ALMOST EVERY DAY BRINGS another unpleasant reminder that we are “not in Kansas anymore.” https://tinyurl.com/ystnhe27
Here, bureaucracy is rampant on a field of papers and telephone answering systems. A 20-minute wait to get to a “real” person — usually a clerk who would like to help but cannot — is more common than not.
CASE IN POINT: My wife got a new cell phone from an Israeli store (מחסני חשמל).
The cell has a THREE YEAR guarantee.
It “broke” within 6 months.
In “Kansas” (U.S.A.), she would take the phone back to the store where it was bought and the store would either
- Replace the device
Send it off to a facility to be checked/fixed/returned or replaced
Although there is a store relatively close by, here she must take the phone to another town to be checked/fixed/returned or replaced.
Since we live in a relatively small town (Yavne — it only has been around since well before Johanan ben Zakkai established an Academy here in 70 CE) it lacks stores and services of a bigger community such as Tel Aviv and Ashdod, cities to the north and south of Yavne.
This also is painfully true of medical care; no hospitals in town, although there ARE clinics and urgent care centers.
Adding to her woe, we (so far) have to depend on taxis to get from point-to-point. While the reality is that taxis may, in the long run, be more economical than buying and maintaining a car (insurance, etc.), it is — at least for Americans — an inconvenience.
I have whined in the past https://tinyurl.com/yzn9nrhw about the paperwork with which a patient has to deal versus the patient’s doctor’s office making arrangements.
Here, the doctor writes an order for the patient to see a specialist.
If the specialist is not on the patient’s health plan — think Medicare Advantage — the specialist requires a “Tofes 17” — a guarantee of payment — from the health plan.
The patient then has to go to the health plan to get the magic “Tofes 17.”
In “Kansas,” the doctor’s office deals with the health care company. If the specialist fails to appear on the company’s approved list, the doctor’s office and the company work together to get the patient to the specialist he needs. The patient, who presumably has enough to worry about, is not involved until all the arrangements are in place.
Another “minor” issue is that rather than issue a “Tofes 17” that covers the primary procedure and all follow on related procedures, a new guarantee must be requested for each individual procedure.
In my case, that means a new “Tofes 17”
- For initial surgery/biopsy
Second surgery to partially eliminate cancer
Third surgery for further eliminate cancer
Six weekly chemical treatments to further eliminate cancer *
Fourth surgery to finally eliminate cancer
Post-op follow-up
all of which does not include related tests and interviews with specialists (e.g., cardiologists, vascular surgeon).
- * To be fair, one “Tofes 17” sufficed for the six weekly chemical treatments.
In “Kansas,” I had an open abdominal aortic aneurysm repair, a “Triple A.”
Under my Advantage plan, my initial visit to the specialist was covered and all following related procedures, including a hospital stay and post-op follow-up with the surgeon.
As a patient, my only obligation was to show up.
My PCP’s office, the specialist’s office, and the Advantage provider took care of all the paperwork.
The same process was true for a hernia repair and a fempop bypass.
For several years I have had balance problems; unless there is a handy wall, I tend to fall.
Thanks to my former Medicare Advantage carrier and my former PCP’s excellent referral people, I have a mobility scooter (no cost). I can “scooter” to my local PCP’s office or a more distant office as needed.
Not so my Spouse.
Incidentally, if I needed a scooter here in Israel, it would be out of my pocket. To be fair, some health care is less expensive here (no co-pays for out-patient services) and some (equipment such as scooters) is more expensive.
Bottom line: It’s not Kansas anymore.
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