November 15, 2011-Medical Care in Israel- A First Hand Perspective

The news in Israel was dominated today by the increasing confrontations between the doctors (especially the hospital Residents) and the government. This confrontation, which has been going on for the past few months, is mostly over the working conditions and overcrowding that exists in hospitals here. Negotiations between the two sides have broken down. Some of the hospital Residents have resigned in protest. There are clearly many problems with the Israeli medical system, caused particularly by the fact that the growth in the number of hospital beds in Israel has not kept pace with the growing population. However, as my personal story below attests, the whole system is clearly not broken.

One of the few things that worried me about moving back to Israel after so many years was the fear that my 84-year-old Dad, who is not in the best health, might not get the sort of care he would have likely received in the United States. That is a fear I no longer have. My dad was not well last week. After consulting with a doctor, we took him to the Emergency room of Ichilov Hospital. Ichilov is the nearest hospital to where we live and is widely considered one of the best in the country. It took about five minutes to take care of the minimal admissions paperwork, after which we were directed to bring my dad into the emergency room.

Once in the emergency room, my dad was seen almost immediately by a nurse. Then, despite the fact this was not an emergency situation, a doctor came to see him within five minutes of the nurse's first evaluation. After an hour in the emergency room, where doctors took his medical history; ordered and received the results of a chest X-ray, the doctors decided to admit him. Upon arriving at the ward late at night, he was once again seen by a doctor. First thing the next morning a course of treatment and further tests were set. My dad stayed in the hospital for four nights. Throughout his stay the care was consistently excellent. The most advanced tests were run, in a series of modern well-equipped labs. The hospital staff, on all levels, including the cleaning staff, were polite, attentive and caring.

Now for the most impressive part: Two days after my dad's release from the hospital, we received a call from a nurse from Macabbi Health insurance, one of the three main Israeli health care providers, and the one we selected. She was part of a new program initiated, which calls for a thirty-day follow up of all patients discharged from the hospital. The nurse immediately arranged to have his follow-up blood tests taken at home, with a Macabbi technician visiting our apartment twice a week. Furthermore, the "follow up nurse" came for a visit today, with a social worker from the insurance company, to see how they can help support my father's recovery.

After the nurse's visit, which included planning his follow up care, she arranged for both a dietician and a physical therapist to come to our apartment. The Social Worker directed us as to how to get additional help caring for my Dad. All of this care was given not because we are immigrants, or in dire straits, but because we are member of the Macabbi Health Plan. It should be noted that when we called the much touted "Nefesh B'Nefesh for advise on available resources to help with my Dad, they sent me a list of web sites.

Now this is not to suggest that all of Israeli health care is this good. We are fortunate to live in Tel Aviv; a ten minute walk from the best hospital, a hospital which over the past few years has benefited from major gifts of new buildings donated by two of Israel's richest families. We are also near where many of the best doctors are located. Clearly, if lived in Kiryat Shmona, or other areas of the periphery, we would not likely experience this level of care. However, the problems of quality of care in the periphery are not dissimilar to the problems faced in parallel locations in the US. The Health care received by an upper-middle-class New Yorker living in Manhattan is not the same as the care that a farmer from Nebraska generally receives. The fact that the health care received varies greatly by where one lives, is a serious problem, both in Israel, as well as in the United States. However, our experiences these past 10 days has shown, that at least when it comes to those living in the right cities, with the right health plans, Israeli health care has much to teach American health care today.