Hadassah Hospital

Monday was our first day venturing across the border into Israel. Hadassah is a tertiary care hospital in Jerusalem where Harb’s father used to consult as a cardiologist. We had the connection to spend time with the physicians and medical students there. Of course, the border crossing was a bundle of fun. Cement and steel and people lined up to push through turnstiles. I caused the Israeli security to pause for a moment when I pressed my US passport against the glass. I suppose they don’t see many US passports coming through a Palestinian checkpoint.

At Hadassah, we met Julie, an intensive care nurse who gave us a quick orientation to Hadassah and a presentation on “terror medicine”. There is a great deal of work that goes into preparations for “mass casualty events”. The drills they do here have a greater sense of urgency and relevance than they do in Iowa. The effect of psychological trauma after a terrorist action is a serious concern for the hospital. A terrible corollary is the reaction of the victim and the victim’s family to the nursing staff. There are Arab Muslim women working as SICU nurses, and Julie noted that families can have strong negative reactions to them after a terror event.

There were other revelations for us during her presentation. They take pictures of the patients as they enter the ER, because swelling and trauma progressively make victims less recognizable. They don’t have HIPPA policies to follow mindlessly, so they feed the identities of the victims into a centralized system and provide the names and locations to relatives that call in. Since the information is centralized, it is available from any hospital or government agency, and reduces the confusion after an attack. It is a more pragmatic approach to privacy than HIPPA absolutes.

The hospital is the most advanced in the region, a tertiary care center, and is the referral center for all the US Embassy staff in the Middle East. A brand new building is in construction, a massive structure which will keep Hadassah far ahead of the curve. Palestinians can be referred to the center, but they will not be treated without proof of ability to pay. And the prices at Hadassah are near the American level of expense.

Israel has a socialized healthcare system, and the payment into the system is income based. You can purchase private insurance beyond the government issue. Hadassah’s doctors are allowed to run a private practice in addition to their public duties. This system isn’t any great answer to our own difficulties in the much larger and more expensive American system. In fact, the doctors are unionized and preparing to go on strike later this week. It doesn’t seem like the Israeli approach is a silver bullet that could be used to kill the American healthcare crisis.

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