There is now a deep and wide consensus -- both within the government and in the general populace -- that the American system of health care is severely dysfunctional and must be fixed. We must do this properly -- and soon -- to avoid the perfect storm of escalating anguish for the roughly 47 million Americans who cannot afford decent medical care and the potentially crippling threat to the U.S. economy from out-of-control health-care costs that continue to increase at rates far in excess of general inflation.
This subject is currently getting a great deal of publicity, but whether it will receive the attention required for meaningful and positive change will depend in no small measure upon advocacy efforts. We -- the public, in general, and the Jewish community, in particular -- must mobilize to convince members of Congress, the Obama administration and other key decision-makers of the importance of finding ways to reach the goals that are widely accepted, rather than letting themselves get mired in the often controversial details of how to get there.
Inspired by the moral mandate from our Jewish tradition to "pursue justice" for all, coupled with our communal experience in providing health and long-term care to millions of vulnerable people in communities across the United States, two of the most important umbrella organizations in the organized Jewish community -- UJC/Jewish Federations of North America and the Jewish Council of Public Affairs, representing the Jewish community relations organizations -- have joined together to lead our part of this campaign that is so important for all Americans.
There is a consensus in this country that an equitable health-care system will provide all medically necessary preventative and curative care (including wellness and environmental programs, chronic and long-term services and supports, as well as acute care) to all Americans, regardless of where they live, their pre-existing conditions, their ability to pay full costs and other entrenched disparities. In addition, such a system must do so in a fiscally sustainable manner that preserves and expands the choices available to health-care consumers.
With the fastest-aging population group in the country, Jews have a particular stake in health-care reform that affects seniors. In the Greater Philadelphia area alone, 20 percent of the Jewish community is 65 or older, as opposed to 13 percent in the general community.
It is especially important that any new health-care program include provisions for an affordable continuum of care that will be able to withstand the influx of baby-boomers, who will need supportive services as they age, and not create harmful cuts in Medicare or force states in fiscal crises to weaken Medicaid in an effort to cover other budgetary shortfalls. Such reforms would also benefit every federation's home health and skilled nursing-care providers by shielding them from the damaging cuts in Medicare payments recently threatened by the Medicare Payment Advisory Commission.
Prompt action by each of us is vital as Congress deliberates comprehensive health-care reform over the coming weeks and strives to strike the proper balance among coverage, benefit design and financing. During this short time period, we must educate ourselves about the ways to achieve our desired goals, discuss them widely and build coalitions with like-minded organizations -- whether faith-rooted or secular, provider or service recipient-focused, local or national.
We must act now to achieve these widely shared goals before the baby-boomer generation stresses the health-care system even further than it is today.
This must happen while there still exists the political will in Congress and the White House to make changes of the magnitude required to produce a system that gets it right. Paraphrasing the well-known words of Hillel: "If not us -- who? And if not now -- when?"
James Rosenstein, a local attorney/mediator, is co-chair of United Jewish Communities' Health and Long-Term Care Workgroup. For information on local efforts, e-mail David Rosenberg at the Jewish Federation ([email protected] ) or Adam Kessler at the Philadelphia JCRC ([email protected] ).