Tali Nir
Featured Post

Who will heal Israel’s healthcare system?

An ill-fated trip to the emergency room illuminates the sorry state of national medical care

It was a quick and painful cut – almost a routine injury – that brought me to the emergency room about two months ago. Eventually I discovered that I had cut the nerve and tendon in my palm. My trials and tribulations following this relatively common injury – in one of the country’s top hospitals – illustrate the sad state of the health care system and the need for substantial action from the coming government.

It began in the waiting room. Despite being in intense pain, I waited an hour before seeing a doctor. After a series of tests I was told that I needed surgery. The plan was to have surgery that day, but soon the on-duty intern arrived to break the news: since the operating rooms were full, the surgery would have to be delayed until Sunday (this was on a Thursday). This would have been puzzling, as there were still plenty of hours left in the day, but I guessed the reason. Even if the rush on the operating rooms were to let up in the afternoon, by then the senior doctors are all off working in their private practices.

Although I didn’t say a word, the intern, seemingly reading my thoughts, made the case for why I should not have my surgery performed at a private hospital. His central argument was that it would take more time at a private hospital. His preparedness to acknowledge and engage in competition with private practice amazed me. I hadn’t realized that the private sector had grown to such great proportions that public hospitals would actually feel the need to fight back and compete.

Accepting my fate, I asked who the surgeon would be on Sunday, but no one would tell me. After an anxious weekend, I arrived on Sunday morning, but there was still no answer about who the surgeon would be (or what time the surgery would be). I waited from seven in the morning until just before four in the afternoon, when the surgeon finally arrived and prepared to operate on me. Naturally, I didn’t have time to find out anything about him. I left it to chance.

Following the surgery I waited for hours in the recovery room because the orthopedic department was full. At midnight I was transferred to the cardiac department, which was the only place with room (I was told I was lucky). This is what happens when there is a deficiency of 3,000 hospital beds and the government thinks it sufficient to add only 1,000 beds in five years.

The next day I returned home in intense pain. The doctor who discharged me recommended I take Optalgin, but it didn’t help. All of my attempts to reach the hospital and my doctor in order to receive stronger painkillers failed. My family doctor tried to give me something, but rather than ease my pain, it only caused me insomnia. The same thing happened with the orthopedist at the kupat cholim. When I complained about this during a subsequent visit to the hospital, the doctor just shrugged. What can they do? The system is not designed for doctors to be in contact with their patients once they’ve been discharged.

In the end, I used personal connections to reach a pain specialist who gave me a prescription for a suitable drug which though expensive, is available at a discount for patients with conditions like mine. But when I tried to fill the prescription at the kupat cholim I was told that I would need committee approval in order to receive the discount. Meanwhile, still in pain, I paid full price. It turned out to be a wise decision; at the end of the day the committee notified me it was not approving the discount. I gave up.

Now I’m undergoing occupational therapy at the kupat cholim with wonderful therapists. They schedule my appointments a month in advance because they know that otherwise they won’t be able to fit me in to their busy client load. At another check-up at the hospital, the doctor was unhappy with my progress. I asked if it was worthwhile for me to go to a private occupational therapist. He suggested that it was.

These problems are known to everyone who has lately been in need of medical care. They are the result of years of budget cuts and the privatization of the health care system. Yet despite these problems, health care is not a major issue on the agenda during election time, even as nurses are striking. It is much more important who is going out with whom and who is sitting with whom. No one argues about the actual content of our lives: about health and housing, about education and our working conditions.

Just before we go to the polls, it is possible to receive slightly more concrete promises from the parties?

Adapted from a Hebrew article published in Yediot Aharonot on 1.1.2013

About the Author
Tali Nir is the CEO of 121- Israel’s leading NGO for advancing public policies for social change.