Health Care, A Personal Comparison

Health care – A Personal Comparison


The health care debate rages back in the States. Between those who believe that health care is a basic right and those who believe it is a privilege. Between those ready to sacrifice some of the individual choice basic to the American privileged-based system, and those unwilling to tamper with the market dynamics of the current system. There is considerable middle ground to be had, but a basic philosophical fault line beneath all.

The Robbins family is living this debate. We have just completed the first five years of our son Coby’s life. Hampered by interstitial lung disease, stomach dysmotility, reflux, and eating disorders. We know the American health care system – its greatness, its weakness. Now we live in Israel, where Coby is just completing his first lengthy hospital stay, as a high risk child struck with swine flu. As we do, Amy and I have been switching places in the hospital and at home, and have had a bird’s eye view into the operation of a high-quality Israeli hospital.

In the United States, I thanked God every day that I had a job and a good health insurance policy. I liked my work as a rabbi. I liked it even more because it paid me enough money to pay the massive premiums for its excellent health insurance policy. Before departure, we put down in the vicinity of 1600/month to protect our family.

It was sadly and woefully pathetic to regard the families regularly sitting next to my child and me in Children’s Hospital of Philadelphia Emergency Department, knowing that the ER was their only possible medical destination. With little or no chance to acquire the fabulously specialized treatment that our son regularly enjoyed beyond the confines of the ER into the vast web of medical services offered by CHOP, its satellite care centers, and affiliated pediatric offices.

It was humiliating to navigate the maze of insurance alleyways. So many manned by people eager to serve and help. Yet with a mighty market headwind relentlessly trying to keep your hands off the prized benefits. Pre-certification. Pre-authorization. Expired referrals. Keystone this instead of Keystone that. The wrong department, sorry, and they’re not open now. No, I can’t give you my name or telephone number. You’ll need to call back the same switchboard.

Money, of course. Always money. Time to discharge, because of money.

We wanted privilege, and we got it. Cookies. Shampoo. A parents’ and kids’ center filled with videos, literature, newspaper, computers, and everything else to help make a long or short-stay easier. Not bad things at all. Good things. But how relatively important compared to giving another kid access to the basic health services that our son had?

Here, in Israel, I thank God every day that I don’t have to have a job to have health insurance. We pay relatively miniscule premiums – 50$/month – to avail Coby and the rest of the family of the services that every other citizen of this country is entitled to. That every other citizen of this country is entitled to, by virtue of basic humanity and residence in the society.

There is the bureaucracy, and there are the waits. I cannot get non-emergent specialized care tomorrow unless I pay for it out of my own pocket, purchase an expensive “private insurance” plan, or get lucky. So I have to walk on my painful hammer toe for another couple of months before getting it addressed by a specialist. Should this really be so hard?

In the hospital, I, not the nurse, need to physically give my son his oral medications. I have to strain to take his temperature with a mercury thermometer, because there are just not enough of the digital ones to go around. There is not an endless supply of linen and care-ware for parents and visitors. What you need, bring yourself. Television – pay for it if you want it. Remember those days?

But here, doctors give you their cellphone numbers. Call me when you need. They take their quasi-parental responsibilities quite seriously. Office visits do not require your cash or credit card. Can you imagine that? You’re not reminded of HIPPA every single time you do anything medically.

Friends, I’m rolling on too long. Truthfully exhausted. A fried oleh. Wanting to share a creative thought after a hiatus. Wanting to hopefully make a little impress on your health-care thoughts. And wanting to tell you that the socialist ethic so maligned in the American media is alive and well here in Israel, expressed not everywhere but in some of the absolute right places. Like health care.