Healthy migration
It’s been a little over 8 years since I left Israel and immigrated to the US of A. A lot has changed since then, both in terms of my personal motivations to choose one location over the other, and in terms of the issues that I feel strongly about in the public sphere in either of these places.
Comprehensive stock-taking on both of these fronts is beyond what I want to write about today, but two things that came up today made me want to write. One occurred several months ago, pretty much out of the public eye – the publishing of a book; the other is very public – the resignation of a member of the Israeli parliament – the Knesset.
When I left Israel I was not concerned with public health policy. In all my years in Israel I never had to think twice about seeing a doctor, and not just because I was young and healthy. Israel’s national health insurance system worked well for me and all I needed to pay out of pocket was a small quarterly copayment (and only in quarters when I actually visited the doctor’s office). I didn’t mind paying the national health tax. It made sense to me. When I moved to the US, I knew that in this new place I’m not entitled to any health care as a basic right so I made two choices about health care: 1-buy insurance, 2-never use it, so as not to find out how good or bad it actually is. It took a few years of being mostly self employed before it fully struck me how dysfunctional and unjust this system was, and just how good I had it back in Israel, where I did not have to worry about taking care of my health.
The book I read about today is “Circles of Exclusion: The Politics of Health Care in Israel” by Dr. Dani Filc. I learned about it from a posting on the Physicians for a National Health Program Facebook page. I’ve been following this organization and others similar to it, which are trying to move American public health policy towards eventually adopting a nation-wide, “socialized”, single-payer health care system. It’s an uphill struggle, and for me it’s the single domestic American political issue I feel most strongly about. Just from reading the forward I learned that the Israeli health care system is actually not so great – it works pretty well for young, healthy, educated, well to do, Jewish citizens of Israel (like me) and increasingly worse as you fall further away from that description. It turns out that Israel has been adopting the worst of American ideas in the field of public health policy, like in so many others. I ordered the book on Amazon. Stay tuned for a full report.
The resignation is Ophir Pines‘. Earlier in his career, as recently as a few years ago, he worked from inside government in various positions, including minister of interior, to fight for justice and for the rights of the disenfranchised. He resigned his ministerial post in 2006 when that government took a turn to the right, and away from its moderate core principles, and today he left the Knesset after futilely fighting for months to keep the Labor party honest and true to whatever ideas it seemed to have and to its voters. Over the last decade or so the Israeli parliamentary and overall political landscape has been stricken with a severe shortage of any real leaders who could demonstrate both political acumen and some kind of moral fortitude. The only ideological stalwarts in Israel are the radicals on the right that have ridden the wave of general malaise and public attrition after years of occupation-driven violence into power. There is no representation of any real left (no one in the Israeli media even bothers to count politicians that are not considered Zionist). Pines seemed to be one of the few people in the dwindling left/center block that had any ideas he clung to even at the cost of losing his hold on power. He follows a long list of once-idealistic, and later dispirited and deflated Israeli parliamentarians who realized, after many years in the system, that they just could not work it any more.
Why am I writing about both of these items in one post? In my mind they resonate off each other. I have been struggling to define my identity for many years; the Israeli component is clear and undeniable, and I often wonder if it will ever pull me back to live in Israel. Over the years living in the US I’ve become more and more interested in the national political arena, and have been learning more and more about how fundamentally corrupt it is. I feel that these two places are my only two options for a place to call home, and they’re both in steady decline. Each of these countries is destroying itself from within through bad governance and bad policy that come from two very differently structured political systems. These two systems have some common traits, like the preference for political gamesmanship over public integrity. The image of two drunken college kids comes to mind, as they drink each other under the table, downing shot after shot of bad tequila. Israel is mimicking the US, of course, so this might be the better place to try to bring about some kind of change.
Tags: expats, Healthcare, Israel
January 8th, 2010 at 02:57
In all of human history, governments were always corrupted. If you look for a place to live based on the pureness of those in power, you might as well go live on the moon. When you realize all is bad you go back to look closer to you and about what makes up your daily life and gives you energy and happiness. Some would say you live in a bubble. I don’t think so. I think the fact the someone like chose to live and raise my kids in any place is a statement and will make an impact, but at the end of the day it is the mundane, daily life that matters.
January 8th, 2010 at 09:38
Writing one’s thoughts publicly is but a small way of fighting defeatist thoughts, idealistic perhaps, but still significant. Awareness is the first step, backing righteous politicians is another and who knows, maybe speaking publicly can also move mountains? Thank you for the wake up call this morning. It’s good to feel outraged, lets us know we’re not totally numb, pushes us to good places, maybe angry, maybe active.
January 8th, 2010 at 10:47
This post actually came about from a very mundane consideration – several months ago I had moderate (in my opinion) hopes that the US congress would pass health care reform legislation that would allow me to get my health insurance through a government-run “public option”. I hoped that it would be a first step towards having a national health care system – medicare for all. As I followed the disgusting sausage-making involved in the legislative process, and came to realize that all they’re legislating is federal subsidies for more expensive private insurance, I began considering a life back in Israel, just imagining not ever fearing falling into bankruptcy caused by a medical problem in my family. You see – I’m the perennial idealist, and the eternal pragmatist. Then I was reminded that things may not be so rosy on the other side of the pond; not even in the narrow field of public health policy.
So, realizing that all is bad, I have come back to feeling outraged, and maybe I’ll even become active. Who knows.
January 8th, 2010 at 12:49
What makes daily life better or worse is the great ideas and the great changes that were made by people who worked little by little on a tiny, tiny thing.
I personally believe that Activism is our obligation as human beings.
(Udi, could you please tell more about what those changes in Israeli health care…?)
January 8th, 2010 at 14:26
I believe that disengagement from the political sphere and the focus on our close others, personal happiness (and other new-age ideas) only make us more docile and perpetuate the status quo. Besides I always thought that personal happiness (in the hedonic sense) is extremely overrated.
I was not willing to admit even (moderate) hopes regarding Obama (and even less so regarding Pines) but was disappointed nevertheless. My greatest disappointment is the lost of public resistance (or even discontent). I am very happy that you share your discontents with us. Maybe they will help our
politicians to fail better next time…
January 8th, 2010 at 15:38
Hey man, good to see you are writing and taking action as you see fit.
Did you see :
The Ubama Deception: http://www.youtube.com/watch?v=eAaQNACwaLw
Zeitgeist : http://video.google.com/videoplay?docid=-594683847743189197#docid=7065205277695921912
If you didn’t, you will find them VERY interesting.
If you have and understand in what world we are living in, it will be easier for you to accept that the public’s well being is not at all at the top of the interest pyramid of the people leading it.
They are playing a whole deferent game with a deferent set of rules and interests.
Udi, THEY don’t care about us.
As hard to accept as it is, it’s true.
Look around you.
I feels like loosing a parent.
It feels like being betrayed by the very structures you thought want to keep you safe.
We would do anything to avoid the acknowledgement of living in a world like that, and we are.
Cheers from the Holy Land…
January 9th, 2010 at 09:36
Julia, I haven’t read the entire book yet. I was spurred to write this post form reading the excerpt from the forward that I linked to:
““In its early years, Israel’s dominant ideology led to public provision of health care for all Jewish citizens-regardless of their age, income, or ability to pay. However, the system has shifted in recent decades, becoming increasingly privatized and market-based. In a familiar paradox, the wealthy, the young, and the healthy have relatively easy access to health care, and the poor, the old, and the very sick confront increasing obstacles to medical treatment.”
Adam, when you realized that the democratically-elected forces do not work for the good of the people, doesn’t this make you want to do something about it? Where are you in your grieving process? Depression? Acceptance?
January 9th, 2010 at 13:01
Not Everything has to have a response.
Just looking or seeing something or acknowledging it can be enough.
I am not affected more then just a mere disappointment and i grow from there.
Many understandings make you grow and not only fall into a depression or other reactions.
It makes me look for other methods governing and living.
You choose what to believe what to embrace and what to leave behind.
I invest my talent and mind to researching and inventing new ways.
Every one of us CHOOSES the hell or heaven they live in.
I try to teach my loved ones to find their heaven and be free.
This is my little contribution to our world.
Maybe one day i’ll find a bigger answer i can share with the world.
January 9th, 2010 at 15:45
Just watching excerpts from a movie about Howard Zinn, and his phrase resonates in this context: you really _can’t_ be neutral on a moving train. Willful ignorance is equal to collaborating with the mainstream.
Not that I personally can say that I do much about it, but I would also never want to stop feeling uncomfortable about it, and am happy to whatever small gestures this discomfort may lead, as occasional as they are.
January 10th, 2010 at 07:52
I didn’t read the other comments so sorry if I’m repeating (I was naively thinking I was going to leave the first comment when I finished reading your post).
Just wanted to say that I found your post touching. These are complicated issues of identity, that I’m not going to get into now, but I sometimes think that the Israel I keep missing is the Israel of 1973-2000 and I should probably update my beliefs and expectations for when I move back. And don’t get me wrong: Israel of 1973-2000 was far from perfect. But this was Israel I grew up in, and probably an Israel that no longer exists.