Leeches can still be used in cosmetic or wound care, and to relieve joint pain. This happens not only in the CIS countries: the US Food and Drug Administration (FDA) classifies leeches as a medical device. But whether they are better than other medical methods, no one really checked. Speaking of devices: scientists have long developed a mechanical leech that sucks blood better than real ones and, instead of an explosive mixture of substances, injects studied heparin up and down. True, it has not yet entered into widespread use.

However, bleeding that is difficult to stop, the risk of acute kidney failure, infection (paradoxically, this also happens), allergies and other side effects gradually forced this method to give way to new ones. And even the authors of a review in a journal dedicated to complementary medicine admit this.Bez_Keyvorda_112

Without kewood

Without Cavorda for free, but for money (reflections of the former Soviet doctor about Israeli medicine) Anna Isakov, by profession, I am a doctor: I received a medical education in the USSR and

Without kewood

Free, but for money

(Reflections of the former Soviet doctor about Israeli medicine)

Anna Isakova

By profession, I am a doctor: I received a medical education in the USSR and worked for six years in urban hospitals and polyclinics of the Lithuanian capital. During this time, I managed to get two specializations – on cardiology and infectious diseases, passing all the required standings and exams. But after moving to Israel (1971), it was necessary to start all over again, since none of my previous professional achievements, except for a medical diploma, were not recognized here.

Solar baths for tuberculosis patients in the Hospital "Shaar Zedek". Photography Tsadoka Bassan. 1920s

A colleague, who came, as I, from the USSR, but a few years later, determined the difference between the Israeli and Soviet medicine as follows: they are taught here how to use all that, without which we were trained to do. I would add to this difference in the attitude of emergency situations: the fact that the USSR was considered a medical heroic, here is considered as a shameful voice.

Based on these differences, it is possible to understand the difficulties of the transition from one type of medical practice to another. For example, Israelic medicine does not understand how to do without the ability to handle the most modern equipment, but it is difficult to make a diagnosis if this equipment suddenly fails. On the other hand, I did not manage to interest Israeli colleagues with stories about the valiant Soviet doctors removing appendix on the drifting ice floe with the help of a pocket mirror and the attempt razor. True, it is reasonable to answer the question that he did on the drifting ice, this doctor, if he had only that he had a pocket mirror and a blot razor, I didn't know either.But I can testify that the Soviet ability to do without the necessary and learned knowledge of what needs to be done when the situation seems hopeless, sometimes helped.

Specializations in Israel are long – at least five years. I decided to add to therapy gastroenterology. Two more years. Exams. Then work by profession is preferably in the hospital, which involves – for the sake of promotion in service – compulsory scientific work and acquaintance with the rest of Israeli hospitals. And also – for the sake of earnings – running on consulting points of hospital cash desks, private receptions and afternoon trials in privately non-involved medical units working on a special principle of which in any other country of the world, as far as I know does not exist.

What is this principle?

Somehow a polyclinic stationary reception (another special invention of Israeli medicine) came to me by a person from Kutaisi and demanded: "Leach me as for Dangy, but for free!" So, the principle discussed says exactly the opposite: to treat, as for free, but for money. In other words, to serve extraordinary patients during working hours using hospital equipment, but for an additional charge – a doctor and hospital.

This is not private medicine. Private medicine works in private clinics and hospitals and works only on profits. And this, of course, is not public medicine, since the patient pays for it from his pocket, albeit substantially less than in a private institution. At the same time, the patient's money pays the work of medical staff only partially. Most of the profits go to the hospital – to buy new equipment, repair of hospital premises, scientific surveys and free provision of poor services that are somewhat more direct money for extra money.

In other words, the Israeli's business citizen pays a health tax and in addition pays medical services from his own pocket personally.Well, not exactly pays in full, but, let's say, pays the medical institution extra for the extra effort, while deducting charitable tithes to help the poor. And this is not all the tricks that allow Israeli public medicine to survive, and most of its patients receive quite decent medical care. Some – "like for money, but for free", others – "like for free, but for money."

It wasn't always like that, although that's how it always was. Israeli medicine began with ascetic doctors who came to Palestine according to the Zionist wish. They traveled from all over the world, representing here a variety of medical schools, economic and political views. Some opened private clinics and hospitals, others merged into sickness funds, as was customary in the Jewish communities of Europe, others tried to create something like public medicine. Political parties appropriated sickness funds and built hospitals for their supporters, while religious communities did the same for their members.

From this jumble, a complex of medical services gradually matured, which only a person who is well versed in the internal situation could and can use zealously. One thing was clear to adherents of all medical directions – there can be no situation in which a Jew who settled in Palestine would not receive medical care. Like for money, but for free or vice versa. Even topsy-turvy, but by all means.

And with the formation of the state, the matter became even more confused, since health care developed before the state appeared. Therefore, the state has only to act through the already existing healthcare puzzle, in which the devil himself will break his leg.

Meanwhile, the war was going on and there were many wounded. And there were hundreds of thousands of poor fellows from fascist concentration camps, from Africa teeming with miasma, from lice-ridden and hungry post-war Europe, from India, which surprised with medical curiosities.All of them needed to be cured by the forces of public-private-party-confessional-state medicine from tuberculosis, bilharzia, scab, exhaustion, beriberi, typhoid, malaria, dysentery, worms living in the liver and under the skin, and other misfortunes.

Doctors and nurses told how they cut sheets into bandages, boiled nettle decoctions, collected medicines and equipment around the world and delivered them in extraordinary ways, without asking what was legal and what was not legal in this activity.

We worked as long as necessary, without looking back at the schedule. And they thought that was how it was supposed to work. They even showed me a memo letter from Professor Sheeba, who ran the hospital until 1971, which said that, due to the special situation of the Jewish state, the hospital resident should work not for money, but for food and housing provided on the hospital grounds. The same professor Shiba, by the way, left the Beilinson socialist hospital, since doctors were forbidden to practice privately there. Not in the hospital itself, of course, but in home clinics. And he built the Tel-a-Shomer hospital, in which doctors with private practice could work in peace. Shiba himself never had a private practice. And the first hospital in which leading doctors were allowed to have “own” beds for private patients was the Beilinson Hospital in Petah Tikva. Such is the purely Israeli situation.

However, until now we have spoken, albeit in Russian, but in Hebrew. It's time to add Cyrillic.

In 1973, I was summoned for a conversation by the then director of the Ministry of Health, Uri Frand, who was considered part-time one of the heads of the department in which I worked, and asked me, a fresh repatriate from the USSR undergoing specialization, the question: does it make sense to change Israeli medicine in order to save public medicine? way of organizing health care in the Soviet?

For reflection and essay on a given topic, I was given all the time of the big Jewish holidays – from Yom Kippur to Simchat Torah.

The war lasted longer. Frand already had one "tsalash" (the highest Israeli military award). For the six days. He was demanded to be rewarded by soldiers who survived the meat grinder on Givat ha-tahmoshet (Arms Hill) in Jerusalem. They did not remember the name of the distinguished doctor, and he remained in the history of this war as a “doctor from Givat ha-tahmoshet”.

Uri was not called up for the Yom Kippur War. It was not supposed to be due to occupational status, or age, or health reasons. Frand volunteered, organized a hospital near Suez, and then found himself surrounded by a large group of paratroopers, among whom were many wounded. The group was fired mercilessly, but it was decided to try to take out the seriously wounded, because otherwise they had no chance of surviving. The helicopter landed under heavy fire. The wounded were loaded. Fran was not supposed to fly with them. He had to stay down and wait for the breakthrough. But he flew. The helicopter took off, it was shot down, and no one was left alive.

And on the ground, the case ended, in principle, safely. The second "tsalash" for the feat of Uri Frandu was not given, but was posthumously promoted in rank. And they also began to call them “parachutist doctor”.

Since then, I have been compiling the requested report annually. I usually do this around Yom Kippur, but this year the doctors' strike intervened. What exactly their demands are, the strikers find it difficult to answer. Some doctors say one thing, others say something else, commentators comment, journalists interpret, and in the end it turns out that all this polyphony comes down to a question once posed to me by Uri Frand. Is it possible to save public medicine and what needs to be done to achieve this?

But now I understand the meaning of the question. And then, in 1973, Frand's question seemed to the repatriate a cunning test of loyalty. Well, who could have thought to take seriously the example of the administrative and social catastrophe called Soviet medicine? And haven't I seen with my own eyes how much better, more progressive, more effective Western medicine is? Who needs such clever setups? I've had enough of the Soviet government with its Jesuit methods of detecting dissenters!

For this reason, my very first report then still sounded the Living Director of the Ministry of Health. Create health care in Israel to the Soviet model, I approved, it is not difficult. It is necessary to arrange a shortage of drugs and dressing material, allow the medical staff to rude, put the promotion of doctors in the service in direct dependence on party accessories and train interns to write disease history not for medical registration, but for the prosecutor. Exactly, according to the Yerevan Radio, you can arrange Soviet power in Switzerland. It is asked only: why spoil a good country?!

I tried your wit for Dani Michael, the future of Professor, Director of the Ministry of Health and the Head of the Hospital Cass, and then the head of the neighboring department. Dani was known for its good attitude towards repatriates. And also by the fact that he was a clever, a brother of the nationwide beloved humorous actress Mikhaili and the first ingenious among doctors. From time to time I went to him to consult and simply talk. Dani had a special look at reality and a special ability to understand this reality and explain.

Somehow the conversation went about the problems of health care, and I stated to Dr. Michaeli my view of Soviet medicine. It was suddenly that the question given to me the late Uri Ford was not a mockery of Soviet medicine and who came from there with doctors. Judging by the reports at international conferences, the Soviet hospital and polyclinic associations are exemplary devices that ensure the continuity of patient treatment and a high professional level of constantly iridescent from the hospital in an ambulatory and back staff. In addition, this combination allows you to optimize the use of equipment, while in Israel there is no connection between the hospital and polyclinics, which is why there is a serious medical and methodological problem, which is added to an incredible spraying of public funds.

In other words, a situation arises in which good treatment can only be obtained in a hospital, in view of which wealthy citizen-patients encourage hospital doctors to engage in private practice, which threatens public medicine with the most terrible consequences. No less terrible than those that threaten the Israeli economy with full-fledged capitalism. And something needs to be done about it!

Uri Frand, "doctor from Givat ha-tahmoshet", director of the Ministry of Health (1973), hero of two wars – the Six Day War and the Yom Kippur War (posthumously)

Personally, I did not see anything wrong then in the fact that Israeli semi-socialism tends to be transformed into full-fledged capitalism, as well as in the fact that private medicine can overcome the wretchedness of public health. I was by no means alone in this conviction. Most Israeli hospital doctors began to focus on US medicine, which was acquiring the status of the best and most correct throughout the medical world. And even when the first medical publications appeared, claiming that the cost of modern medicine with all its tools and pharmacological richness was becoming unbearable for the budget of even the most developed and wealthy country, they were interpreted not as a warning about the danger of irrepressible instrumentalization, but as confirmation that medical equality impossible in principle.

The moans about the destruction of public medicine became more and more muffled, and private medical activity flourished and bore fruit. I will not say that my Soviet upbringing rebelled against such a turn of events. On the contrary, in the early 1980s, it seemed to me that the privatization of health care was not proceeding fast enough and that it was necessary to quickly abandon the system of sickness funds and move to direct health insurance in insurance companies. Yes, and the law on state health insurance, when it was still being discussed, I saw at best an unforgivable mistake, and at worst a political sop to the socialist sector, bordering on a punishable offense.

I could say that my mind has changed when hundreds of thousands of immigrants arrived in Israel, and in the essence of refugees from the former USSR, for the most part of the poor and needing free medical care.

Could, but I will not say. The fact is that mercantilization that followed the onset of private medicine to public has changed a lot in the system of Israeli health even before the arrival of mass immigration. In the 1970s, one of the medical faculties were going to close, because in Israel there were more doctors per thousand population than in the most prosperous countries of the Western world. No faculty was closed, some faculties were even expanded, and the doctors per thousand population became so few that they were going to deliver not from South America, not from Italy, not from Georgia. Meanwhile, the repatriation from the CIS brought with itself at least 40 thousand doctors. Part did not manage to pass the qualifying exams, but the majority went into the system. Israeli medical hours in the meantime increased the number of graduates. Where did they go? Cut? Did you retrained in the manager or the computer?

I have no answer to this question, and there is no need to look for it. In demand specialties, that is, where the genus of specialization provides good earnings at the expense of the private sector, the doctors are enough. There are no them in those specialties, which in the private sector is small, but without which the public sector cannot do without. Therefore, the strikers appear under the slogan no longer protection, but the salvation of social medicine, relying in this with President Barack Obama and Clea Clinton, who came to power to a large extent because of the problems associated with private medicine.

That very, which was recently considered exemplary, and now seeing something so antiguman, which can claim the attention of the Hague Tribunal as one of the crimes against humanity. After all, if you believe the statistical calculations, cited by American democrats, the number of poor people die without medical care due to the lack of medical insurance exceeds the figures of human losses as a result of unrighteous hostilities at any, even the very bloodthirsty, political mode.

So, was Soviet medicine really the most advanced in the world, as Soviet textbooks claimed? Was this absurdity, based on scarcity, patronage and deceit, still of undeniable value? Could it be that it is she who will remain a symbol of unattainable bliss, since she is no longer anywhere? Moreover, it cannot be, since it has been statistically proven that even a country like the United States cannot pay for public health care from its budget. And something needs to be done about this, because no democratic state can allow some of its citizens to suffer from diseases more than others, just because these citizens do not have money for treatment. Therefore, all Western states are concerned today with the problem of public health.