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January 13, 2006

National Health Care: How It Worked for Me

July 06, 2009 09:18 PM UTC

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From August 14, 1975 until February 7, 1998, I resided in Israel. When I arrived in the country, health care was organized in the form of four health funds that most Americans might have termed "socialized" medicine. However, behind that label were some realities that were surprising. In the health fund that I joined, I could choose my own doctor. I could go to most specialists without a referral. In the event that I went to a hospital, I had to obtain a form, Form 17 it was called, to ensure that the health fund would pay for the care in the hospital, but that was a simple procedure. Years later, I learned that two of the other funds had similar structures, and eventually, even the fourth one developed into the same structure. Payments for the membership in each fund were based upon a person's salary; a member would have to submit a payment stub to have membership dues calculated.

In 1995, Israel adopted Universal Health Care, a national law that made health care available to all residents of the country. At that point, membership in a health fund became mandatory and dues were collected in the form of a health tax. Salaried individuals paid for it out of their salaries. Self-employed individuals paid for it together with their tax payments. Persons receiving government benefits had the tax deducted from their benefits, and unemployed persons had the tax deducted from their unemployment payments.

That explains the payment part of the health care system, but the real question relates to the quality of the system. From my own viewpoint, I would say that the quality of the system was excellent, and I never feared insolvency as a result of having to partake of health care of any sort; I could focus in on getting well exclusively.

I had surgeries without any significant problems. I was in hospitals ahd received prompt, efficient care. I also tell the true story of my father-in-law who had a stroke and spent a week in the hospital and then afterward spent 2 1/2 months in a live-in rehab center; for the entire period, he paid only $80, and he came out functioning very well.

To see a doctor, I would go to the clinic, where a receptionist would pass my magnetic membership card through a reader to determine if I had paid my quarterly copay -- one payment for unlimited quarterly visits. The amount was very small. When I went into the doctor in the next room, he had all my records online and was ready to treat me. It was the same with a specialist. If a doctor wanted the vital signs, he took them himself; there was no staff employed to do that. Nor were there stacks of folders; all the information was kept online.

Insofar as prescription medications went, I would receive scripts from my doctor that were written on forms from the health fund. I would present them to a pharmacy, where I received the medications at a subsidized price.

When I returned to the United States in 1998, the first thing my father and stepmother hit me with was the hysterical warning, "Get yourself some health insurance - now." I was able to do that soon enough, thanks to some very supportive people that I met. As time has gone by, I could not help but remember how I had lived in a system that worked. It wasn't free; there were taxes, much like the premiums we pay here. Yet everyone had coverage, something we can't say here. All it takes for me to feel nostalgia is to receive a medical bill that insurance hasn't covered, for whatever reason there may be. Having worked in a managed health care company for a short period, I know how the industry works, and it's all pure business; that only makes me yearn more for a system that places health at a higher priority than a profit margin.