Affordable heath care, Israeli style

When I made Aliyah in 2015, I was excited to deepen and formalize my commitment to this amazing nation. My love story with Israel was a totally unexpected romance, and becoming a citizen seemed like the next logical step in our relationship.

I read a lot and heard a lot about what Aliyah would be like, so I knew I would be asked to pick a health insurance provider as part of the process. What I didn’t know was how different it would be from my previous experience in the US. For the first time in my adult life, I was offered health insurance because “hey – everyone here has health insurance.” It was not a benefit of my employment, and I didn’t have to navigate a menu of confusing and overwhelming options that were all ultimately too expensive.

Instead, I was asked to pick which of four insurance providers I preferred. It was my choice entirely, as long as I picked one. Israel, like so many other nations in the world, wants all its citizens covered by health insurance. No one here confuses lack of insurance coverage for personal freedom, and there’s no terrifyingly incomprehensible marketplace of options most folks aren’t qualified to navigate.

For the first time in my life, it didn’t matter what state I lived in, my previous or current medical condition, whether or not I had a job or what kind. I didn’t have to prove that I had previous coverage or for how long. I was immediately offered access to a system that serves everyone, now myself included, along with a financial subsidy to help me get adjusted. For me personally, the biggest challenge was finding health care providers that spoke English!

Lately, I’ve been listening to politicians In the US talk about repealing and replacing the Affordable Care Act (Obamacare), which is already far from adequate. These politicians talk about the healthcare marketplace being driven by consumer choice, which makes it sound like Americans make decisions to ‘purchase’ healthcare in the same way they decide to buy cars or cell phones or t-shirts. They want us to believe that healthcare is just another consumer decision, not an essential need or human right.

They ignore the reality that we all need health care, whether we or a loved one is well or sick, aging, growing, having a baby, hurt in an accident, or a thousand other things that can go wrong with the human body. Imagine not having to worry about losing your insurance when you lose your job. Imagine knowing that your children, parents, spouse, etc., are also covered, and that a change in personal status (marriage, graduation, move, etc.) won’t change insurance coverage.

The relief at being able to access doctors I needed, when I needed, without even a co-pay, made me understand for the first time what is possible, and how broken our American system is. Expensive plans, punitive deductibles, and de facto co-pays add a level of fear, anxiety, and financial stress to one of the most universal and ordinary needs that we all share.

Last spring, in the wee hours of the morning, I needed urgent care. I went to Terem, Israel’s home-grown answer to keeping people out of the emergency room. At about 4am, when it was clear that I was ok, I was discharged and asked to pay my bill. The total? 21 shekels, or about $5.50. When was the last time you paid less than $6.00 for medical care in the US?

I was thrilled to pay the bill (in cash), for the privilege of affordable health care. This was actually the only time I remember being asked to pay a bill upon leaving a provider. Imagine that – no co-pays, no deductibles, no unexpected lab costs, and no anxiety about incurring medical expenses that could take month to pay.

Even crazier, my Israeli insurance provider calls from time-to-time to remind me about scheduling routine or preventative screenings or procedures because they want me to stay well. And all my records, test results, prescriptions, appointments, etc., are available to me and my medical providers through my online account. It’s true that it’s mostly in Hebrew, but that’s my limitation not the system’s.

It’s not a perfect system, because it’s a human system, and no human system is perfect, but it works, and works well. Israel is a high-tech society, and I don’t know of any medical technology you would need that you can’t get, and get affordably. There’s provider choice, available private supplemental insurance, and even ‘alternative’ medicine providers and options. Here’s a link that explains how it works in plain English.

So now, being back in the US, listening to the conversation about healthcare here, knowing how broken the system is, and how broken the conversation about it is, makes me even more grateful that I know what can be. And it makes me even more frustrated to know that the US has chosen to contextualize human need as consumer choice.