy.  From the prophet Jeremiah to the rabbis of the Talmud to Maimonides, the Shulhan Arukh, Tzitz Eliezer, and the Rabbinical Assembly, all have advocated medical treatment for the ill, and a communal obligation towards those who can’t afford medical treatment on their own.  For your convenience I have left a source sheet on this subject outside the sanctuary this morning.

Lest you worry that I am mixing synagogue with politics, I am truly just reminding us all of some Torah teachings on a subject currently in the news!  And whether or not you like the idea of universal health care, whether you love or hate Obamacare, whether you think it’s a great idea somewhat poorly implemented, I think we all can admit how important having access to medical assistance is when someone is ill, and how this impacts us as individuals and a community.  As Rabbi Samson Raphael Hirsch wrote concerning our portion:  “The serpents were sent to show the people that danger beset their every step and it was only thanks to the miraculous and perpetual intervention of Divine Providence that they were able to proceed, unharmed.  Their path was so smooth that they failed to perceive the constant miracle in their unmolested progress.  Every victim of the serpents’ venom had to concentrate his attention on the image of the brazen serpent, to enable him to realize that, even after God had delivered him from the serpents, there lay ahead of him fresh dangers.  He had to thank Divine Providence for every minute of security granted him..Happy is he who takes note of the unseen “fiery serpents” that beset his path, put to flight by the Almighy.”

May each of us thank God each day for the gifts of health that we have, may we pray for ourselves and others who are not healthy, and may we pray for a time in our world when everyone truly has the ability to receive quick and effective treatment for their illnesses as easily as the Israelites looking to Moses and the brass serpent.

 

Source Sheet

Halakha Mandates Access To Health Care

“Is there no balm in Gilead? Is there no physician there? Why then has the health of my poor people not been restored?” (Jeremiah 8:22)

Therefore only one person was created to teach you that whosoever kills a single soul the Bible considers to have killed a complete world. And whosoever sustains and saves a single soul, it is as if that person sustained a whole world. (Mishnah Sanhedrin 4:5)

A Torah scholar should not live in a community unless that community has available medical care. (PT Kiddushin 4:12 [66b] and BT Sanhedrin 17b).

The duty to return a lost object to another (in Deut. 22:1-3) includes returning “a person’s body, for if one sees him dying and can save him, one should save him, whether physically or with money or with knowledge.” (Rambam, Comment to Mishnah Nedarim 4).

God created food and water; we must use them in starving off hunger and thirst. God created drugs and compounds and gave us the intelligence necessary to discover their medicinal properties; we must use them in warding off illness and disease. (Rambam, Commentary on Mishnah Pesahim 4:9)

“Doctors are required to reduce their fees for the poor. Where that is still not sufficient the community should subsidize the patient.” (Shulhan Arukh, Yoreh De’ah, 249).

“One who has medications, and another person is sick and needs them, it is forbidden to raise their prices beyond what is appropriate.” (Shulchan Aruch, Yoreh De’ah 336:3).

“It has been enacted that in every place in which Jews live, the community sets aside a fund for care of the sick. When poor people are ill and who cannot afford medical expenses, the community sends them a doctor to visit them, and the medicine is paid for by the communal fund.” (Rabbi Eliezer Waldenberg (a 20th century Israeli posek), Tzitz Eliezer 5:4).

In relation to the obligation to pay the costs of saving the life of a sick person who is in danger of dying: 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 (a 20th century Israeli posek), Minkhat Shlomo, V.2, 86:4).

“The community clearly has an obligation to provide for the medical needs of the indigent. This establishment of a fund to defray medical expenses represents both a needed social amenity as well as a charitable obligation, and the community is fully empowered to levy a tax for either purpose.”  (Rabbi J. David Bleich, Tradition 31:3)

The Mandate To Health Care Access Applies To All Members of Society

 “Our Rabbis taught: ‘We support the non-Jewish poor along with the poor of Israel, and visit the non-Jewish sick along with the sick of Israel, and bury the non-Jewish poor along with the dead of Israel, for the sake of peace.’” (BT Gittin 61a).

“In a city where non-Jews and Jews live, the tzedakah collectors collect from Jews and non-Jews and support Jewish and non-Jewish poor; visit Jewish and non-Jewish sick and bury Jewish and non-Jewish dead, and comfort Jewish and non-Jewish mourners, and return lost goods of non-Jews and Jews, to promote the ways of peace.”  (PT Demai 4:1).

Rabbi Nissim ben Reuven of Gerona (the Ran) ruled that funds dedicated for medical care may not be re-appropriated for needy students and that such funds are for the “needy of the world,” not just the “needy of the town.”  Ran, She’elot U’tshuvot 1, Dibbur hamatchil “V’haben hayoresh.”

“The government may not excuse itself from its responsibility toward the sick, since the government — and not the doctors — is responsible for the health of the people.” (Rabbi Shlomo Goren, former Ashkenazi Chief Rabbi of Israel, Sh’vitat haRofeh L’or HaHalachah, Assia 21).

“If an individual cannot afford to pay for needed health care, the obligation to provide for that care devolves on the community as a whole. … Preferred ways to meet this communal responsibility for the care of the poor include a societal health payment program, perhaps analogous to Medicare or national health insurance, or direct government provision of medical care.” (“Responsibilities For The Provision Of Health Care,” by Rabbis Elliott Dorff and Aaron Mackler (approved by CJLS on Sep. 9, 1998), pp. 330-31).

Fri, March 29 2024 19 Adar II 5784