Monday, June 15, 2009

There are things I hate about this country

The healthcare sytem to begin with. Did I just say a few weeks back that it was not so bad? Apparently I lied. Big time.

So walking home the other night in the dark I tripped over some out of place brickwork (gee thanks local construction site for leaving uneven bricks in the middle of the sidewalk!) Yes I should have been paying closer attention. That is nto the point.

Anyhow, so there I was walking home, listening ot my ipod and wham! next thing I know I am on the ground in rather a lot of pain. Not, as one might expect, in my "Hey look I really am related to the rest of my family" bad knee, but in my foot. It feels like a rubber band is squeezing my foot.

I get myself together and hobble my way back home. Lord knows people fall. I can move it. I can walk on it. No big deal right?

Well, I get home to discover it is a little bit swollen but nothing major. I ice it and put it up a little. I go to bed shortly thereafter. I woke up in the middle of the night at least 4 or 5 times in pain- God bless advil and some slightly stronger Israeli stuff I have in the medecine closet.

In the morning I try to figure out what to do.

Ok, so I am pretty sure it is only a sprain, so not an emergency. Then I find out that even if I knew, 100% certain it was broken, and you know, bone was poking out of skin, I would still pretty much have to follow the same rules anyway.

The below is all hypothetical as I just went with "It's a sprain", got JASon to grab a tenser bandange on his way home and am going with the RICE (rest, ice, compress and elevate) plan. So far it seems to be working.

1) Make doctors appointment online (no appointments are available until Tuesday morning- 2 days later. I find out after I can just go, sit and wait and hope ot squeeze in between people. I find out much, much, much later there is also a nurses room you can go to without needing an appointment. By the time I find that out the office is closeing in under a half hour. I should remind you we do nto have a car, for variosu reason I did not have cab fair in the house, and I was not in a position to walk either to the office or even to the bus stop).

2) Once would have seen a doctor they would give me a referal for an xray. I take that down the hall to the secretery for the kupah in that location. Before she can send me over to the xray, I need ot get a hitchayvut, literally an authorization from the kupah that they will pay for whatever the procedure in question is (in this case the x ray).

3) Once I have the referall and the hitchayvut I can take both of those over two one of two places where I could actually have the x-ray done. No it isn ot in the same location. In fact, it is across town. Literally. One of which is in an area not even easily accessable by bus. Did I mention no car and no cab fair?

4) If there wasa break, and it was simple they could set it there (most likely- maybe) or if it is bad they would send you, (not by ambulance unless you know, the bone happens to be sticking out through your skin and, I don't know, jabbing you through the heart or something- so yes, one hell of an expensive cab ride) to Jerusalem where, (you are going to love this) you owuld need a seperate hitchayvut from your kupah to get the issue dealt with! Yes laddies and gents, if you kupah is not associated with the hospital in question, you could theoretically be turned away or have to pay out of pocket foe having a bone set.

I should add it is not like there is no health coverage. Every single citizen in the country has health care under one of four "kupot". Each of the four has it's own pluses and minuses. Each has gold plans avaialble for purchase if you want, otherwise each citizen is entitled to make use of their regular coverage as needed. We carry cards in our wallets just like OHIP cards- only showing it does not get you in to see the specialists.

It is the single most ridiculous thing I have ver come across (and I say that having come across a lot of ridiculous things!)


lorienbalofsky said...

If it makes you feel better, the cab ride is actually cheaper than the ambulance. Ambulance rides cost upwards of 400NIS and are only reimbursed by the kupah if you are admitted to hospital overnight.

happyduck1979 said...

are you kidding me???????

no. I don't expect you are.

Shelly said...

The more I hear about health care complaints, the more I like it just the way it is where I am. Which in turn makes me feel like a spoiled snob because not everyone has it and some people are on the crappy state kind....which sucks....

Sigh. I find it alarming though that you could be like "Hi. I'm going into cardiac arrest. Can I get a referral to the hospital? Yes I can wait. Just throw some water on me if I faint though, k?"

Marion said...

You CAN go to emergency without the hitchayvut. It just depends on the hospital what the procedure is. For Sha'arei Tzedek you have to leave a deposit cheque (send the the hitchayvut, they return the cheque). At Hadassah they give you 10 days to send the hitchayvut, then they send you a bill in the mail. Usually you get the hitchayvut and the kupah faxes it in for you.

Ambulance rides cost 408NIS (or they did last October when Shai was born). If the ambulance picks you up from a public location (not home/shul/school/office) or at the site of a traffic accident (lo aleinu), there is no charge.

In Beit Shemesh you can also go to Terem, who should have some sort of arrangement with the kupah. In Ma'ale Adumim we can have x-rays done on the spot (at Terem) for the same 25NIS that it would cost for the hitchayvut, and they get the hitchayvut afterwards from the kupah.

Pesky Settler said...

I believe with Macabbi, if you go to the ER AFTER Kupah business hours, you don't need to jump through hoops to get the Ishurim and Hitchayvuyot pre-approved. You can simply show up at the ER, they take care of you, you pay, but then you take the paperwork to your Kupah administrative offices to be reimbursed.

It's only when you have emergencies during Kupah hours you need to go through them first.

Yaffa said...

If you show up at Hadassah you don't need to show up with the hitchayvut on the spot, you get a notice for payment which you can take to your kupah and they will send a belated hitchayvut to the hospital.

Also, to be fair, it really depends on what kupah you are and where you live. I know living in Jerusalem with Meuhedet the main clinic is open till midnight or so, and they do the x-rays on the spot. We went there for Shawn's foot a year or so ago and they took care of everything on the spot. He saw a doctor who sent him to an orthopedist in the building, who had him do an x-ray right then and there, and then went over his results with him. We're actually quite thrilled with health care here.