How much of a Priority is Your Health?

By JAN VAN MIL
I am a sceptic. I am a pessimist. I have a lot of criticism for Israel and its governing bodies. Some may even call me a leftist. However, sometimes you get a glimpse of things where right or left doesn’t make much of a difference.
A couple of days ago, my neighbor, a sixty-year-old lawyer, behaved awkward. Her husband, and two of her sons, who are all abroad for various reasons, called me to check up on her. She, being a strong-willed, independent person made it clear that to me that she was OK, that she has a doctor’s appointment in the morning and that all is well. It was late at night, so I accepted her explanations and went to bed, but not before promising her husband, I would check up on her the next morning.  At six thirty next morning, when I knocked on her door, I found her confused and having difficulty speaking. From overseas, her husband had spoken to a physician friend who urged that she go to the Emergency Room at the hospital to be checked out. By then, she also realized that something was amiss and she agreed for me to take her to Rambam hospital in Haifa.
We arrived just after eight and after we managed to find our way through the well-organized but very big parking lot, we got to the Emergency room.
The crowd was (still) thin and within twenty minutes, a physician saw us who ordered blood tests, a consult with a neurologist and a CT scan. The blood tests were taken immediately and the neurologist examined my neighbor shortly after. The CT scan took longer, because, as we were explained later, they needed to make sure that my neighbor did not have elevated levels of creatinine, which would indicate kidney problems that might cause a problem when during the CT scan she would need to be injected with a contrast liquid.
After the scan, the neurologist again saw her and discussed the diagnosis with her. She had suffered a small stroke that affected the area in her brain that controls speech. The prognosis was rather good but recovery would take several weeks at least.
My neighbor was hospitalized and the next day she had another CT scan to evaluate the effect of blood thinners she had been receiving. They also conducted an examination of her heart function, since most strokes of this type are caused by (small) blood cloths that form when the heart is not functioning properly.
The day after, she had a discussion with a neurologist about prognosis and timelines, and she was released to her home.
In and by itself, this is not a remarkable story. What made it special for me (in addition of course to the fact that we are talking about my neighbor who I have known for 25 years), was to see how the hospital operates. The people that make this work, the men and women that make sure that a person like my neighbor gets the best care possible and with a smile!
The guard at the entrance to the emergency room, who, even though he told us that only one person may accompany a patient, did not hesitate to allow my neighbor’s son (the third son) who had rushed to Haifa from his Army base in the south, to go and see his mother.
The woman at the reception, who even though my neighbor only had a handwritten referral sent by WhatsApp, made an effort to extract it and print it out so the physician would be able to read it.
 
The young neurologist, who showed patience and understanding to the confusion of my neighbor and reassured her without giving her false hopes.
The Dutch born nurse who, while running around performing all kind of tasks, did find the time to check up on my neighbor and make sure she was ok and taken care off, while at the same time, recognizing me as being Dutch as well, from my accent (and I don’t have an accent!).
The nurse (Zvika) who kept checking on us to make sure that my neighbor would get her CT scan, and afterwards made sure that a bed was found for her in one of the departments.
Israel’s healthcare system has been under severe stress for years, with expenditure lagging behind (7.4% of GDP with 8.9% as the OECD average), which comes down to just over 2,800 dollars per capita (with 4,000 dollars the OECD average). Moreover, 23% of this expenditure is so-called “out-of-pocket” expense, paid by the patient himself.
Israel has a lower than OECD average of physicians per capita (3.1 per thousand people vs. 3.4) and a frightening shortage of nurses (5.0 per 1,000 people vs. a 9.0 per thousand people OECD average). There are 3.0 hospital beds per 1,000 people, available in Israel, vs. 4.7 per 1,000 people as OECD average.
Equipment wise, the situation is even worse, with 4.9 MRI scanners per one million population (the OECD average is 16.4 machines, only Hungary and Mexico are behind us), and 9.7 CT scanners per one million people, with an OECD average of 26.1 machines!
Waiting times to see a specialist physician may run into months with especially outlying areas in both the north and south being notorious for the extremely long time you have to wait to see an orthopedist or almost any other specialist.
Money is the only reason Israel lags behind in medical care. A CT machine will cost a couple of million dollars and an MRI scanner even more. Building a hospital and running it, including staff of doctors and nurses requires many millions of dollars. Spending money on health care is a matter of priorities.  Israel of today, spends enormous amounts of money (both openly and through elaborate shady dealings) in the occupied territories and except for defense, everything else is second tier. Having a Bennett as Education minister, Akunis as Science minister and Katz as Social Services minister, shows the importance given to these sectors, and the fact that we do not even have a Health minister, but only a “vice-minister”, who is not much more than a puppet in the hands of some rabbis, shows that the powers that be, really do not care.
I do not know if our experience in Rambam hospital this week was exceptional, but it appears the system is managing. So the OECD figures are inflated? We really do not need so many nurses? We have enough MRI machines? Or maybe, we just need to be grateful that the medical staff in hospitals is covering for their incompetent and uninterested leaders. These people manage to make the best of the limited resources and through hard work and dedication succeed in making up for the negligence of the political echelon who should be serving these very people but are mostly busy furthering their own goals and agendas.
What is strange, is that these people, and their patients, are very well aware of the situation in Israeli health care (as in Social Services, Education, etc.) but that apparently this is not enough to change the political picture in this country.
I guess that as long as you are healthy, the problematic state of the health care system is not a really on our minds and there are more pressing issues.
Maybe we also have our priorities wrong.