Individual Choices Impact Society

Is it draconian and wrong to make receiving child stipends dependent on immunizing your children?  That depends on how you look at it.

Let’s start with the fact that the state is not obligated to give us money each month just because we have kids.  We can continue with the fact that health care here costs peanuts, and the vaccines are free.  A vaccine only makes it into the health care “basket” with no co-pays if it is determined that funding the vaccine for everyone in Israel costs less than it would to hospitalize, and treat, the number of people who would become seriously ill with the disease.

If the vaccines cost money, you could say that the state can’t require you to put out so much money.  But the state is paying for the vaccines, paying for the healthcare, AND paying you 140 shekels a month, per kid.  So, why can’t the state say, “Hey, guys, listen up.  We don’t want to pay for the added healthcare that your kid is about to cost because he’s not vaccinated AND pay your child stipend.  Choose what’s more important to you.”  Honestly, the child stipend isn’t what will make true anti-vaxxers vaccinate their kids, nor will it break anyone’s bank account (despite complaints otherwise), but maybe it will make some extraordinarily low SES families (and therefore, by definition less-educated and probably at higher risk of contracting illnesses) give their kids vaccinations.  However, the state has a right to say this, I think.

If this were all there was to it, it would be pretty simple.  Do what you want, and leave others alone.  I read an opinion article on Kristen’s blog that asked basically, “Why are we allowed to question every aspect of parenting except vaccines?”  And the answer is this: Because if you want to formula feed your baby three days after he’s born, you are risking damage to YOUR baby’s gut.  If you want to buy a second-hand car seat, you are risking YOUR baby’s life.  True, it is everyone’s taxpayer money; true, it hurts everyone to see your kid suffer.  But the ones who are going to pay the highest consequences are you, your child, and your family.

HOWEVER, if you choose not to vaccinate your child, it goes beyond that.  Yes, you are costing us taxpayer money, because you are exposing your child to an illness likely to require lengthy hospitalization and/or rehabilitation.  BUT, the difference is this: You are forcing your choice on the rest of us.  Those with weakened immune systems, those pregnant, the elderly, those who cannot receive vaccinations, those who received the vaccines but are only partially immune, those too young to be fully or even partially vaccinated.  You are putting ALL OF US at risk for dangerous diseases that can be avoided and even eradicated, against our wishes, and without asking or informing us.  Your unvaccinated child is likely to begin or spread an epidemic, and that puts the rest of us at risk as well.

That is why it is different.  Cloth diaper or use disposables.  Feed your kid formula, breastmilk, cow milk, goat milk, or chocolate milk.  Feed your kid junk food, only meat, vegan with no vitamins.  Put your kid in the front seat, the back seat, the car seat, with or without an airbag.  Smoke beside your kid, but not around mine.  And do not expose my family to dangerous diseases, just because you think you are more educated than everyone else.  I don’t care how educated you are.  If you don’t want to vaccinate your kids, keep them away from my kids’ environments.  Period.  If your kid gets hurt by your choices, my heart will hurt, but there is nothing I can do about it.  They are your kids.  I will feel bad, I will be shocked, I will wish it didn’t have to happen.  But they are your kids, and you are in charge.  If you want to risk their lives, that’s your business.  BUT, I don’t allow you to take risks with my kids.  My kids are my responsibility, and I take that responsibility seriously.  If you don’t vaccinate, the least you can do is make sure to only hang around with like-minded individuals, and alert everyone else that you are a potential carrier of dangerous diseases.

Israel’s Socialized Health Care

Israel has socialized health care.  I never realized what it was until a few weeks ago, when I read a couple of articles that gave a name to the health care system.

First of all, some background: Israel has an identification system in which each person has an identity number that is connected to pretty much everything: bank accounts, health care, drivers’ license, passport, places of study, contracts, phones, and everything else you can think of.  When you fill out a form, you fill it out with your name and ID number.  Sounds scary?  It’s not – as long as the government’s files are safe.  And identity theft is incredibly difficult here.

On to the health care system.  Here is how it works:

Each person has to pay premiums to the National Insurance Institute.  If you don’t pay, you get in trouble.  Why?  Because every citizen is automatically insured by the government.

While everyone is insured by the government, the government is not the one providing the actual health care.  There are four health funds: Meuchedet, Maccabi, Leumit, and Clalit.  These health funds are in direct competition for government funding.  They get paid per head.  Each has its own supplemental insurance plan that you can purchase, that is slightly different than the others’.  The basic basket, however, is identical and “free”.  “Free,” meaning, that it is paid for by your premiums that you pay to the government.

Just to be clear, a housewife (a married woman who does not work outside the home) and a child under the age of 18, do not pay premiums.  If you are a student or unemployed, you pay a minimum fee.  If you are employed, it comes out of your paycheck before you even knew it was there, with you paying part and your employer paying the other part.  What this means for us is that only Yitzchak is paying for health insurance now.  If I teach (or get another out-of-the-house job) again, they will take care of it.  If I don’t work outside the house, I don’t have to pay at all.  So, until our kids turn 18, only Yitzchak has to pay insurance.  Pretty good deal, no?

Now to the doctor visits: We are with Meuchedet.  They have a number that you can call to schedule doctor visits and other appointments.  Usually, they will have an appointment free within two weeks, unless you are insisting on going to a doctor who is booked for months on end.  It happens to be that I don’t insist on female religious doctors, so I have never had this happen to me.  Whether for Yitzchak, Shlomo, or myself, there is usually something available for the week you want.

Most medicines are 85% subsidized.  Meaning, you only pay 15% of their cost, if you have a prescription.  If you don’t have a prescription, you pay more, but it is usually not expensive.  I know that there are some medicines that are not covered.  Thank G-d, the only one I have encountered so far is birth control (and I didn’t end up filling it).  Please, G-d, I hope that no one in my family ever needs another medicine that is not subsidized – or any medicines that are, but are not benign.

Blood tests are free.  Urine tests are free.  Doctor visits are usually free, unless you are seeing a specialist, in which case you pay 21 shekels (maybe a bit more now – it goes up a bit every year).  OB/GYNS are not counted as specialists in this regard.

Ambulances and hospital visits, if they turn out to be medically necessary, are free.  If they turn out to be unnecessary (a false alarm for a birth, for example), then there is a co-pay, which may or may not be expensive.

Another bonus: You can go to any after-hours clinic that works with your health fund, and they will have your medical records at a swipe of your card.  If your card isn’t working, your identity number will.  In fact, a “temporary card” is a piece of paper, printed on the spot by one of their secretaries, that states that you ordered a card and lists your ID number.  It’s basically proof that this ID is part of their plan.  That’s all.

In short, Israel’s health care system is not perfect, but is definitely a good model for other countries to follow.

Where Could I Find a Job That…?

The amount of paid maternity leave in several countries.

Here’s part of the reason I don’t live in the United States: Maternity leave and health care.  Sometimes, I contemplate moving back to the U.S. – just to be closer to my in-laws and to be in a smaller, more close-knit community.  But then I remember: Maternity leave and health care.  And I chicken out.  Where could I, where could anyone, find a job that:

1) Has flexible hours, so the kids’ school schedules aren’t a problem.

2) Will give full insurance coverage for the employee and his entire family, no matter what “preexisting conditions” there are.

3) Will give mothers paid maternity leave.

4) Will give paid bed rest if medically necessary.

5) Does not count said bed rest or maternity leave off of vacation or sick days.

6) Will allow telecommuting if it becomes necessary or desirable, without compromising the employee’s position.

7) Pays enough that hiring a private babysitter instead of using a daycare center won’t take half a mother’s salary.

Where can I, where can you find a job like this?  It’s sad, but they’re pretty rare today.  But, find me a parent who doesn’t want the best for the child.  And find me a parent who won’t change careers just to get the kind of job mentioned above.  I am not sure such a parent exists.  I hope that Obama, now that he has been re-elected, will change some of these things for the better.

And in Israel?  Basic health insurance is mandatory and subsidized by the government.  Supplemental health insurance is optional.  Once you choose one of the four health funds, they are obligated to cover you for the basics and for supplemental insurance if you choose (i.e., they cannot turn you down).  It’s not perfect, but for the vast majority of the population, it is good enough.  Some specific medications and treatments are paid for out of pocket, but most are at least partially subsidized.  Bed rest, if determined to be medically necessary, is paid for.  So is maternity leave up to 14 weeks.  After that, to each his own.

However – telecommuting here is nonexistent, and flexible hours are a distant dream.  One day, when we stop fighting wars to live, and start paying more attention to living, that will change.  One day.  Oh, well.  We can’t have it perfect, can we?