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Thursday, June 22, 2017

Comparing healthcare systems–Israel vs Canada

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I got a great question from a reader today – I love hearing back from you! – and I thought I’d share it once I was done writing back.  The reader asked, based on my experience with healthcare in Canada and Israel, how I’d compare the two.

It’s actually something I haven’t put a lot of thought into.

As Canadians, socialized health care wasn't such a big transition for us.  American friends have had a variety of reactions, from giddiness that they wouldn’t go bankrupt trying to stay healthy to… well, I don’t think I’ve heard of any who really had a hard time adjusting, so I don’t know what the worst-case scenario is.  I suppose for people coming from the U.S., there may be longer waits and more of a “socialized” feel to things here, if that makes any sense.  But most, as I said, are far too delighted that the safety net exists here to worry about the nitpicky details.

Also, full disclosure:  baruch Hashem (ptoo, ptoo, ptoo!), we haven't had to have a lot of contact with the healthcare system.  However, although we’ve had no major health problems, we have all seen a variety of specialists, done the basic urgent care visit for little-kid stitches, non-emergency hospital visit, and routine health things as well.  Mostly, if it has been harder here, it is because of difficulties with the language, not the system.

A few particulars that I’ve found are different here:

  • Israel is more complicated in terms of choosing a kupat cholim (healthcare plan) and package.  Canada does not have different kupat cholim or any of the premium packages that they offer here – you just get the plan offered by your province.  The model here is more like the U.S. HMO system, even though it is socialized.
  • You are more often asked for a co-pay here in Israel, but these are very low (like 30-something shekels – under $10 – for a course of 6 physio sessions).  Unlike Americans who come here, was a shock to me to have to hand over money to see a doctor, but I forced myself to maintain a bit of perspective.  It was 20-something shekels for emergency stitches for my son.  Nothing, really, in the grand scheme of things.
  • With our kupat cholim (Clalit) in Israel, you are more likely to see your doctor in a clinic than in a standalone office - this isn't a plus or a minus, just good to know.  The clinic has its pluses – there’s a lab on site as well as a pharmacy, so it’s a self-c0ntained little healthcare centre.  But the minus is that it’s less warm and personal in some ways than an office.
  • The system here in Israel is more centralized and computerized, which is great for referrals to specialists (though you should still take a paper copy of the referral just in case!), with a central nationwide call centre.  The call centre supposedly offers English, but in my experience, not really.
  • The basic plan in Israel (whichever kupat cholim you choose) includes the partial cost of many medications, while in Canada no medications are covered.  If something is prescribed by the doctor, you buy it in the kupat cholim’s pharmacy (instead of any independent pharmacy, like we did in Canada) and pay much less than the full price.
  • Like in Canada, here in Israel, the basic plan generally does not include teeth or glasses.  Some of the premium plans here do. 
  • The system in Israel can often FEEL like more a two-tiered system than the Canadian one, especially when the Dr. recommends a medication you can’t access because you don’t have a premium plan (or a nasal-inhaler flu vaccine that isn’t in your plan so you have to get an old-fashioned needle instead)
  • Here in Israel, it feels to me like we're more connected with a NETWORK of health providers instead of just a primary-care doctor

These are just a few vague thoughts based on my own experience.  If you’re in Israel, I’d love to hear from you about your experiencing transitioning to the Israeli Way of Healthcare…

Also:  I feel I must add.

If you have ANY questions or problems with navigating the healthcare system as an English speaker, there’s a place you can turn!  It’s called the Shira Pransky Project, and their goal is exactly that: helping English speakers navigate the Israeli healthcare system.  It’s named after an English speaker who, unfortunately, was not aware of her rights, some of which her family only found out about it after it was already too late.  Having access to this information might not have saved her life, but might have given her far more comfortable and secure in her final months.

Tzivia / צִיבְיָה


2 comments:

  1. On the whole I think that the Israeli system has evolved into one of the best of all in the world. Choice is good, and you can go to different clinics of your system wherever you are. Basic membership for the elderly is free. The working elderly doesn't pay "Bituach Leumi," National Insurance, which covers health care dues.
    OTC drugs are cheaper in the clinic pharmacies, at least if you have gold/silver cards, and prescription drugs are discounted in private pharmacies if the have the gold/silver.

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  2. And let's not forget that fertility treatments - tests, procedures, and prescriptions - are fully covered by Kupot Cholim. I think it's until either 2 children or 2 successful pregnancies, and then the percentage covered is less, but it's still a considerable amount.

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