Tuesday, October 23, 2007

Health care

Having experienced all three health systems I think Israel's is superior to that of the US and the UK. Here we belong to one of several private yet Government subsidized Kupat Holim (Sick Funds). The largest one is called Clalit (General) that has its own hospitals, then there is Maccabi, that we belong to, and there is the smallest one Meuhedet (Special).
This subject came up because at the ripe old age of 69 I finally decided to start exercising. I found a gym close to home, tucked away in a basement, but convenient and friendly. I went a couple of times to see if I liked it and had a trainer give me appropriate tests, treadmill and bicycle. But, the catch is that before you can do such exercise in a gym you have to provide a doctor's letter. So I called my GP and asked for a letter, but she said that I first had to have a batch of blood tests to check me out and go to a cardiologist.
So I went to a cardiologist, and he said that before he could give me such a letter I had to have a stress test, and instead of giving me one on the machine in his office, he sent me to Tel Aviv to have an extra-special test there. So the following week I went to Tel Aviv to the Basel Hotel where Maccabi has a suite of machines devoted to cardiology.
The tests took 4 h, not only 10 min on the treadmill all wired up, but a radioactive test to check the heart blood flow. The staff were very professional, dealing with about 10 patients at a time, running us in and out of the tests, and injecting and timing everything. There was one Arab woman in full regalia, with an embroidered black flowing dress and matching scarf, although not a face covering. She was treated exactly the same as the other patients (she had a young man with her).
None of this cost me anything! I am still waiting for the test results, but when they do come I hope that I am OK to actually begin to exercise. For my 70th birthday I want to be lean, tanned and handsome. Well one out of three would be good.
But, comparing this system to that in the UK, in an incredibly unscientific comparison,. British doctors will not order tests unless they are judged to be essential. This is based not only on my own experience but on that reported back by our family living there. Also, because everyone is covered you have to wait incredibly long times, 3-6 months, for operations that you would get here or in the US almost immediately,.
However, in the US, while we had excellent health care (Blue Cross, Blue Shield), it was very expensive - then a minimum of $100 for a doctor's visit and ca. $300 for a specialist, in addition to the fund's fees. And we were lucky, many people in the US, especially those without jobs, have no health care (ca. 20% of the population), and go mostly to the large municipal hospitals that are free for the poor and indigent. There they can have excellent health care but they are incredibly crowded and unpleasant.
So overall give me the Israeli system. It is a mixture of private/public and often inefficient, but it is responsive and provides excellent care.

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