Kol Tzedek Aims to Alleviate Medical Debt in Shmita Year

Rabbi Ari Lev Fornari (Photo by Chris Baker Evans)

Reconstructionist synagogue Kol Tzedek in West Philadelphia is working on abolishing the equivalent of $2.5 million in medical debt.

Congregant Adrian Shanker is asking the temple’s 350 families to help raise $25,000.

According to Shanker, $25,000 can eliminate $2.5 million in health care bills because hospital systems sell unpayable debt at discounted rates. In other words, if patients can’t pay, hospitals just try to get what they can. Shanker says that every $100 is equivalent to $10,000 in unpaid health care costs.

Temple members chose a tzedakah effort that was particularly appropriate because the upcoming Jewish year, 5782, is a Shmita year. According to the Torah, Shmita is the seventh year of the agricultural cycle. During those 12 months, Jews must take off from working the land and need to forgive all debts. Kol Tzedek congregants believe that medical debts are especially immoral.

“Health care is a human right,” Shanker said. “We don’t believe medical debt should exist.”

Kol Tzedek’s effort is designed to help low-income Philadelphians. The synagogue is partnering with RIP Medical Debt, a national charity that works with hospitals.

Penn Medicine is a frequent RIP partner, and doctors from Kol Tzedek have contacted Penn about participating in the effort.

Kol Tzedek has already raised $20,000, according to Rabbi Ari Lev Fornari. It plans on continuing the initiative through the High Holidays and into October. Also in the fall, it will reach out to other hospital systems, like Main Line Health and the Children’s Hospital of Philadelphia.

Fornari said the ultimate goal is to raise $40,000.

The temple is asking for donations as people sign up for small-group and virtual High Holiday services. Members can also contribute during Rosh Hashanah and Yom Kippur services.

On Aug. 25, Fornari hosted a virtual talk with RIP co-founder Craig Antico. The topic was Jewish values as they relate to debt abolition.

“A core Jewish value is economic justice and caring for those most vulnerable,” Fornari said.

And, the rabbi added, there is no justice in the American health care system, only vulnerability.

Keeping yourself healthy, and perhaps even alive, is not just an economic decision, Fornari said. But it’s one that can cost thousands or even tens of thousands of dollars. You don’t even get to hear the price up front.

For a low-income person, the choice is often impossible: a necessary procedure or years of debt, according to the rabbi.

“Even with insurance, the bill can be astronomical,” Fornari said. “It’s completely predatory.”

Shanker, who leads an LGBTQ+ community center in Allentown, encounters the medical billing process on a regular basis. Often, it’s not the bill that gets people; it’s the collection process from not paying the bill, which compounds the debt and hurts your credit report, Shanker said. And with bad credit, it becomes difficult to rent an apartment, or to buy a house or car.

Fornari and Shanker are hoping to inspire other communities. The rabbi said they’ve already reached out to Reconstructionist synagogues in other cities.

The New Synagogue Project in Washington, D.C., Congregation T’chiyah in Detroit and Kadima in Seattle are considering their own drives.

Shmita begins in September and lasts for a full year.

“Shmita is often talked about as environmental issues and land stewardship. That’s very important,” Shanker said. “But part of what happens in a Shmita year is release from debt.”

“The vision of the Shmita year is environmental and economic justice,” Fornari said.

The rabbi said the synagogue is trying to do its part by asking for small donations. But he said it would welcome a bigger contribution.

Shanker’s math problem — a $100 donation equals $10,000 in alleviated medical costs — can be extrapolated, too.

“If someone writes a check for $10,000, they are eliminating $1 million in medical debt,” Fornari said. “This is going to make a big difference in individual lives.”

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