6 Great Things About Israel’s Healthcare System
Why Israel’s healthcare has a well-deserved reputation for excellence
I’ve written several times before about the pros and cons of living in Israel — at least as I see them.
The Pros and Cons of Living in Israel
(And Why I Still Think the Cost of Living is the Elephant in the Room!) medium.com
And whenever I do so I preface my observations with one major caveat:
Like many Jewish immigrants, I came to live here for ideological and not pragmatic reasons. I see Israel as the only logical home for Jews and the idea of playing a role in its future, and helping make the country better, is a tremendous motivator that empowers me to keep trying even when the going is hard (frequently, it is). Therefore, I currently live there. For me, the ideological drive supercedes all logical considerations.
But if we do want to get into the nuts and bolts of what it’s like to make a life in this part of the Middle East, I have plenty to say about that — and I’m far from blindly positive (some would even say I’m doom and gloom). I’ve already highlighted some of the less desirable aspects on this blog: it’s annoyingly expensive; customer service is frequently kind of rubbish; and driving here is so stress-inducing that more days than not I’d rather just take the bus.
My Theory About Why Customer Service In Israel Is So Frequently So Bad
In a sometimes pitched battle for bare profitability, the small buyer frequently gets the raw end of the stick danielrosehill.medium.com
But there are things about living in Israel that I think are objectively good.
And one of those is its healthcare system.
While Israel may have prematurely robbed me of my gallbladder (another days’ grievance!), I have overall only good things to say about healthcare here. Here are five ways in which I think it is outstanding.
Healthcare in Israel is thoroughly digitized
The login to my Macabbi healthcare portal where I can do everything from book doctor’s visits to send my doctor messages to see how much I paid for my last prescription. Screenshot: author via Macabbi website.
Before I left Ireland, I attempted to get hold of some recent blood tests.
What can I say? I’m neurotic about digitization, my scanner is one of my favorite possessions, and I try to keep as few pieces of paper as I possibly can.
The outcome? I needed to file something that felt very like a freedom of information request to liberate a document that looked very much like it had been scanned. I had no idea I would be creating so much hassle.
In Israel, digitization, and electronic medical records (EMRs) are the norm rather than the exception.
My health maintenance organization (HMO; Hebrew: kupat holim) has an online system through which I can do everything from book doctors’ appointments to find specialists in my area.
Everything — and I mean everything — gets electronically logged in this system (not all of the data, such as doctors’ notes, is visible to patients).
I can see when I filled prescriptions; exactly how much I paid for each; and what medications I’m currently taking. I can also send my doctor a limited number of questions per quarter. And if I’d rather just book a telephone appointment — they added this feature for my family doctor to minimize clinic visits during the pandemic — there’s an option for that too. Alongside a whole lot more.
The system, while terrific, isn’t perfect. The psychotherapy system, in particular, doesn’t tie in anywhere near as well as medical specialties do. But overall booking doctors’ visits, or reading your latest blood tests, is as easy as opening up an app.
Quality of care is good — and you can find doctors who speak your language
Using the Macabbi web based system in order to filter available doctors by the language(s) they speak. Screenshot: Maccabi
While I try, to the fullest extent possible, to use Hebrew as much as possible in my day to day, there are things I’ve realized that it just doesn’t make sense to risk misunderstandings over.
One of those is medicine.
When you’ve got a pain in your right side and you don’t know how to describe it as “sharp” or “gnawing” you really don’t want to risk misdiagnosis by botching the vocabulary.
Fortunately, as a country of immigrants, each kupat holim(health maintenance organization, there are four) tends to have doctors — and even specialists — who speak your language.
English-speaking doctors, in particular, are easy to find. After all, English is the international language and — as far as I’ve been told —many doctors need to develop at least some proficiency in English for professional reasons.
My health fund (Macabbi) allows me to search by language. Whether I need a doctor who speaks English, French, Arabic, Yiddish, Russian or any of the many languages spoken in large number in Israel — I can do so with ease. This alone takes a lot of the pressure off ensuring continuity of care when you move here.
The COVID Vaccine Rollout Has Been World-Leading
Hopefully, by the time you read this blog post the whole pandemic fiasco will have been behind us.
Israel’s COVID numbers have varied from “world beating” to “what on earth went wrong over there?”
But in at least one respect most people can agree the country has done a great job: and that’s in quickly rolling out a vaccination program.
Why has Israel been so proficient at ensuring that its population received both double vaccinations and boosters in an extremely timely fashion?
A few reasons can be offered.
Firstly, while Israel does some things poorly (see above comment about customer service; or walk into any post office in Israel; actually, just try to join a “queue” for coffee), it excels in other areas.
One of those is logistics. As a nation of conscripts that frequently finds itself at war, Israel has put in place some excellent infrastructure for liaising between decision-makers and the general population.
One such institution is of course the Israel Defense Forces (IDF).
Another is Israel’s general affinity for everything related to technology. It’s much easier to roll out a vaccination programme for several million people when everybody already has access to an online system.
More presciently, Israel’s well-digitized medical system — and small size — made it a perfect leading-edge test case for the rest of the world. Israel cleverly used this fact to its advantage by cutting a data-for-doses deal with Pfizer.
May the rest soon all be history.
Access to doctors, and specialists, is generally fast
This morning, I saw my family doctor — which provided the impetus to write up this post.
The visit was routine, although I’d rather not share the details.It resulted in the generation of one prescription. I filled that about five minutes later. No paper necessary.
I booked the appointment online last week and simply showed up at the clinic at the right time. No phone calls or dealing with harried secretaries necessary.
During the tenure of my time in Israel, I’ve needed to see several specialists and have a few test done.
As a lifelong asthmatic, it makes sense for me to see a pulmonologist every now and again and have a spiromety test done. I never heard the word “spirometry” before I moved here. Nor did I know that it should be done to make sure that what you “think” is asthma it’s really something else.
Access to specialists is, in general, amazingly quick. Particularly the more frequently-seen ones such as ENTs.
Psychiatrists and rheumatologists are apparently a little slower. But you’re still talking about months rather than years. This is all through accessing the healthcare system through the conventional “public” channel. (Israel does have supplementary healthcare and insurance although the mainstream care is so good that many are perfectly content with the level of care provided through their HMO).
The system is mostly pretty well joined up
There are four health maintenance organizations in the country — Macabbi, Leumi, Clalit, and Meuhedet.
By law, every citizen needs to be signed up to one — irrespective of their employment status.
For the past three years, I’ve been (full-time) self-employed. I make monthly payments to the National Insurance Institute (Bituach Leumi) and pay a small monthly fee to my health maintenance organization. Together, they ensure that I have access to healthcare.
When I read discussions among American freelancers about the stresses of living without healthcare, I feel bad for them.
Being freelance/self-employed can be stressful enough without having to worry about being able to pay for your insulin/inhaler on top of everything else. I’m grateful that Israel makes it relatively easy for even those on a modest income to afford the medications they need to stay well and healthy.
Israel also has an urgent care network — Terem — that sits somewhere between the HMOs and the emergency room network, which Israel tries to reserve for real emergencies.
If I’m referred to Terem by my HMO — for instance, I need urgent care and its out of hours — I’ll receive a discounted rate. I can even see details of ultrasounds I’ve had done in external providers, and my gallbladder surgery, in my HMO file. Systems “speak” to one another.
Overall, costs are quite low. Prescription medications are affordable.
Here are the current prices, in shekels (NIS), for the health plans with Maccabi:
‘Zahav’ (gold) is the more basic plan. It more than covers my needs. ‘Macabbi Sheli’ (My Macabbi) offers you some extras.
Within my age bracket (30–45), my monthly fee for Macabbi Zahav is 51.91 NIS. At today’s dollar exchange rate, that’s $16.23 — or just shy of $200 ($193) per year.
If I want to go for Macabbi Sheli, I’d be paying 97.24 NIS per month. That’s $30.40 per month. Or $365 per year.
Prescription medications involve surcharges — although what you pay is a discounted rate.
Some recent purchases from my list:
- 30 capsules of omeprazole for 18 NIS ($5.63).
- Relvar (fluticasone furoate/vilanterol) for 27.57 NIS ($8.62).
Naturally, healthcare in Israel isn’t perfect.
You can encounter doctors you find less than helpful. Sometimes, you feel as if the system works a little too quickly (my referral to gallbladder surgery felt a little bit rushed).
And ultimately you’re dealing with a system that’s underpinned by socialized medicine and which is designed to serve the whole population for a relatively low cost. If you want really in-depth care, many will pay to access private doctors.
Overall, I think that healthcare in Israel is excellent.