Our morning lecture was about the health care system here. Among the interesting points.

1. All doctors are on a set salary. This explains a lot. Because there is no reward, well no financial reward, for quality work. You get paid the same if you take 17 coffee breaks, keep all your patients waiting, and never look up from you desk as if you work nonstop, give each patients your full attention, and spend your breaks researching new treatments. So umm. . . if you're a little tired on a given day (or most days) and you know your paycheck is coming no matter what, which doctor are you going to be?

2. To compound the above problem, there is basically no punishment for malpractice. Unless you literally murder or rape a patient, the most you're likely to get is a 3 - 4 month suspension. While I think it's terrible the way doctors are paralyzed by malpractice fears in America- I do believe doctors should be terrified to misdiagnose , mistreat, or harm their patients. Basically we have this tremendous socialist system where everyone gets healthcare. But with no incentives in place- it's basically mediocre healthcare for everyone. And of course you get self-motivated doctors who do extraordinary work all the time, and I would hope the majority of doctors do care a tremendous amount about their patients and the quality of their care. I'm sure many/most of them do. But it does explain a lot of the laissez-faire-ness that seems pervasive around here.

3. The ministry of health both sets health care standards and pays for those changes to be made. Which means that, for example, the ministry of health decides that every hospital must have functioning sprinkler systems. Then the ministry of health realizes that it is socialized health care and that they are responsible for giving the hospitals the money to install aforementioned sprinklers. Then the ministry of health realizes that will cost 400 million shekels and they can't afford it. So the ministry of health decides that all hospitals do not need to have functioning sprinklers.

Right. So the organization that is supposed to set the standards of health care in this country voluntarily lowers its own standards so that it can afford to meet them.

Confused? Concerned, perhaps? Yeah me too.


Ahhh, middle east. Sometimes I enjoy the contradictions. For example, the only gym /health club in my city has . . . a bar in it. I should clarify. The gym is actually in the bar, you have to walk through the bar to enter the gym. And there are windows so that bar patrons can peek into the spinning studio or weight room as you work out. There is nothing stranger than walking out in my sweaty gym clothes at as the bar is opening and having to squeeze out through a room of smoking, drunk, dressed up people. The fun part is that the DJ will usually come in and spin in the gym for a bit before the bar opens and occasionally they move the gym stuff aside and have actual parties inside the gym. It's special.

But what's amusing and fun and different out in daily life is significantly less funny in the hospital. Well, it's kind of funny, but in a "are you serious?" kind of way. The patients smoking out on the balconies with the nurses with their oxygen and IVs still attached. Or the way the AC rarely works on the wards so you have really sick old people lying in beds next to windows wide open (as though that helps anything when its 120 outside)with dust and smoke and germs from the other wards blowing right on in. Or the way the nurses don't ever seem to know where the patients in their own ward are. Or the way there are cats wandering about the high-risk pregnancy ward. And the hospital is really quite clean and modern and professional and there are just little carelessnesses that drive me crazy.