Heal the health system

The major overhaul that our health system so desperately needs can only be implemented by PM Binyamin Netanyahu.

Rambam doctors strike march 311 (photo credit: Piotr Fliter)
Rambam doctors strike march 311
(photo credit: Piotr Fliter)
Protest was spontaneous, emotional, and massive in proportions. On Wednesday hundreds of medical residents and interns in hospitals across the country walked away from their posts. Some took to the streets to block traffic. Others gathered in front of the Israel Medical Association offices in Ramat Gan.
The doctors, at the beginning of their careers and still strapped with exceedingly long work hours – eight to 12 26-hour-on-call shifts a month in addition to a regular full-time schedule – at ridiculously low pay – NIS 22 an hour for interns and NIS 25 an hour for residents – broke ranks with the Israel Medical Association, the union that represents some 15,000 physicians, after reports were leaked of the details of a labor agreement reportedly about to be signed to put an end to 109 days of strikes and sanctions and bickering.
The outcome of long hours of negotiations was apparently so bad that hundreds of interns and residents simply could not control themselves and staged a nationwide walkout.
A restraining order issued late Wednesday night by National Labor Court President Nili Arad ordering the rebellious physicians to go back to work was widely ignored Thursday.
Dozens adopted creative modes of protest. Dr. Ariel Margolis, in residency at Meir Medical Center in Kfar Saba, has been making his rounds with a sign plastered to his midsection warning his patients, “You are receiving treatment from a doctor who is tired, frustrated and on a hunger strike.”
Others switched places with patients, checking themselves into emergency wards with genuine complaints of fatigue. At psychiatric wards, doctors complained of mental breakdown.
In short, the situation has reached crisis proportions.
The hierarchy of medical responsibility is being undermined with real concern that patients might be affected by the unrest – though interns and residents insist they are taking utmost care not to endanger life.
The crisis is all the more acute seen on the backdrop of the steadily spreading phenomenon of tent cities being set up from Beersheba and Sderot to Kiryat Shmona and Afula to protest the lack of affordable housing, along with the grassroots protests against exorbitantly priced consumer goods known as the “cottage cheese uprising” after the most conspicuously overpriced item.
But unlike the housing and cottage cheese demonstrations, the doctors seem concerned primarily with the health system as a whole – particularly the chronically understaffed and overcrowded hospitals – and not solely with their own pockets.
Admittedly, after years of neglect it is unrealistic to expect all of the doctors’ demands to be met. For instance, there is a shortage of 2,500 hospital “beds,” which includes the doctors, nurses, equipment and physical space need for each of these beds. The agreement about to be reached between the IMA and the government would reportedly add just 650 beds over the next three years. If it’s adopted, doctors – particularly interns and residents – will continue to be spread far too thin, forced to work gruelingly long hours while being responsible for more patients than they can ever hope to provide with decent care.
But while the current situation is untenable, there does not seem to be any easy solution. Acquiescing to interns and residents’ demand for the immediate addition of 1,000 beds is unrealistic. With the dearth of physicians, the only way to supply hospitals with more doctors is to borrow physicians from community health services, which would be severely compromised.
The establishment of a new medical school in Safed is a step in the right direction but will only begin reducing the shortage of doctors years from now.
Doctors in the IMA who are intimately familiar with the negotiations are under the impression that the Treasury has reached the limits of its bargaining flexibility.
A higher government authority must now step in.
The major overhaul that our health system so desperately needs can only be implemented by the leader of the State of Israel, Prime Minister Binyamin Netanyahu, who also happens to be our health minister. It is now up to Netanyahu to use his ample skills of persuasion to garner the political support of his coalition partners and prepare public opinion for the painful but essential fiscal expenditures needed to implement the far-reaching health reforms long overdue.
Once upon a time a given of our fledgling Jewish state was that no Israeli citizen would be left without proper medical care. A nation with a strong sense of choseness that aspired to create an exemplary society could do no less. The doctors’ urgent, heartfelt cry for health reform should serve as a wake-up call for us to return to our roots.