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The Public Obligation

As of this writing, it seems as if the “public option” in health care reform may go the way of other well-intentioned but ultimately futile attempts to persuade America to live up to its promise. In other words, nowhere.

As of this writing, the Senate appears to have pushed aside the idea of a government-run insurance plan in favor of more politically palatable half-measures that are probably worthwhile if they rescue the overall process from derailment. The business of legislating is not for the purist, as we’ve learned painfully through this endless debate.

That could all change, of course, if and when it becomes time to reconcile the Senate version with the House mandate to include a modest public option. Which is why “as of this writing” is not used here as a literary embellishment. It’s a recognition of the shifting fortunes of President Obama’s once-ambitious plan to bring sanity and fairness to the nation’s system of providing health care.

Once, not very long ago, that was a moral imperative — to ensure that all Americans have access to decent health care. As legislation makes its way through the Congressional cuisinart, it’s essential to remind ourselves again that this isn’t just about controlling costs, extending benefits and protecting private interests. It’s about a public responsibility that has been too long ignored.

No one said it better than the president himself when, in his speech before Congress in September, he quoted from a letter he had just received upon the death of Senator Edward Kennedy. “He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that ‘it concerns more than material things,’” Obama said of Kennedy. “‘What we face,’ he wrote, ‘is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.’”

These are not only Democratic principles, or even American principles. There is a deep strain in Jewish thought and teaching that emphasizes the obligation society has to provide for health care. As Rabbi Jill Jacobs notes in her book “There Shall Be No Needy”: “Jewish law not only mandates the establishment of funds for the sick, but also fiercely opposed any attempts to re-appropriate these funds for any other purposes.”

So the argument that providing a public option to cover the uninsured — mostly working Americans, remember, who either don’t get insurance on the job or lost it because of a health condition — cannot be considered because it may, one day, cost taxpayers money is not only a bogus fear. (There are easy ways to prevent a government bailout if it’s ever necessary.) It is, arguably, contrary to Jewish values.

Yet that’s the line that Senator Joseph Lieberman uses to justify his threat to stand in the way of any health care reform measure if it includes a public option. Throughout his Senate career, Lieberman has positioned himself as a man who takes religious teaching seriously, in his personal practice and public stances, who cares so much about character that he once scolded President Clinton’s scandalous behavior from the floor of the Senate. To see him turn his back on this central obligation for such a limp reason is either a sign of weakness or hypocrisy. Either way, it’s deeply disappointing.

Kennedy was right. This is about justice, and about character. We can hope that whatever finally emerges from Congress will be an improvement over the expensive, erratic and inequitable health care system currently in place. But our cheers will be tempered by the recognition of a moral obligation only partly realized.

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