Monday, July 27, 2009

Healthcare in Israel

The health system in Israel has been touted as a model for the US to follow given the political war now being fought by Pres. Obama and the Democrats against Republican opposition in the US for health care reform.
What is the system in Israel? First, let me say that we are very satisfied with this system here and so it seems are most of our friends and acquaintences. This could not be said about the situation in England, where the British health care system seems to be floundering, and has been for many years. In Israel there are a number of so-called health (or literally "sick") funds (in Hebrew, Kupat Holim) to which every person in the country belongs. The first and largest of these, the so-called General Sick Fund (Kupat Holim Clalit) must take any citizen who applies for health care. All the sick funds are subsidized by the Government, and the Government also plays a role in deciding how much they charge each member, and the cost it taken from their salaries at source or (by agreement) from their bank account.
Nevertheless, each fund is independent and can set its own programs and priorities. For example, our fund Kupat Holim Maccabi, tends to be more modern and somewhat more expensive than Clalit. We have GPs who are part of Kupat Holim Maccabi and we pay them about $1 for each visit (in addition to our basic charge). If we need to see a specialist we get a referral from our doctor and then its usually easy to make an appointment (sometimes the wait is a few weeks). At every doctor's or nurse's station in the Maccabi clinics there are computerized screens that have the names of the patients and their appointment times. Since the Maccabi clinic near us is so crowded and heavily used they are completing the construction of a new larger more modern center about another 5 mins walk away. Clalit owns many hospitals and generally is very crowded and requires longer waits for doctors. The other main fund is the smaller Kupat Holim Meuhedet, or special fund, although I don't know much about this.
Far be it for me to recommend that the US adopt this system, of independent but Government subsidized health funds. I believe it developed in Israel as a result of the strength of the trade unions and the early control of the Labor Party. However, it is clear that a fully Government run system as in England is not a good model to copy.
Although I oppose Obama on foreign policy, I support the general position that all Americans need to be covered by some kind of health care insurance. No modern country can or should function without it. And the problem is that this is going to cost mucho bucks, given the cost of modern health care and the millions who are not covered in the US. How to do this without bankrupting the US is indeed a problem. So I support the principle of universal health coverage, but how this can be accomplished in America is indeed a difficult problem. I hope that Obama spends more of his time trying to accomplish this, than wasting his time trying to control Israeli building on the West Bank and in East Jerusalem. In the long run it will be far more important for him.

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