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Jonathan Tobin: Defending the Right to a Jewish State

Heather Hale: Compliment your kids without giving them big heads

Megan Shauri: 10 ways you are ruining your own happiness

Carolyn Bigda: 8 Best Dividend Stocks for 2015

Kiplinger's Personal Finance editors: 7 Things You Didn't Know About Paying Off Student Loans

Samantha Olson: The Crucial Mistake 55% Of Parents Are Making At Their Baby's Bedtime

Densie Well, Ph.D., R.D. Open your eyes to yellow vegetables

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Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

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Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

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The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review January 21, 2008 / 14 Shevat 5768

Almost-Poor

By Rabbi Dr. Asher Meir


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Should the lower-middle-class be eligible for credit and discounts?


http://www.JewishWorldReview.com | Q: Our medical institution gives free care to the indigent, and those with health insurance obtain care through their plan. But what about people who aren't really poor but don't have the means to get really adequate insurance? They fall between the cracks.


A: The problem of the "almost poor" arises in many contexts. Recently, Harvard College extended its financial aid package to solidly middle-class families. They concluded that the college had become a place for the rich (who can afford it) and the poor (who are eligible for extensive aid), but had emptied out of the middle class.


This problem exists in Jewish law as well. In fact, the Mishna specifically states that there is a sharp boundary of eligibility for charity:


One who has 200 zuz [an amount sufficient for basic expenses for a year] may not take the dropped or forgotten sheaf, or the corner of the field [all these must be left for the poor] or the poor tithe. If he has even one dinar less and he is given even a thousand [zuz] in one sum, he may take it.


If [his assets] are liened to his creditor or to his wife's kesubah [support in case she is widowed or divorced], he may take. We do not compel him to sell his house or his [essential] furnishings. (1)


This is similar to your case: an impoverished person is entitled to free medical care, which can easily be worth five times a year's living expenses (the example given in the mishna). But a person who is not impoverished is entitled to nothing!


However, there are various alternative solutions to this problem.


First of all, we need to recognize that even in the case of the impoverished, Jewish law favors loans over gifts, at least when it comes to large amounts of aid. The dropped or forgotten sheaf and the corner of the field are generally small amounts which are enough only for subsistence; even the poor tithe is not usually a huge amount, and a thousand-zuz gift would be very unusual in practice. The very Torah verse which admonishes us to take care of all the needs of the poor speaks of loans, rather than outright charity:


When you will have a needy person from one of your brothers, in one of your gates in your land which the Lord your G-d gives you, don't harden your heart and don't shut your hand to your needy brother. Surely open your hand to him and lend to him enough for his needs, which are lacking to him (Deuteronomy 15:7-8).


So one practical solution is to offer people of limited means credit, by means of generous repayment terms, even if they are not eligible for a discount.


Another important consideration is that the commandment of charity is precisely "enough for his needs, which are lacking to him." Normally, a person with enough assets for subsistence is not needy, but a sick person has much greater needs. In this case, we fulfill the charity obligation even when we give to a person who would not normally be considered "poor", because in relationship to their extraordinary needs they are indeed lacking. So if it is possible to extend eligibility for aid to middle-class people who have extraordinary expenses this would be desirable


There is also an additional factor at work. Officially your practice defines the regular price as "full price", whereas indigent patients are treated pro bono. But in many cases the reality is that regular patients pay more than what the practice would charge if there were no pro bono cases, so in effect they are making two payments: one is a charge for service, the other a subsidy payment for poor patients.


In this case, it would be fair to charge the patient of limited means only the "true" charge. (This is not the same as "at cost" since you are not deducting your profit, only the subsidy portion.) Jewish law has a clear analog to this. In general every person has to give charity; the most common custom is to give a tenth of one's income by analogy to the poor tithe the Torah imposes on farmers. If a person is poor, then instead of giving charity he receives it. (Jewish law actually states that even a poor person who lives on charity has to give a token amount to charity, (2) since giving charity is a basic human need which is itself "his needs, which are lacking to him".)


But there is also an intermediate category of someone who is not rich enough to give charity and not poor enough to get it. It is appropriate to charge such a person the fee that would apply if there was no need to subsidize poorer patients.


Jewish tradition encourages generosity towards others and obliges us to provide for the poor, but it also educates us to strive for independence. There is no general obligation to give charity to those who are able to make ends meet, even if they have to struggle a bit. But it is certainly desirable to help such individuals out with credit. In addition, "poverty" has to be measured in relationship to a person's needs, and some medical treatments are enough to impoverish even a middle class family. So when expensive treatments are needed even such a family may be considered "needy" for the purposes of giving charity.


Finally, while the almost-poor aren't eligible to receive charity, they are also not obliged to give it (beyond a token amount). So it is desirable to give such individuals a "discount" to credit them for any part of the regular fee which you would consider a kind of subsidy to enable you to provide pro bono services.

SOURCES: (1) Mishna, Peah 8:8 (2) Babylonian Talmud, Gittin 7b

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JWR contributor Rabbi Dr. Asher Meir, formerly of the Council of Economic Advisers in the Reagan administration, is Research Director of the Business Ethics Center of Jerusalem, Jerusalem College of Technology. To comment or pose a question, please click here.

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