Israel is a country of stark contrasts. For example, in the medical field, you hear dramatic weekly radio reports about a brewing health crisis, dangerous overcrowding in emergency rooms and hospital wards, and a shortage of doctors. Yet, Newsweek magazine just named the Sheba Medical Center in Ramat Gan one of the top 10 hospitals in the world.
To get an overview of the healthcare situation in Israel, The Jewish Press recently spoke with Professor Jonathan Halevy, director of the Shaare Zedek Medical Center in Jerusalem. After 31 years, Professor Halevy, 71, is stepping down from his post. The Israel-born physician has been an untiring developer, transforming the once small community hospital into a 12-acre medical complex that boasts some of the best medical departments in the world.
A gastroenterologist and liver specialist, Professor Halevy will continue to teach medical students, guide the hospital’s ongoing development, and carry on as its number one fundraiser as president of the Medical Center.
The Jewish Press: A recent article in Yediot Achronot reported that you are retiring, in part, to protest the growing medical crisis in Israel.
Dr. Halevy: Not at all. It makes for a dramatic headline, but I made plans for my retirement a decade previously, even choosing my replacement, Dr. Ofer Meron, 11 years ago. While I have deep frustrations about the severe government under funding of our national health system, it has nothing to do with my stepping down as the Medical Center’s director.
Should Israelis be worrying about dying in emergency rooms because of terrible overcrowding or of patients being turned away because there are no available beds in hospital wards?
Absolutely not. Once again, headlines like that may help to sell newspapers, but the facts are quite different. I won’t say there isn’t a shortage of hospital beds in the winter when everyone has the flu, or that people don’t have to wait a long time for non-emergency surgery, or that a shortage of physicians in the rural areas of the country isn’t a problem.
But patients aren’t dying in hospital corridors for lack of attention. On the contrary, Israel boasts one of the most advanced and comprehensive healthcare standards in the world.
According to Bloomberg’s World Healthcare Efficiency Index of 2018, Israel has one of the highest life expectancy rates in the world: 82 years.
The longevity factor is proof of the efficiency of Israel’s overall healthcare system, but it also causes an overcrowding in our internal medicine departments and geriatric wards. This admittedly distressing situation could be easily alleviated by more adequate government funding.
When Knesset members and cabinet ministers fall ill, they tend to receive VIP treatment and don’t personally encounter the overcrowded emergency rooms which are genuinely understaffed. For decades, my urgent appeals for added assistance from the Ministries of Health and Finance have largely fallen on deaf ears.
Where does funding for Shaare Zedek Medical Center come from?
In Israel, everyone pays monthly dues to one of the four government-supported medical societies of Kupat Holim, which, in turn, reimburse us for the various services we provide. That covers hospital operating expenses which run to $450 million per year. But the money for new departments, new buildings and wings, advanced-equipment purchases, and the like must be privately raised.
This interview is a good time to thank all of our supporters in America and around the world who are the real building blocks of the hospital. Throughout my 31-year tenure, I have traveled overseas, almost every other month, mostly to America to fundraise for our medical center.
Many religious people choose to go to Shaare Zedek for their medical needs because of its reputation for respecting halacha.
Your assumption is not necessarily correct. Perhaps, when it comes to our Birthing Center. But I think religious people come to Shaare Zedek for the excellence of our medical services.
The founders of this hospital, back in 1873, decided that the hospital would always be run according to halacha. I take great pride in the fact that more than a century later, Shaare Zedek has remained true to that goal and proven every breakthrough in modern medicine can exist compatibly with Jewish law. This is possible only after thorough research which applies the tenets of ancient Jewish law to new advances in medicine like open heart surgery, fertility assistance, and prenatal care.
What are some of the benefits and advances in Israeli healthcare today?
As the so-called “Start-Up Nation,” we enjoy many of the most innovative techniques in modern medicine. I like to say: In America, it is wonderful to be a doctor; in Israel it is wonderful to be a patient. In my opinion, in most complicated cases, a seriously ill person is better off in Israel.
I have heard many stories of long waiting times for operations.
Not concerning emergency operations. Emergency surgery takes place immediately in Israel or within a matter of hours. Urgent surgery is within a few days. Non-urgent operations can take several months, that’s true. The solution is for the treasury to allocate more hospital funding.
When it comes to cutting up the national pie, how does Israel’s budgeting for healthcare compare with other countries?
Countries allocate funds to their healthcare systems based on a percentage of the Gross National Income. In Israel, 7.3 percent of the government budget goes toward medical needs. In the United States, the figure is 17 percent, but since doctor salaries in America are very high, I won’t use it as a comparison. In Western European countries, for example, in Britain, healthcare receives 9.1 percent of the national budget. Scandinavia and France, 10 percent. Germany, 11 percent.
If Israel were to raise its healthcare budget to even just 9 percent, all the problems you are talking about – emergency room and hospital overcrowding and long waits before non-urgent operations and appointments with specialists – all of these would be eliminated.
I am sure you have heard the argument that Israel’s high military budget doesn’t allow for an increase of funding to other important areas.
Of course I have heard it, but it’s not true. The government of Israel has a lot of money. By adding 3 billion shekels a year to the healthcare system over the next five years, Israel could prevent the medical crisis that could develop if warning signs are not addressed now.
What are some of the major joys you’ve experienced as head of Shaare Zedek?
When I came to Shaare Zedek 31 years ago, it had 300 beds and lacked many basic medical departments. Today, we have 1,000 beds and 26 state-of-the-art departments in almost every field, led by many of the country’s top physicians. From 280 births a month, we have risen to 1,400. I have great satisfaction in having had the merit to play a part in the building of such an advanced medical facility serving the community of Jerusalem.
On a more one-to-one level, every time I am involved in a birth at the hospital, or a successful operation, sharing the patient’s and the family’s joy is a deep satisfaction.
Of course, medicine is not mathematics, and mistakes and misfortunes occur which are always painful. During the height of the Second Intifada, the emergency room at Shaare Zedek received the brunt of the terror victims. These were months of hell. On September 9, 2003, when Dr. David Appelbaum, the former head of our Department of Emergency Medicine, was killed in the terrorist attack in Café Hillel in Jerusalem, along with his daughter, Nava, on the eve of her wedding, it was a devastating blow to all of us, especially to those who had worked closely with him at the hospital.
Often, he was the first physician at the site of a terror attack, or in the emergency room to treat the wounded who were brought here in ambulances. Myriads of people owe their lives to him. A large plaque at the entrance to our emergency room pays honor to his extraordinary achievements and dedication to medicine.
If you were to give a lecture to Jewish medical students in the United States, what would you tell them about choosing a medical career in Israel?
First, I would tell them that, in my opinion, every Jew should be in Israel. Here, in Israel, especially in Jerusalem, a person can live a much fuller Jewish life. Here, one feels that he is playing a valuable part in the rebuilding of our own sovereign nationhood in the Jewish homeland.
In addition, a doctor in Israel can make a respectable living for the family, education is far cheaper, and a physician can achieve all possible professional aspirations in whichever medical field one chooses. Also, if a person has a passion for research and innovation, the sky is the limit in Israel.