BGU | MY PATH, Haim Doron, MD

The Plan to Bring Doctors from Latin America to the Negev The gravest problem occupying my thoughts during the period we lived in Beer Sheva was the problem of the shortage of doctors in the Negev and immigrant settlements -- particularly in development towns and in border areas. I fear this problem, with all the ramifications this carries as a nation was one of the biggest failures in the historic mass immigration of Jews to the fledgling State of Israel. Who hadn’t tried to solve this problem? Prime Minister Ben Gurion raised several proposals: There was an attempt to mobilize physicians for a period of compulsory service treating patients in these areas -- something the doctors’ professional organization, the Israel Medical Association (IMA), never accepted; nor did Minister of Labor Golda Meir accept this idea. A year of service in underserved communities for medical students after graduation was tried, material incentives were offered, and other schemes -- but the problem remained acute. When I arrived in Beer Sheva in 1954, I asked myself - why shouldn’t my friends who studied medicine with me in Argentina not come to serve as doctors in these areas? After all, they were put off by the Argentinean medical system, and a portion of the Argentinean Jewish physicians was active already in Zionist circles. But, why weren’t they making aliyah . My explanation to myself was: They aren’t coming because they fear the unknown. They don’t have a clue about Israeli life or how the health system operates in the country. They don’t know the language. And they fear they won’t be able to cut it, i.e., to make it, and so forth. I devised a plan to offer solutions to their fears: They were afraid to come alone? Have them come in groups. They are apprehensive of not knowing the language? We’ll ensure they can first go about learning the language in specially-tailored intensive Hebrew courses ( ulpan , in Hebrew). They worry about their lack of familiarity with the health system in the country? We’ll provide them with an introductory orientation course to the Israeli health system. I turned to two entities who together could execute this plan: the Jewish Agency, the body responsible for arranging the aliyah of Jews from the Diaspora, and Clalit, which, beyond major population centers, was almost exclusively responsible for providing medical services in the country. First of all, I approached Yitzhak Kanev, Clalit’s chair at the time. Kanev was, historically speaking, the father, or architect, of social security in Israel. He was the chair of the committee that prepared Israel’s National Insurance Law, and for years he headed various committees that proposed a national health insurance scheme for the country. Although he was the chair of Clalit’s directorate -- loyal to the Labor Federation under which Clalit operated, and while he strived to preserve the Labor Federation’s vested interests, he was in favor of state-mandated health insurance. It was a top priority in his mind. 16 His worldview as an economist had been greatly influenced by economists at the London School of Economics. I went to present my plan to him, and he immediately responded enthusiastically, asking: “Perhaps you would like to travel to Argentina to bring the doctors?” I had no interest in such a trip. I told him there was no need for me to go and that if the plan was launched, there were suitable Israeli envoys in place who could organize the plan from there. So, I went with the plan to my friends from my days in Argentina -- lawyer Ephraim Avigur who was the head of the Latin American desk of the Jewish Agency’s Aliyah Department. He also was immediately enthralled, and lent a hand to carry out the plan. At the time Avigur was at the Jewish Agency, there was also an organization called PATWA (Professional & Technical Workers Aliyah ) that had emerged in England and a bit in South America via which we advertised the program. 16 Clalit was but one highly hegemonic body established and controlled by Labor Zionists, which was far more than a union. It embodied a Federation-run ‘workers’ economy’ network ranging from construction companies like the above-mentioned Solel Boneh group along with major manufacturing entities and marketing channels, agricultural and transportation coops to banks and other financial institutions. While the overarching objective was to forge a civil society, scaffolding for an independent Jewish state, the Federation not only provided essential services, but also had enormous leverage in shaping Israeli society along Social Democrat lines. A Federation-controlled health system that required membership in the Federation to qualify for Clalit membership embodied inherent conflicts of interests. Not the least of these was the status of Clalit on an uneven playing field, far too often viewed by the parent body as a cash cow to underwrite other Federation needs and priorities that had nothing to do with healthcare. This led to conflicts of interest and thrust managers such as Kanev into an impossible position of trying to serve two masters at the time while preserving their integrity. (D Ashkenazi, translator.)

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