Changing Views of Health Care Delivery 115
and by the non-Jewish state. The good will and tzedakah efforts of the individuals was recognized and encouraged, but the community did not rely on it.
The underlying philosophy of this well established system dealt with both the individual and the broader society. Ideally, individuals should be motivated to care for everyone in the community— certainly the basics such as food, shelter, health, and security. The call for justice is clear from the biblical period onward. The weakness of human nature was recognized early, however, and responsibility was shifted to the broader community. The system developed and became more complex as needed and in accordance with the ability of the community. The debate over individual responsibility ceased when suffering demonstrated new needs as our concern with universal medical care.
Although the problems of hunger and decent shelter have not been completely solved even in our wealthy western societies,we are closer than any generation before us. For a vast segment of the population, the primary issue now is a reasonable level of health care— delivered in a way that is not degrading and that is provided to everyone. This is certainly possible, but will not occur if left to individual or corporate conscience. What we have described in this paper dealt with the idealistic efforts from biblical times through the centuries; some appealed to individual conscience while others sought communal concurrence. All failed, but practical communal ordinances, rigorously enforced through police poweers succeeded. Poverty may not have been eliminated, but a basic standard of living existed. The wealthy grumbled as always, but they managed well nevertheless.