I'm remembering the ma'aseh with the dream teller, who would take money from Abaya, and tell a fortune for him, but tell a very different fortune for Rava who'd described the like dream. I had this question: what is the ethicality of serving others differently based upon their level of contribution? What if the contribution of one, 'client,' benefited your sect, or denomination, and that of another only your brother's sect? Does the ethicality differ for professions such as health care, or for essential as opposed to non-essential services? How is it better than shochad, or ribbis, to differentiate like so?
H David Levine, Roanoke, VA USA
This is a broad question so I'll try and summarize: Shochad as you mentioned it applies only in the context of a judge or public servant, since they are being paid (very well) to give fair and objective service and cannot be swayed by financial considerations. (Pilpula Charifta Sanhedrin Chapter 3) Ribbis is applicable only in a loan or in some cases before and after a loan. Thus they do not apply to a tip given to a waiter to get better service, which is perfectly acceptable as he expects such tips and even his boss accepts the concept when he pays insufficient wages.
The concept of VIP service is based upon contribution and is not considered unethical. Those who pay more deserve VIP treatment, such as expediting their requirements over others.
However regarding medical services there is a difference. Since everyone is obligated to save lives and today only authorized doctors can practice medicine, they have an obligation to save lives irrespective of how much that person paid them. If for example his needs are more pressing he must be preferred over the others even if they paid more. (Tashbetz 1:45) However for elective surgery and Choleh She'ein Bo Sakanah, those who pay more can get preferential treatment. A doctor is allowed to take high pay for his expert advice (Yoreh Deah 336:6) and is not required to be a charity service for those who cannot pay, even though this would be laudable behavior. However the medicines themselves cannot be overpriced just because people are in need of them (Tashbetz 4:20)
Regarding Bar Hadaya's behavior to Rava,it would appear that Rava called him a Rasha because he had no obligation to give him bad interpretations of his dreams and could simply have told him to pay for the service. The fact that he gave a bad interpretation instead when he could easily have either given him for free or demanded money up front was wrong and evil. Causing unnecessary anguish because one was not paid is unacceptable.
Yoel Domb
How would the Torah characterize someone who withheld VIP service, either by not divulging its availability, or by accepting the payment from certain individuals and not accepting it from others, or by accepting it only as a tip or donation from those they wish to deny?
There are some who say that the dictum, "the best of doctors goes to Gehinom" (Kiddushin 82a), refers to those doctors who prevent treatment from those who cannot pay for it. Asaf ha'Rofeh, a 7th- century Jewish doctor, wrote, "Do not harden your heart from having mercy on the poor and treating them." Some Poskim even suggest forcing doctors to treat the poor (Teshuvah me'Ahavah III, Yoreh De'ah 336), but others say that this is only if there is no other doctor to treat them (Tzitz Eliezer 5:24).
However, in the Gemara in Ta'anis (21b) we learn that Aba Umna reached an exceptional level because he did not take money from the poor, implying that this is a level of piety not required by regular doctors.
However, in the case you cited, the doctor is willing to perform VIP service for some and not for others, but it is not clear why he acts in this way. A doctor is certainly entitled to make a VIP service and charge certain patients more for individual service, but at the same time he should maintain a regular practice for patients who cannot afford VIP (Teshuvos V'Hanhagos 1:897). In this way, he fulfills the Gemara's requirement that he take only a minimum fee (Sechar Batalah) with regular patients and at the same time sustains himself with the VIP patients. However, it is preferable that even then he should take less money from those who cannot afford the high rates for VIP service.
A doctor who does not divulge the VIP service to people in order to give them less effective treatment is guilty of preventing an act of kindness from his fellow man.
Yoel Domb