Medical expert contrasts U.S., Israeli health care

Americans treat health care "as a commodity," while Israelis treat it "as a right," said Dr. Gabriel Barbash, Israel former surgeon general, while visiting Teaneck’s Holy Name Hospital on Tuesday.

The U.S. health-care system is based on a free market approach with minimal government involvement, he said, adding, "the Israeli system believes in intense government involvement."

From 1993 to 1996, Barbash served as director general (the equivalent of the U.S. surgeon general) of Israel’s Ministry of Health. Since 1996 he has been the director general of Tel-Aviv Sourasky Medical Center. Barbash was the keynote speaker at Holy Name as Israel Bonds honored the hospital for its continued support of the Jewish state. Holy Name’s investments in Israel Bonds total $1,’50,000, said Ed Ruzinsky, chair of the hospital’s finance committee.

Ed Ruzinsky, chair of Holy Name Hospital’s finance committee, Paul C. Mendelowitz, Holy Name’s chief medical officer, and Gabriel Barbash, former Israeli surgeon general. Photo by Roy Groething/jersey pictures

In a talk that compared the American and Israeli approaches to the health-care industry, Barbash cited two major failures of Israel’s market that do not allow it to operate as a free-market system, as in the United States. First is the gap of information between patients and what he called the suppliers.

"When [patients] come to seek help, [they] don’t know the diagnosis, options of treatment — many times [they] don’t know if [the diagnosis or treatment] was good or bad," he said.

The second failure is the price, a critical factor in any industry, he said. Whereas a higher price for a commodity typically determines whether a person buys that product, this is not the case in Israel, since most people are not paying out of their own pockets. Because of that, they are less willing to compromise on the quality of the services they receive.

"In Israel, we believe the only way to achieve equality in health care is by government involvement," he said. Every citizen pays 5 percent of his or her earnings to a national social security program based on the ideology that "you pay what you can, you get what you need," Barbash said. Not-for-profit HMOs cover every Israeli citizen. Still, 34 percent of Israelis have additional private health insurance, which, Barbash said, serves no real purpose since only ‘ percent of Israeli hospitals are private and the government’s basic insurance is so extensive. The people left out of the national health care are illegal immigrants, such as refugees from Darfur and undocumented workers.

Under Israel’s basic health-care law, citizens are entitled to "a basket of services," Barbash said. Since the law was established in 1994, a committee made up of members of the finance and health ministries, health professionals, HMO representatives, and private citizens meets every year to update the services covered.

"On average, what the citizens of Israel are getting is a good system of health care," he said. After Barbash’s talk, representatives of Israel Bonds presented Holy Name President Michael Moran with the Israel Peace Medal, which recognized Holy Name’s "dedicated support of Israel’s continuing effort to build a strong economy and to achieve a secure and lasting peace."

"We are a religious organization in a very ecumenical community," Moran told The Jewish Standard. "For us to put money in [Israel’s] infrastructure, communities, and rebuilding in the north is in line with our mission."

Holy Name has invested with Israel Bonds for almost 10 years and its investment at any one time has never been below $500,000, Moran said.

Barbash, who briefly toured the hospital before his talk, told the Standard that he was impressed by Holy Name’s "seriousness and in-depth preparation for mass casualties."

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