Opinion Editorials, August 2009

Health Care Crisis in the US:

An Islamic Perspective

By Hassan Ali El-Najjar

Al-Jazeerah, ccun.org, August 22, 2009, 1st of Ramadhan, 1430

 
 
First, the facts about the health care crisis in the US: *
 
1. Many insurance companies do not renew insurance policies if the insured develops a
 costly health condition, like cancer.
 
2. Many insurance companies do not insure persons with pre-existing conditions, i.e. those who are abandoned by health insurance companies after developing a costly  health condition, like cancer.
 
3. Many people lose their health insurance when they lose their jobs, particularly in time of recession, which is a characteristic of the capitalist system.
 
4. Many people cannot afford to buy health insurance like new graduates or part-time job holders.
 
5. As a result of the above, there are about 46 million people who do not have health insurance in the US.
 
6. Health care costs have contributed to the failure of businesses to be competitive, whether these are small business or even giants, like auto makers.
 
7. The most troubling of all facts about health care in the US is that it is projected that the costs of the two government-administered programs of health care, MEDICARE &     MEDICADE, will grow to levels which threaten insolvency within a decade from now.

Second, What do these facts mean, as signs of a looming crisis?

1. The millions of people who do not have access to the health care system will be suffering and dying just because they are denied that access.
 
2. Health insurance companies continue to reap huge profits from people as long as they are healthy but without being obligated to take care of them when they are truly in need, i.e. after developing a costly health condition.
 
3. We will continue to have recessions at least once in every decade, which are inherent in the capitalist system. It is illogical that whenever we have recessions, they people who lose their jobs will also lose their access to the health care system.
 
4. Millions of people who cannot afford buying health insurance work but their income is not big enough to enable them to buy health insurance, like in the case of minimum-wage workers. This is a case of justice. The legislative branch of government has done this category of workers injustice by allowing business owners to give them a “minimum wage” that does not enable them to buy the minimum of life necessities, like health care.
 
5. American businesses big and small will be more competitive locally and globally if they are relieved of health care costs. A good example is the case of American auto makers who have been competing against German and Japanese auto makers. They could not win this competition simply because in Germany, Japan, and other industrial societies, health care is shared by several partners, particularly the government.  
 
6. If nothing is done to reform the system of health care in the US, tens of millions of poor and elderly Americans, who receive Medicare and Medicaid, will be added to the 46 millions who are already without health insurance.
 
Third, consequences of leaving the health care system as it is, without repair?
 
1. Whenever there is a crisis in any aspect of life, society as a whole has to intervene to reform or repair the system. This was the case during the 1930s depression and during the 2008 financial crisis. To save the financial system, the government bailed out the banks, the housing industry, and the automobile industry with about one trillion dollars.
 
The health care industry is not different from the other industries, which were reformed by the government intervention this year.
 
2. If the system is not reformed, and millions of people continue without access to the health care system, they will still affect it by adding INDIRECT costs to it through coming to the emergency rooms in hospitals and through spreading infectious diseases.
 
3. Those who are denied access to the health care system may become less competitive and less productive members of society, which affects the productivity and competitiveness of society as a whole in this current competitive global economy.
 
4. American businesses will continue to be less competitive locally and globally because their costly products as a result of the burden of health care costs.
 
5. The most important negative consequence of not reforming the health care system is that the poor, the needy, and the elderly in society will be left behind to suffer alone without help from the rest of society.
 
Society will grow to be less humane, without mercy, without compassion, and without justice.
 
Conclusion:
 
Nobody should be denied access to health care in society if we want that society to be healthy, competitive, productive, humane, merciful, compassionate, and just.
 
 
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An Islamic Perspective on Health Care in Society
 
 
Then, what’s the Islamic position towards leaving millions of people deprived of health care in society, with the negative consequences mentioned above?
 
Islamic teachings promote social cohesion and social solidarity, in order for members of society to enjoy their life as much as they can whether they are fortunate or less fortunate.
 
The poor and the needy should not be left behind suffering. To the contrary, the more fortunate should pay attention to and help those who are in need.
 
1. The third pillar of Islam, after the proclamation of faith and prayers, is giving away charity (Zakat), the minimum of which is 2.5% of annual savings. The objective is enabling the less fortunate to have the life necessities, like food, clothes, housing, education, and health care.
 
In Verse 60 of Chapter 9 (Surat Al-Tawbah), Allah praise to Him specifies the categories of people who should be the recipients of Charity. He says:

إنَّمَا ٱلصَّدَقَـٰتُ لِلۡفُقَرَآءِ وَٱلۡمَسَـٰكِينِ وَٱلۡعَـٰمِلِينَ عَلَيۡہَا وَٱلۡمُؤَلَّفَةِ قُلُوبُہُمۡ وَفِى ٱلرِّقَابِ وَٱلۡغَـٰرِمِينَ وَفِى سَبِيلِ ٱللَّهِ وَٱبۡنِ ٱلسَّبِيلِ‌ۖ فَرِيضَةً۬ مِّنَ ٱللَّهِ‌ۗ وَٱللَّهُ عَلِيمٌ حَڪِيمٌ۬

 
“Alms (Charity or Zakat) are for the poor and the needy, and those employed (to collect and  administer the funds); and for those whose hearts have been reconciled (to Truth, the new believers); for those in bondage (to free them) and in debt (to pay off their debts); in the cause of Allah; and for the wayfarer: It is ordained (obligatory) by Allah, and Allah is All  knowledgeable, All wise.”
 
2. The needy have a right in the fortunes of the wealthy because all the wealth is from God, entrusted to some of us to spend on themselves and on others.
 
In Verse 19 of Chapter 51 (Surat Al-Dhariyat), Allah praise to Him emphasizes that the needy have a right to receive charity from the wealthy. He says:

وَفِىٓ أَمۡوَٲلِهِمۡ حَقٌّ۬ لِّلسَّآٮِٕلِ وَٱلۡمَحۡرُومِ

 
“And in their wealth, there is a right for (the needy) who asks and for the deprived who does not ask.”

وَتَعَاوَنُواْ عَلَى ٱلۡبِرِّ وَٱلتَّقۡوَىٰ‌ۖ

“Cooperate (Help one-another) in righteousness (doing good deeds) and piety (avoiding the violation of God’s prohibitions).”
 
In Verses 9 and 10 of Chapter 93 (Surat Al-Dhuha), Allah praise to Him instructs those who have wealth to give some of it to those who do not have it, as in the case of the following two categories of the needy. He says:

فَأَمَّا ٱلۡيَتِيمَ فَلَا تَقۡهَرۡ

 وَأَمَّا ٱلسَّآٮِٕلَ فَلَا تَنۡہَرۡ

 
"Therefore treat not the orphan with harshness;
Nor repulse the petitioner (who asks you)"
 
The meaning is that orphans represent a category of the needy who are too young to ask and too helpless to fend for themselves. This is a command from God to take care of them as well as taking care of the needy who petition or ask you to give them of what God enabled you to get.
 
3. People in a given society are partners in major resources that affect life and death, as we were instructed by the Prophet Muhammed, peace and blessings of Allah be upon him, in a Hadith (saying) narrated by Wakee’, Hareez, and Abu Khurash, May Allah be pleased with them.

حدثنا وكيع ، حدثنا ثور الشامي ، عن حريز بن عثمان ، عن أبي خراش ، عن رجلِ من أصحاب النبي ، صلى الله عليه وسلم ، قال: قال رسولُ الله صلى الله عليه وسلم:

"المسلمون شركاء في ثلاث: الماء ، والكلأ ، والنار."

The text of the Hadith states that:

“Muslims are partners in three (resources): Water, grass, and fire.”
 
The meaning of the Hadith is that people in a given society cannot survive unless they share basic resources such as water for them to drink, grass for their animals to eat, and fire (energy) for them to use in heating, cooking, production of electricity, etc.
 
Health care is a basic societal resource which protects people from diseases and keeps them healthy and productive. Denying it to some people because of their poverty is like denying water to those who do not own water wells or live far away from rivers and lakes. It leads to their demise.
 
4. Societal intervention is required if danger is expected by doing nothing. This is the lesson we learn from a parable story taught to us by the Prophet Muhammed, peace and blessings of Allah be upon him.

The parable story is about  two groups of people sailing in the same ship. One group stayed at the bottom and the other stayed on top floor of the ship. The people on top wanted to prevent those at the bottom to come up to fetch water. The people at the bottom replied by threatening to make a hole in the ship to get water directly. If they are allowed to do so, the ship may drown and all may die but if they are prevented (by allowing them to share the water from the top), they will all be saved.
 
The meaning of the Hadith is that societal intervention is necessary to prevent danger from happening to the majority. If millions of people continue to be denied access to health care and millions more will be denied that access if the government-administered programs collapse, then a great catastrophe may fall on society as a whole, as explained above.
 
In conclusion, Islamic teachings promote social solidarity and assistance to the poor and the needy, and consequently promote extending access to health care for those who lack that access.

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References
 
* The above-mentioned facts about the health care system in the US have been used by President Barack Obama during his speeches about the topic in various American cities, particularly his speeches in Montana and the Organizing Forum about Health Care in the White House, on August 20, 2009. All of the President’s speeches were published on the White House website. See also:
 
http://www.whitehouse.gov/issues/health_care/  
 
C-Span has published major articles, videos, and debates about the US health care reform. These can be found at:
 
http://www.c-span.org/search.aspx?For=health+care

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* Dr. Hassan Ali El-Najjar has a Ph.D. in Sociology and a Master’s degree in Cultural Anthropology from the University of Georgia, USA. He is also a native speaker of Arabic.