Could Israel be a model for American health-care reform?

Jewish activists tout the health-fund system for integrating public and private options

By SAM GREENBERG, THE JERUSALEM POST, WASHINGTON
US health care protest 248.88 (photo credit: AP)
US health care protest 248.88
(photo credit: AP)
WASHINGTON - With the nation sharply split over how to fix the ailing health care system, groups of Jewish activists are trying to paint Israel's system as a model for America. While several Jewish organizations are deeply involved in the health-care debate, largely backing the Obama administration's plan, The Israel Project sees an opening for touting Israel's accomplishments in providing national health coverage. With millions of Americans lacking medical insurance and the cost of care skyrocketing, US President Barack Obama and the Democratic Congress are pushing a plan that would expand coverage for Americans and attempt to keep costs down, in part by allowing individuals to access publicly-funded or subsidized insurance options. Though they have not proposed a European-style model of government-provided care, they are still walking a delicate line on the explosive issue of private versus public health care. Conservatives strongly oppose any program perceived as nationalizing the industry, while progressive groups would like the government to go farther in mandating and providing care. In Israel, in contrast, all citizens receive care through four government-funded providers. All citizens must select a provider to join, and can also elect to buy modestly priced supplementary insurance to cover more health services. Public health services are funded through a progressive tax, and, while precise estimates vary, Israel spends at least a few thousand dollars per capita less on health care than America does. The system is not without its flaws, and the exact same system couldn't be replicated in America. But there are parts of Israel's system that experts feel could be beneficial to America, particularly in maximizing universal care at low cost while allowing individuals to supplement their coverage as they see fit. Dr. Bruce Rosen, director of the Smokler Center for Health Policy Research at the Meyers-JDC-Brookdale Institute, explained some of these features on a recent conference call organized by The Israel Project, which works to spread information about Israel. "The basic philosophy in Israel is that the government ought to take care of financing to ensure access and equity while the nongovernmental sectors ought to take care of most of the healthcare delivery - that takes care of responsiveness and choice," he said. "Our government also plays an important regulatory role to make sure that the insurers and hospitals are acting in the best interest of the population." A specific lesson he pointed to was the benefit of having advanced, widespread electronic medical records. "Most of the Israeli doctors feel that these [electronic] records actually help them give better patient care," Rosen said. To bring some of these concepts to America, Rosen's institute is partnering with the Jewish Healthcare Foundation in Pittsburgh to analyze what America can adopt from Israel's healthcare system. While many Israelis express satisfaction with their system as a whole, they still debate various aspects of the way of it works, including what drugs and services should be included in the national health basket. However, every citizen receives some degree of coverage. "We believed that voluntary insurance was not enough. There was the need for a law," explained panelist Dr. Alex Leventhal, director of the Department of International Relations at the Health Ministry, referring to the 1995 National Health Insurance Law. The concept of requiring health insurance or otherwise having a national plan has been met with resistance in some American quarters. Since Israel's model partners basic universal coverage with the ability for individuals to purchase expanded benefits, it provides a model for integrating public and private options. Even so, The Israel Project noted that Israel's system hasn't gotten much attention in America. Even among the Jewish organizations advocating health-care reform, Israel seldom comes up. "President Obama and other experts and people in the media have been talking about health care a lot," noted Laura Kam, senior advisor at The Israel Project. "They have not necessarily mentioned the health-care system in Israel, which I think Israelis and people who support Israel should be really proud of." Last week, hundreds of people attended an interfaith service and rally near the White House held by Believe Together, a coalition of over 40 religious organizations advocating health-care reform. "Two thousand years ago, the Jewish tradition argued that two central ideas underlie the ancient Jewish commitment to provide health care to all God's children," said Rabbi David Saperstein, director of the Reform Movement's Religious Action Center and one of the event's keynote speakers. "Providing health care was not just an obligation for the patient and the doctor but for societies, as well," he said. "In many Jewish communities, a public health-care system was set up to guarantee that every person, rich and poor, would have access to health care." Rabbi Shawn Zevit, director of outreach and tikkun olam at the Jewish Reconstructionist Federation, which cosponsored the event, said that reforming health care is "an issue of tzedek, of justice; we can't sit idly by as the Jewish community." He added, "It's an imperative for us to be involved in issues that affect not only the Jewish community, but all peoples." "We support universal access to health care. We believe there needs to be a public option in whatever plan they come up with," said Jewish Council for Public Affairs Washington Director Hadar Susskind. While the JCPA tries to formulate country-wide policies for the Jewish community, based on the input of scores of communities, not all American Jewish groups support Obama's approach or that articulated by JCPA. Republican Jewish Coalition executive director Matthew Brooks urged that Democrats "reconsider their apparent determination to saddle Americans with a deceptive 'public option,'" even as he envisions "progress toward universal health-care access and a more sustainable health-care financing system." The public option would be government-funded health insurance that critics worry could drive private insurers out of business. Jewish groups working on the issue noted that in many cases their efforts began before the new administration began to focus on the issue. B'nai B'rith director of aging policy Rachel Goldberg said her organization has long been advocating changes in health care. Even though she isn't looking to Israel for specific ideas, she sees it "as a sign of what's possible, that you really can have a functioning health-care system in which people have coverage and people have access."