Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei
Hayeshua Hospital
PROBLEMS WITH ISRAEL'S MEDICAL SYSTEM
I haven't studied the medical systems of Europe or
Australia, but I know the USA and Israel. If you are
traveling to Israel, live here or have relatives here,
understanding this article is important.
Israeli medicine is socialized, and every citizen has
automatic medical insurance. That is the good news. However,
medicine is not held in great esteem nor is health seen is
an important budgetary item. There are not enough hospitals,
there are not enough good physicians, there is little spent
on educating the public on the prevention of disease, water
purity and food purity attract little notice.
Let's say you don't feel well. In Israel you go to Kupat
Cholim, where a general doctor checks you out. He may have
any credentials in the world. Due to politics, many
physicians that received poor training have received medical
licenses. Specialists may have no credentials in their field
other than experience. The general physicians are in general
overworked and are scared of malpractice, so you may have
many tests that are not necessary, be shipped back and forth
to specialists and be put on antibiotics for reasons that
defy reason. The results are delays in diagnosis, and
overuse of antibiotics which result in the emergence of
bacteria that are resistant to antibiotics. The doctors are
under big pressure to save money, therefore they may ship a
serious problem to a specialist in some office rather than
send to the emergency department, which costs more money.
[Editor's Note: Reports from America say that in recent
years doctors there are also under increasing pressure to
save money and that the experience there is similar to
here.]
Hospitalization costs too much as well. So the kupot try to
minimize the hospitalizations and the days you can be in the
hospital, to save money. Should the Kupah have an agreement
for a gross fee to be paid to the hospital for the whole
year, the hospital itself may seek to not hospitalize or
release you early to save money.
Kupot by law must cover certain medications, but necessary
ones that are new may not be covered. Operations for cancer
and transplants may not be covered especially if not done
here in Israel. Nevertheless, they spend millions on
advertising, because they get a stipend from the government
for each new member of the Kupah.
Should you need to go to the emergency department, you need
a doctor's note or you must pay out of your pocket. During
the day you must wait in a long line at your Kupah for this,
but in the evening when you have no doctor (your family
doctor will not be on call usually), you can either take
your chances going yourself to the emergency department or
call a doctor for a home visit. These doctors are usually
not of very high quality and are under the same pressures to
not send to the hospital and save money. Many times you will
be sent to an urgi-center with again, varying quality. Any
medical service by the way is with a co-payment which seems
to get worse every year.
Want good medical service in the community? You'll have to
arrange it privately. It can be very expensive, even as high
as 1000 shekel for a consultation, but at least you can
depend on the quality. Most people are unable to afford
this.
While we are on the subject of the community, medical
knowledge in the community is on a very low level. Many
people think that smoking is good for you, that antibiotics
help cure fractures and headaches, and that herbs and
Chinese medicine are good treatments for diabetes instead of
insulin. Dogs run wild in this country, so rabies is a
problem, and water purity is a myth. Dysentery is rampant
and sewage and industrial waste are dumped into the ocean,
rivers and in wadis. Good nutrition is also problematic:
foods are spiked with high sugar content, and the use of
saturated fats is commonplace. Many medications and vaccines
that could help people have not been approved for use here
yet, while many old fashioned drugs are still in use. Child
safety caps are not necessary by law.
This is all in the community. Write me in care of the
Yated.
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