Health care in Israel, established under Israel’s 1995 National Health Insurance Law, sets up “the most extensive and successful implementation of regulated (or managed) competition in the world,” according to David Chinitz in a 2017 article in Tablet Magazine.
Emanating from pre-state socialism and early Histadrut worker health care plans called Kupat Holim Clalit, today’s comprehensive coverage offered by four competing health plans is not only universal, it is compulsory.
“Bernie Sanders, who talks about a single-payer system for the United States, would do well to point to the Israeli system as a model more closely adaptable to the American context,” Chinitz writes.
An April 17, 2017, article in Haaretz points out that Israel’s basic medical service coverage available to every citizen appeals to immigrants. Costs are primarily covered through a national health tax. Citizens who earn a salary or are self-employed are taxed 3.1% of their monthly salary up to 5,804 NIS (about $1,600), with an additional tax of 5% on any earnings above that amount. Those who are not earning a set salary pay about $25 a month. Exemptions include women who do not work outside the home and children.
I travel several minutes by car in Cleveland to the medical building housing the office of my healthcare plan’s approved primary care physician. Appointments, arranged through a telephone app or by a phone call, must be made way in advance. Before the doctor enters the examining room, I am weighed, pulse and blood pressure are taken, and interviewed by a nurse or a doctor’s assistant. Minutes later, the doctor enters with a small laptop, ready to examine me. I pay a small amount for a PCP visit and a larger co-pay for approved specialists, none of whom need a referral from my PCP. Tests and X-rays can be very pricey, with all kinds of associated fees that add up very quickly and may not be covered if the description of the service does not match specifically to what our plan covers.
A few minutes away from our apartment by foot, our Russian-born Israeli doctor sits in her small office/examining room in the Meuhedet Clinic that houses both Jewish and Muslim medical staff. I make an appointment by phone app or call, or just by dropping in and waiting a turn. After checking in electronically for the appointment, I take a seat in the waiting room, where I need to be on guard lest another patient jump into the office ahead of me.
Our doctor is seated behind a desktop computer and there is a small partially screened-off examining area. Vitals are not taken as a matter of course. After sliding in my Meuhedet card and reading my general information on her screen, she listens to the reason for my visit. The office is not very private, and other patients and medical staff feel free to interrupt – in typical informal Israeli style. The doctor handles it all with grace and compassion. If I need to see a specialist or get an X-ray, a printed hafnaya (referral) form from my doctor is imperative. I travel to another Meuhedet Clinic near Machaneh Yehuda for fully covered X-rays, which are processed onto a DVD and handed to me within minutes.
We are preparing to transition back home to Jerusalem toward the end of November. While the U.S. Congress struggles with decisions about universal health care, we are enjoying its benefits in Israel. Having the luxury of that extra set of eyes and ears for a second view and opinion is not a bad advantage, and perhaps we are even experiencing a taste of U.S. future.
Julie Jaslow Auerbach, a Jewish educator who lives part of the year in Jerusalem and part of the year in Shaker Heights, writes regularly about life in Israel for the Cleveland Jewish News.