 Hello there, welcome back to Daniel Rosal on YouTube. This is Daniel Rosal here, bringing you another video today from Jerusalem in Israel. It is a Sunday, which is the start of the week here in Israel because Israel, like many countries in the Middle East is on a Sunday to Thursday work week rather than a Monday to Friday one. And the question is, do you ever fully get used to it? Honestly, not so far from me. I've been here for eight years. It's still an adaptation. It does get a little bit easier at this time. I wanted to talk today because this YouTube channel is hopefully increasingly focused on stuff to do with Israel, my life in Israel, living in Israel, and also any kind of advice that I can pass on or info that might be useful to people who are earlier than me in their journey in Israel, whether you've moved to Israel for indefinitely, you've made aliyah, or you're just looking to move to Israel temporarily for whatever reason you're here or you're thinking about being in Israel. One of the things you might have to deal with or you will have to deal with is the health care system and health care, of course, is something very, very fundamental, particularly if you have health conditions. And therefore I think it would I thought today for no real reason that it would be a worthwhile topic to cover here on this channel. Now, I've talked before about a couple of aspects of health care in Israel, like, you know, sort of stuff like, well, how do you find a doctor? And, you know, if you're looking for a specialist, how might you do that? Those videos might show up on YouTube under my name. But that's that's actually quite specific to what kind of health care that you have, whether what type of health maintenance fund you have, or if you're going private, etc. So what I thought I would do differently in today's video is just zoom out a little bit and talk about how health care works in Israel more generally. Before I talk about that, I want to say that I think that health care is one of the best things. I was going to say the best things about living in Israel, but I don't think for most people, health care can be considered an advantage. Perhaps a better way to rephrase that is I think that Israel does health care really, really well. Israel is frequently commended for having one of the best and most advanced health care systems in the world. And I would say having accessed it for various reasons, both for physical health conditions and actually also for a mental health condition. And I'll talk very openly in this video about dealing with depression because it's a very common mood disorder, something I've suffered from a struggled with and accessing mental health care services in Israel. Because that's definitely, and of course, part of the picture of health care. I also have asthma so I can offer both a physical health condition and a mental health condition to talk about in this video. But I think generally Israel does it really well. Now, of course, you know, some people are going to say I had a lousy experience with a certain doctor or in general, I don't think health care in Israel is that good. I'm sure there will be dissenting views out there. But from my perspective, having moved to Israel from Ireland, I would regard the health care system here as a lot better. There are definitely things that I think Ireland does better. But in this particular aspect of life health care, I definitely give the price to Israel. I think it does health care really, really well. So the fundamental mechanism for delivering health care in Israel is something called the Health Maintenance Organization. Now, if I'm not mistaken, Israel actually sort of got this model from Germany. Now, the acronym in English for Health Maintenance Organization is, of course, H-M-O. The acronym in Hebrew is a Kupat Cholim. And the best translation for Kupat Cholim is the Health Fund. So Israel has basically universal basic health care. Every citizen of Israel needs to be signed up to one of the Kupot Cholim. Kupot Cholim is Kupat Cholim in the plural. And there are four different Kupat Cholim. There are, let's see if I can remember them. Klalit, Makhabi, Mayochedet, and Le'umit. I think it was easier to say it quickly like that before I forget. I've heard there was originally just one Kupat called Klalit. And then the Israeli government mandated that there would be some competition in the marketplace. You have four different Health Maintenance Organizations or HMOs, and everyone has to be a member of one. So when you're moving to Israel, whether when you do the bureaucracy at the airport, one of the questions you're going to be asked is which Kupat Cholim you want to join. Now my advice in this respect is to do your homework before someone hands you a piece of paperwork at the airport and you're kind of put on the spot. Now what are the differences between Klalit, Makhabi, Mayochedet, and Le'umit? Well, Klalit, generally speaking, is the biggest health fund, right? Klalit in English translates as general. It has the widest coverage network in terms of clinics and specialists throughout the country. So it's kind of the general one. Makhabi has a really good reputation in terms of having good English speaking doctors. So if you ask English speakers, whether you're in Jerusalem or Tel Aviv or somewhere else entirely in the country, Makhabi will be a common recommendation. Personally, I've had Makhabi. I was with Klalit for the first year. And then I switched to Makhabi and I've been happier with Makhabi. Now just to quickly talk about switching between Kupat Cholim healthcare providers, it's pretty easy. You can do it through, generally people don't go hopping. I mean, there's only four to choose from. But basically there are four transfer dates in the year and processing the transfer, it's pretty easy and your electronic medical record will be transferred from one Kupat to the other. So when I moved from Klalit to Makhabi, my blood tests, et cetera, that I did with Klalit were moved over to Makhabi. So we were halfway through talking about the healthcare funds in Israel when I got a little bit sidetracked. So you have Klalit, you have Makhabi, may ochet it, I don't know a lot about. If people have feelings about it, put those in the comments. Leomit, I do know is considered the smallest of the four HMOs but it has the strongest presence over the green line. So in Yehuda and Chomron. In terms of which healthcare fund to choose from, should that be your guiding criteria? A lot of people will choose their Kupat Cholim, their HMO based upon specific doctors or the coverage it has in a specific city. So Makhabi is very popular in Jerusalem but people living in other parts of the country, I don't know, maybe in Elat or Matula if you're very far from other places you might opt for a different health fund because they have a clinic in your area, a very good clinic or they have a great rheumatologist and your health problem is in the realm of rheumatology or in asthma so you need a great pulmonologist or hopefully you're healthy but if you have specific conditions that's often a guiding criteria for why people will choose one of the four Kupat Cholim over the other but as I said, my recommendation would be to do your homework in advance so that when you show up at the airport or wherever you're doing your aliyab bureaucracy ask around social networks are great ask on Facebook, ask your friends again because it can be location specific. So if you have a specific condition and you're in a specific location you're saying, you know, you could ask in a Facebook group well I have, let's just take a, let's take rheumatoid arthritis, right? You could post in a Facebook group I have rheumatoid arthritis and I'm looking at moving to this neighborhood in south Jerusalem, which Kupa has the best coverage and you might get recommendations for different Kupot with different doctors because doctors will work with different Kupot Cholim. In addition to the system of Kupot Cholim the system of Kupot Cholim of HMOs is the basic mandatory healthcare in Israel it's the public healthcare system your average Kupa Cholim will operate doctors clinics they'll operate specialist clinics some of them will operate hospitals imaging services like X-rays and CT scans and MRIs, et cetera. So within the framework of your HMO you have basically, hopefully enough to get your healthcare needs met. I can only speak for Maccabi they actually have their own pharmacy network as well so you can go to a Maccabi clinic, visit a doctor and then walk next door to the Maccabi pharmacy and get your prescription filled. Cabi also have a dental service and they even have a branch for offering complimentary or alternative healthcare something called Maccabi Teva. So really under some of the healthcare funds offer the full monopoly of services but generally you'll be able to get your basic healthcare needs met. In addition to sort of this public healthcare system you do have private healthcare in Israel as well you have private health insurance providers you have private doctors who don't work through the Kupa Cholim or some of them also work through the Kupa Cholim and if you're not getting satisfaction through a family doctor or you need to see a specialist you're also able to access private medicine in Israel. One service I have personal familiarity with is something called Sharap. Sharap stands for Shirut Refui Prati which means the private medical service it's something that exists at Hadassah in Karim Hospital in Israel and for a not enormous fee you can see a specialist medical provider. Now the fee's gonna depend on the doctor but for instance I went to see a gastroenterologist through Sharap and I was able to see someone for 350 shackles per visit which is about a hundred dollars there about. So for seeing a medical specialist at a teaching hospital I think that's still considered pretty good value and that was totally voluntary I was able to access a gastro and this was after I had gallbladder surgery and I was having a lot of problems so I firstly accessed my Kupa Cholim system but I didn't really get to the bottom of the problem or get the problem solved so I voluntarily paid a hundred dollars to see someone a couple of times in Hadassah in Karim so that is private healthcare as well and there's a whole world of private healthcare beyond Sharap that I'm not familiar with so I'm not gonna talk about stuff that I don't know. Now I mentioned that I would talk about mental healthcare in Israel as well I mentioned that I have asthma so I've experienced going to physical doctors if you will, pulmonologists, allergists getting my prescription medications which by the way are pretty cheap in Israel as it goes. Israel, Misrada Habriut which is Israel's healthcare ministry has something called Sal Habriut which means the health basket and that means that the government will subsidize a percentage of medications so when I go to buy my asthma inhaler at the pharmacy my Kupa is charging me a percentage of the medication cost, right? It's covered in Sal Habriut so I'm paying a sub, that was the word I was looking for I'm paying a subsidized rate for my asthma inhaler it comes out to something like $10 per month so my monthly fees for accessing healthcare in Israel personally are, I have to pay my Batuach Leomim my social security contributions that gives me access to a Kupat Cholim among other national services I pay a monthly fee to my Kupat Cholim to remain a member that cost me something like $20 or $30 it's relatively nominal and for that money I can see doctors and medical specialists almost for free if you haven't seen a medical specialist in a quarter of the year sometimes there's a small charge like $5 but it also allows me to get my prescription medications at the subsidized costs so long as the pharmacies work with my Kupat Cholim the one I use is Superfarm which is Israel's largest national pharmacy chain they work with Maccabi so I can either, actually no I have to present my Maccabi cards and they'll be able to call up my prescriptions on my Maccabi card for my asthma inhaler and I'll be able to get it at a discounted co-pay I can also walk into Maccabi Farm and get it for roughly the same price because this is socialized medicine not all the medications are going to be subsidized so if you're looking for a rare medication or a second or third line medication for whatever health condition you might be struggling with you might find that the co-pay doesn't exist and the medicines are pretty expensive but in my experience I haven't really had that so far I said I was gonna talk about mental health care as well because it's such an important topic and as I mentioned this is also something I can speak to from personal experience dealing with depression so okay in mental health care there's obviously sort of two big chunks to that world you have the world of psychiatry which are mental doctors, medical doctors which specialize in treating mental health problems and you have the world of psychology now the last time I checked it was very difficult to find therapy, talk therapy through my Coupat Rolim which is Maccabi I'm not, now it does exist subsidized talk therapy, psychotherapy exists through the Coupat however the process of trying to access it particularly in English was very non-user friendly and I ended up giving up on the process and I did a little bit of talk therapy but I paid privately and yes that was expensive so I would say the world of physical health care in Israel through the Coupat Rolim is better delivered and better organized than the world of mental health care now when it comes to psychiatrists now for a common mood disorder such as depression or anxiety or ADHD family doctors can treat these conditions in Israel so currently I'm working with a family doctor to stay on a medication for depression and if that medication were to stop working or I had problems with side effects I probably wouldn't need to go beyond my family doctor I don't know if this is a case in other countries but in Israel there is a shortage of psychiatrists so for commonplace or you know pretty regular mental health care problems like depression and anxiety family doctors are happy to manage the conditions generally now of course if you're not happy with the level of treatment you're receiving from your family doctor you can ask to be referred to a psychiatrist or you can pay to see a psychiatrist and just like in the other realms of health care in Israel both public and private options exist the catch with public psychiatry in Israel is that depending on where you are in the country there can be a real shortage of psychiatrists and the wait times can be very long so if you need a psychiatrist in Jerusalem through Maccabi there is currently something like four options and the wait time the last time I looked for an appointment was something like four or five months so if you're dealing with something like really bad depression and hopefully if you have depression or anxiety it's well controlled but if you've reached some kind of a mental health care crisis clearly having a doctor you can see in four months is not going to be useful so you might need to opt for a private psychiatry which exists here as well now the health care systems are kind of a little bit joined up so if you were to see let's say a private psychiatrist they can write you a prescription you can give that to your family doctor in the health care fund and they can create that prescription through the kupat-cholim system which will allow you to access that medication at those discounted prices now you can get private prescriptions filled in pharmacies but you're going to be paying more for the same drug I did that recently with a drug called Trentelix which is a antidepressant and the price that I paid privately versus when I got it put into the Maccabi system it was like 100 shackles versus 30 shackles $20 versus $6 so either way it's pretty subsidized but if you want to get your medications as cheaply as possible and get health care as cheaply as possible your best bet is to work through the public system final topic of conversation for today's talk about health care in Israel is regarding urgent care so there is of course a system of hospitals in Israel and there are emergency rooms in those hospitals there's also something called Terrim which is really really a fantastic sort of in-between that it's very very worth knowing about wherever you are in Israel it's spelt in English T-E-R-E-M they have a website listing their national branches and basically this is sort of a intermediate care clinic I believe it's called urgent care as opposed to emergency care so generally often the kupat holim will operate according to the standard Israeli work week which as I mentioned is a Sunday to Thursday work week but of course medical problems can happen 24 seven so you might find that you're cooking preparing food on a Friday and you get yourself a nasty cut on the hand so clearly making an appointment with your doctor on Sunday is not going to be useful to you so there is a network of emergency rooms in Israel but for most stuff like that for you know minor relatively minor stuff even I've gone to Terrim for nebulization for asthma those are the first ports of calls to go to and they work with the insurance provider so it's important to bring your card when you sign up for your kupat holim you will get a card so keep that in your wallet and if you need to access a Terrim they do a fantastic service for not a huge amount of money it's again subsidized and they'll operate on Shabbat when the conventional healthcare networks are generally closed which is of course problematic if you have something urgent that happens on Shabbat and of course there is a ambulance network in Israel as well for emergencies that's pretty much as much as I can sort of thing to get out of my brain at the moment regarding how healthcare works in Israel it's a very good system and it works really really strongly through electronic medical records for instance I can log into my Maccabi website right now with my username and password I can send messages to my doctor up to Maccabi's limit is four times per quarter so you can't you know sort of go crazy on it which is I think very sensible but if I need something like a prescription refilled or I need to write a message to my doctor saying I don't know I need the higher dose of an inhaler I can do that all digitally get the response digitally I can book appointments digitally and I can cancel appointments digitally all through the website or through a smartphone app there is also a call center so if you prefer if you're away from technology or you don't have access to a computer yet and you need to do it all through human agent you can do that as well but I would definitely advise whatever Kupat Cholim you join to download their official application and familiarize yourself with the website because that's generally the most efficient way to get healthcare in Israel is by doing stuff yourself self-service and you may need to learn a few words of Hebrew in order to navigate the website and I don't know if the other Kupat Cholim, Kupot Cholim have translated versions I know Maccabi really sort of doesn't so you do need some basic Hebrew in order to navigate it but you can use I also recommend and just recently found out that a friend of mine didn't know this existed so not everyone knows there is a Chrome extension called Google Translate which if you use the Google Chrome web browser you can add it's also there for Firefox and using that you can select certain words in Hebrew and have those translated to English or your native language so little technological tools like this can really really help to make the process of accessing healthcare in Israel easier I hope this video was useful if you are looking at moving to Israel on Aliyah or you're already here and you're trying to understand how the healthcare system works the main points I would reiterate is the Kupot Cholim the Kupot Cholim collectively provide your basic healthcare cover in Israel and I would advise personally if you're moving to Israel you haven't got here yet or you haven't finalized your Aliyah process yet asking around if you have a specific healthcare condition that's also relevant as well as where you're thinking about living because the quality of the different Kupot Cholim can be quite individualized and I also really recommend downloading the app of your Kupot Cholim and trying to access the services digitally as much as possible because from my perspective that's where the Israeli healthcare system really really shines it's all digital it's all joined up and that generally makes getting the healthcare you require easier and more effective thank you for watching today's video and if you want to get more videos from me about stuff related to living in Israel do consider subscribing to this YouTube channel thank you for watching this video