Yesterday on X I wrote a long reply to a thread from the UK about poor treatment received over an infection and the problems getting hold of a GP and then a Hospital for simple tests.
The thread is here:
https://x.com/peterrhague/status/1865184491578265729
Just about everything in Peter's thread about the UK's NHS (quoted) can be fixed with no more money but with efficiency. At the end I'll give my ideas as to why the Israeli system tends to be more efficient and why it's much closer to the UK's NHS than an American insurance system.
My GP (Maccabi Israeli health system) has an office for just himself. He was a cardiac specialist but I think he just prefers being a GP working for himself.
From 7:30am to 8am Sunday to Friday (Friday is like Saturday here, and Sunday is like Monday) he answers his phone, takes your name and gives you a time that morning to see him. It's usually in the next hour or two. Two days a week he does the same thing in the afternoon.
He doesn't want to take any details on the phone. Just your name. Call is under 10s and there is no hold: if his line is busy, try again in 30s you'll get him.
I walk to his office above the small local shopping centre, he doesn't have a receptionist. Often I walk straight into his room or wait a minute while he finishes with another person. Door opens, person leaves, he calls you in.
If you're just asking follow up questions or need a repeat prescription, that can be done in the app on the phone: no visit needed.
Appointments are 10 mins (I think, I've never gone that long and I've never waited past my booked time). He swipes your Macabbi health ID card.
He does everything straight on the Macabbi internal computer system, no pen and paper and most of that shows up in the app on my phone instantly.
Prescriptions aren't on paper. If I get one I go to the pharmacy in the same shopping centre, they swipe my card and give me a prescription for a small fee (not the cost of the drugs).
If you need blood tests or something else, of if you need urgent but not full on hospital care, there's something called a Moked: a clinic. It's open long hours but not 24 hrs and it does 95% of what you need from a hospital: X-rays, blood draw, some blood tests on site, emergency doctors including many specialists and especially pediatrics. It's open at weekends.
That's where you go for blood draw and other diagnostic tests.
The basic care is all free at the point of delivery. In the background you can pay to top up for extras but the amounts are token ($10's per month compared to the $1000's the Americans pay for insurance).
I also have private insurance (not big bucks) which I have used to get a couple of surgical procedures and a laparoscopy done more quickly or in a way I prefer: when you do that, your Govt Health insurer actually gives you back some cash for saving them money by going private!
Everything in Peter's thread would have been taken care of in around 2 hours at the Moked (depending on the specifics of the tests, but I suspect that a kind of infection like this would have been diagnosed and treated immediately). For sure the electronic sharing and computerisation of records in this country (whilst I acknowledge is a privacy nightmare) is marvelous from a point of efficiency and getting you better again.
It's not all roses here but boy is it better than the UK and no more expensive for either the country or us directly as citizens. Also be aware that our population rate of growth (by birth and immigration) has been far larger than the UK over the last 40 years.
The main point of difference I believe? Competing Public Health companies (I'm with Maccabi, there's Clalit, Meuhedet and Leumit too). You can switch between these (I think once in a year) and often your choice is which ones have better local services in your area. But they all compete. Clalit and Maccabi are the leaders where I live.
The money from the Israeli Govt follows you, so if you don't like your company you can move: within this system there is no concept of "pre-existing conditions" between these companies. Using doctors from different systems is also possible and most of the hospitals and specialists work with one or more of these at least.
This single element of competition seems to drive tremendous efficiency. The way doctors (like my GP) are employed and get paid on a per patient and event basis means that he just wants to see patients and not pay for a receptionist or any other ancillary stuff he doesn't need.
Any questions (and I'm sure a few Israelis will jump in and tell me their horror stories... bring it!)