Selected Reform Responsa 139
None of these sources dealt with institutions which are now the major recipients of charitable funds such as vocational institutions, special education units, social service agencies, hospitals, etc. In other words, the earlier Jewish communities faced so many basic needs that other matters could not be considered.
We may conclude from this that tradition provides little guidance for our age, especially as we have been fortunate enough to overcome the basic problems of previous ages. All sources agree that communities need primary education, sick care, and centers of higher learning. They do not deal with their funding in detail.
Waler Jacob