As the words of the prayer, U'netaneh Tokef, rang out during the High Holy Days, asking who shall live and who shall die, I couldn't help but think of the current health care debate going on in our nation. Too often, who shall live and who shall die is determined by who has access to adequate medical care.

This fall, President Barack Obama called on Congress to help reform the American health care system. As the President acknowledged, this issue has hit a political nerve with many. Let me be clear: my interest in this topic for a Bulletin column is not as a political issue, but rather as one of moral significance.

Health care reflects many values our people hold dear. Jewish teachings emphasize the importance of medicine and the obligation patients have to seek medical care. This teaching goes one step further, calling upon patients to avail themselves of preventative medicine. In addition, Judaism teaches that physicians have an obligation to heal every patient, no matter the person's financial situation.

The great 12th Century scholar, Maimonides, taught that responsibility for health care rests not just with physicians, but with the entire community. In fact, during the Golden Age in Spain, Jewish communities set up health care systems, funded and regulated by the community, so that poor patients received medical care.

If we as a nation ignore our obligations, we risk much.

As the Union for Reform Judaism's President, Rabbi Eric Yoffie, said about our health care system: "If we continue to tolerate it, we will lose our humanity, and no matter what our accomplishments, we will have failed as a people and as a nation.

So let us work to change it, piece by piece and child by child, until no cry for help goes unheard."

Our Reform Movement has a deep commitment to reforming our national health care system. Key leaders of our movement have long been advocates of a health care system that is inclusive, meaning all must be treated with dignity and equity, for we are all created in God's image.

And it seems that most Americans, of various religious faiths and political ideologies, are in agreement that our health care system is due for change. Many on both sides have agreed upon 80 percent of the substance of the changes being proposed.

I am not naïve enough to think that attaining agreement on the last 20 percent will be easy, but our society can not let another opportunity for real reform go to waste.

In a conference call with rabbis, President Obama made clear that the time for change must be now be- cause "the current state is unsustainable."

Forty-seven million fellow Americans are without health insurance and 25 million more are under-insured. We spend $6,000 more per person on health care than any other country. The costs of our current system are going up three times faster than inflation.

It's clear that with our current health care system, many people are suffering. In our own community, the recent economic downturn has led to job losses, which have forced families to go for a period without health care or to pay exorbitant prices to maintain their coverage.

In my 15 years as a rabbi, I have seen elderly individuals who have done everything right. They have saved carefully and lived frugally, only to be devastated in their later years by staggering health care costs.

One woman I know from another congregation had to sell the home she and her husband had shared for 30 years because, even with insurance, his medical bills wiped out much of their savings. When her own health began to fail, resulting in more bills, she was concerned how she would survive.

Our tradition makes clear that as a society we have an obligation to do better. A just society cares for all its members, particularly the most vulnerable.

Let us add our voices to the call for reform so that we can help make this nation one that models the values we hold dear.