Being the Jewish doctor of our group, I found myself seeing what happens with people who are so sick that they cannot be with their families on their premier holiday, as I have done nearly every year since 1976. Medicare keeps the hospital an me solvent. There is a question of whether the medicare beneficiaries benefit from my of the stuff guys like me ask labs and pharmacies to do on their behalf but those people pretty much gets what the doctor requests, except for outpatient expensive prescriptions.
At the other extreme are people like I consulted upon this morning who at age 32 has a chronic progressive disease not doing well despite some rather expensive intervention. Despite his skill as a computer programmer, which has afforded him some decent positions with major companies, he cannot maintain employment, he is uninsurable by any actuarial standard in America. Eventually medicare disability will provide for his needs but a whole lot of the care that many of us give him out of necessity will not be compensated. That would not be the case if he lived in Eretz Yisrael or north or our national border.
The political arguments in America are well known. The application of halacha to what is a national blight remains very unclear. I think people are obligated to seek medical care when sick so any disincentive to this runs contrary to my understanding of the principles of shmerat ha-guf. When Israel debated its health care reforms in the 1990’s the expected communal outcome dominated the discussion. Here it seems to be what’s good for me when perhaps the Jewish approach should be more appropriately what is good for us.