Friday, 11 September 2009

The Health Care System in Israel

Joy at The Other Shoe asked about health care systems in countries outside the U.S.A, so here is a look at Israel's health care system (which was ranked in the year 2000 in the 28th place out of a total of 190 countries and has many achievements in medicine and in medical research)

We have 4 kupot Holim (kupot in short, kupa in the singular) here. I never know how to refer to them (well to my one) when it comes up in a post I want to write - is it what is called HMO in other places? So I think I'll stick here with kupa/kupot.

In 1995 we had a big reform in our health care. Though we did have those 4 kupot and though the majority of citizens did belong to one of them there were some problems. First to belong to the big kupa, one had to belong to the Israeli Trade Union, while the other kupot restricted acceptance of new members based on age, pre-existing conditions and other factors. Second the level of coverage was different. And lastly the fact that not all the citizens were covered.

From 1995 it is compulsory to belong to one of the kupot, to any kupa you desire - there are four times a year when you can switch to a different kupa, and not only can no kupa turn you down, but they have to continue your treatment (though you probably can't just go back and forth between the kupot..).
Before 1995, you paid to be a member of the kupa a certain amount of money, while it might not have been a great sum (really can't remember how much it was :-)), it was the same sum for all. Today you pay a percentage out of your pay-check (about 2.5% of your salary goes to health care and another 2.5% to national insurance. really not a lot), so everyone pays according to what they can, and all get the same services. Might I add that as it is not the kupot who collect this money, that they have no way of telling who paid what.
The basic coverage includes diagnosing, consultation and treatment of medical conditions; medicines - according to a list of medicines that are on the basket at a reduced price [about 10-15% of it's full price]; hospitalization; rehabilitation; medical appliances and accessories; lab services and more.
Beyond this basic coverage, the kupot are entitled to offer more services for an additional fee, but this is really beyond the wide range of basic coverage (for example fertility treatments for a third child [treatments for first and second child are part of the basic coverage, provided you are younger than 45 yrs old]).

And on a personal view as a fertility patient:
Fertility treatments is one of top priority, and so the coverage is great. As mentioned above, it is completely free (as in you do not have to pay for lab tests; for being wanded; for any of the other tests that may be required like HSG; for seeing a doctor; for being treated in a fertility clinic [and might I add reading how patients in other parts of the world are discriminated for being gay/lesbian/single, that it is not the case here. No clinic can turn you down because you are single or lesbian or whatever]; IUIs and IVFs [I am entitled to six IVFs in one year. Taking into account that your body does need to rest and long protocols, that is good enough]).
When I was doing IUIs, I was treated wholly by the public health system. That meant that every time I went to see a doctor at my clinic, the doctor on call was the one that saw me. As they are all top doctors, it was more than fine with me. Proceeding to IVF, I preferred having one doctor who knows my case, so I am now using a combination of private and public health care - I pay to see this doctor, but everything else is free (including IVF place which in fact is a private hospital, but as it belongs to my kupa, I do not have to pay).
And yes, I am very pleased with our system. It probably has it's faults (like what medicines are included on the basket. Luckily no problem with fertility meds, but if you have a rare condition, there is a likelihood that your med won't be included), but it gives all a good basic coverage no matter what ones financial state is (just to clarify, I could have done the IVF completely in the public health care system and with good doctors) and we do have good public health care, good hospitals and all.

Some sites on the health system in Israel:


battynurse said...

That sounds very interesting. What happens with those who are not working either for disability or just flat out laziness? How about elderly? The plan there sounds like a very good one.

Jess said...

That is really interesting! thanks for sharing!!

Billy said...

Basically if you are not working, you have to pay a fixed sum.
But then again there are those who are exempt from payment like a married woman who doesn't work (housewife); soldiers; prisoners; new comers (immigrants).
And then there are those who are on benefits for this or for that, like elderly who get a small amount (really small..) of pension from the national insurance or people with disabilities. I believe that out of the money that they get, some of it is deducted for health coverage, but I am not completely sure how that works and how much they have to pay.

becomingwhole said...

As someone who lived in Israel for a year (tourist visa that was extended), I paid an American dollar a day (in 2004-05) for amazing health care that covered prescriptions and everything. There were some preferred Rx's that were not covered, but I could buy them out of pocket. (pregnancy/fertility treatments were not covered on this plan--there was a more expensive plan that would have covered pregnancy/labor&delivery) As an American visitor, I was completely satisfied with my health coverage there and found it to be extremely economical and the doctors to be top-notch. Before I left I had to be treated at the emergency room, and couldn't have been more satisfied with my treatment.