The Israeli Healthcare System: How to Manage the Differences That Will Surprise Your Senior Parent

Thanks to Sharon Beth-Halachmy of B’lev Shalem, for this week’s important blog post for all those who’ve brought or are thinking of bringing their parents over to live in Israel.

Remember the first months of your Aliyah? The culture shock as you navigated everything from the grocery store to Kupat Holim, from surviving on the road to understanding the school system?  Remember the extreme ups and downs and the wide range of emotions?

Fast forward a few years and you’ve conquered what seemed then like insurmountable challenges. You’ve made peace with (and are even enjoying!) the straightforward (tachlis) mentality and the warm familiarity that defines Israeli culture.

For your senior parent making Aliyah, the transition will be different. Their experience will likely be focused on adjusting to a new – and drastically different – medical system that offers top medical care but can feel primitive and stark compared to what your parents are used to. As with everything relating to Aliyah, the more they understand and the better prepared they are, the easier their transition will be. Below, we’ll review some of the biggest surprises, and how to manage them.

Getting Socialized

Israel offers socialized medicine, which means that you – and everyone around you – can enjoy top-notch medical care – at nominal cost. No pre-existing condition nightmares. No denial of coverage based on age. Seeing your general practitioner costs no more than your minimal, mandatory participation in the medical system. Co-pays are only for specialists and specialized tests, and they’re often limited to 20-40 NIS. Still, the system is overloaded, and the journey to care can include long wait times for appointments, sparse waiting rooms, and often brusque bedside manner.

Battling the Potential Months of Waiting

Generally, getting in to see your family doctor will be quick. But for specialists, wait times can be long. Here, goodwill and kindness can go a long way. Become your kupat holim branch secretary’s best friend, and chances are that he or she will be willing to go the extra mile to help you. We’re not talking a quid-pro-quo kind of arrangement (this isn’t communist Russia – do not bring an envelope full of cash!) but everyone appreciates special interest and kind gestures.

You see, in Israel, “No” and even “Absolutely impossible” are just the beginnings of a conversation. If you’re able to wait for an appointment months away, and it’s nothing urgent, that’s great. If you don’t feel that a long wait is a plausible option, however, explain the issue to your new secretary friend. Ask to be informed of any cancellations (yes, this does happen, and if the secretary knows your situation, he or she is likely to call you immediately when a cancellation comes about.)

Phone regularly, using a pleasant tone (anger isn’t going to get you where you need to go) and ask for any updates. If the situation really is dire and nothing seems to be working out, turn to the manager of your local branch and plead. Israelis respond well to pleading, especially from immigrants; these managers are concerned people – both with your health and in the satisfaction rating of their branch. They’ll go out on a ledge to get you your appointment.

What to Expect at Your Appointment

Redefining “normal” is the base of feeling comfortable with the medical system here. Even the most highly esteemed specialists often don’t have a secretary, unless they’re in a multi-doctor practice. Upon arrival for an appointment at your kupat cholim office, stop by the receptionists’ desk area, if there is one, just to check in. Let them know you’re there. If there’s a co-pay to take care of, that’s when you’ll manage it. Often, the co-pay is taken care of automatically, straight from your bank account (thanks, StartUp Nation).

Find the specific room where your appointment is to be held and check the name list on the door to make sure you appear. For confidentiality reasons, the lists will often only display first name and last initial. Here’s the kicker: you need to ask other waiting patients which appointment is currently being seen. You need to establish whom you will be following and keep tabs on your place in line. Yes, this might feel supermarket deli counter-ish or Department of Motor Vehicles-ish, but this is the deal here. You must be on top of your place in the schedule, or you’ll have no place. Channel assertiveness (not aggression.) Think Murphy Brown, not Genghis Khan.

Once you do get your turn, you may be surprised to see that office furnishings are simple and often sparse. That’s just the style here – governmental resources are spent on knowledge and equipment, not fancy couches. What is rich and plentiful, though, is not only the top-notch, world-class, accessible medical expertise but also the authentic, Jewish heart.  There is an ingrained, true concern and respect throughout every level of the system, from the orderlies who transport patients within the hospitals to department heads advocating the use of antibacterial handwash.

Options of Local and Homey or One-Stop Shop

When choosing your care providers, choices are plentiful. Many general practitioners see patients at their neighborhood-based offices, serving patients from all the various kupot cholim in the area. These are generally smaller, local clinics with a homey, personalized feel. The patient becomes quickly recognized by clinic staff (a plus when you’re seeking a favor). There is a certain charm and beauty to this set-up, which is a perfect fit for many Israelis. If a referral is needed for further testing or for a specialist, patients are directed as to where to receive these services.

Another option is to choose a doctor stationed at a larger, more centralized branch of your specific kupat cholim. These larger centers (there are usually a few for each kupah in larger cities and one in smaller cities) are a one-stop blessing to those, such as the elderly, who have trouble traveling from place to place for appointments and tests. They generally offer both nursing and doctor care, including numerous specialists, as well as blood tests, x-ray, ultrasound and other tests and treatments – all under one roof. With numerous team members in one location, this approach minimizes hunting people down through phone calls and frustration to get approval for tests or to involve one doctor in a conversation with another.

In Israel, you’re in excellent medical hands. They are different hands than before – the ring is less flashy and the watch is simpler, but these hands are among the finest available, worldwide.

About the Author

Sharon Beth-Halachmy is CEO of B’Lev Shalem, a life care management company for seniors in Israel. She and her Care Management team work tirelessly to address the full spectrum of needs unique to seniors in Israel, from the routine of daily living to medical oversight, community, and advocacy. B’lev Shalem’s expert Care Managers are available 24/7, ensuring maximum quality of life for seniors and peace of mind for their families.

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