'Obamacare'

Wed & Thursday

The US health care debate

As Israelis observe Americans debate universal healthcare, we find ourselves struck by the fact that our little country is actually more advanced than the US in providing all residents with medical coverage. But we take no pleasure in the realization that political discourse in the US has sometimes deteriorated to the crude levels too often seen in Israel.

Most of America's 307 million people do have health coverage, either through their employers, Medicare, Medicaid, veterans' benefits or special government programs targeting children of the working poor.

But 49 million don't; some of these probably want coverage but can't afford it. An additional 25 million Americans have too little insurance for their needs.

Yet even without universal coverage, America has a budget deficit of $1.8 trillion and spends twice the average share of its gross domestic product - 16 percent - on health as Israel.

President Barack Obama wants every American to be able to choose a private or government-backed health care plan. Members of the House of Representatives and the Senate have put forth several schemes (some with White House input) as they hold town-hall meetings with their constituents. No one yet knows what the final healthcare bill will look like.

Ardent conservatives, among them the influential radio personality Rush Limbaugh, say Obama's plan shows "similarities between the Democrat Party of today and the Nazi Party in Germany." Limbaugh: "Obama's got a healthcare logo that's right out of Adolf Hitler's playbook"; and "Adolf Hitler, like Barack Obama, also ruled by dictate."

Former Republican vice presidential candidate Sarah Palin claims the president is intent on setting up "death panels" of government bureaucrats empowered to determine whether disabled or elderly Americans are "worthy of healthcare."

WHAT explains such vituperative language? Part of the answer is that America's political culture abhors a concentration of power in any one branch of government out of a visceral fear, dating back to the founding fathers, of tyranny.

Moreover, as with all Big Lies, there is a kernel of truth to the implicit charge that universal healthcare will not provide unlimited care, forever, under all circumstances.

On the other hand, those who now have private insurance live under those same constraints, and those who have no insurance have no protection at all. All plans - commercial, governmental or hybrid - "ration" healthcare.

According to the Pew Research Center, most Republicans say the US healthcare system doesn't need fixing, while most Democrats argue the opposite view. But overall, says the center, 75 percent of Americans do want to change the system. And Obama remains popular with an average 53:40 approval rating, while his Democratic Party controls both houses of Congress.

Even Obama supporters say he needs to give the American people more specifics on how the plan will be paid for and better explain why providing a public or quasi-public option is not some elaborate plot for a government takeover of all healthcare delivery.

WE DO not presume to tell Americans how to proceed. We can only point to our own experience which demonstrates - albeit on a smaller scale - that universal coverage is workable.

However, there is no doubt that Israelis sacrifice a level of privacy that Americans enjoy. For instance, medical records in Israeli health funds are computerized, and their confidentiality is hardly airtight.

Visiting a family doctor here tends to be a no-frills affair. Care is generally of a high standard, but there are no stylish offices or solicitous receptionists. You hand the physician your magnetic card; there's a minimum of small talk; you're treated and quickly out the door.

Israelis belong to one of four health funds, equivalent to HMOs: Clalit, Maccabi, Meuhedet and Leumit. Your GP does not oversee your care during hospitalization. There may be a wait for elective procedures.

But hospitalizations and medications are fully covered, though most people also purchase supplementary health insurance from their health fund and some take out additional private insurance coverage.

Everyone is covered. We pay for it all through individual sliding-scale health taxes deducted from our salaries and transferred to the health funds via the National Insurance Institute.

It may well be that a modified version of our system could work well in the American setting.

Crime in Israel

Crime and values


Crime in Israel doesn't just seem to be getting worse. It is worse. On Monday, The Jerusalem Post published a "crime blotter," compiled from reports after the weekend by news editor Amir Mizroch, of murder (and dismemberment), armed robbery, intimidation of the police by mob figures, stabbings, rape, sexual assault, family violence and juvenile delinquency.

Many Israelis are dismayed by what is happening; especially the senseless murder of Leonard Karp and the assault on his wife and daughter on the promenade at Tel Baruch beach in Tel Aviv. A group of eight Arab youths, who were inebriated, accompanied by two young Jewish women, one a soldier, allegedly murdered Karp, who just happened to be in the wrong place at the wrong time.

This news came on the heels of the recent discovery of body parts both in Ramat Gan and north of Netanya; the arrest of a suspected serial rapist in Haifa; and an apparent revenge murder in Beit Dagan - among other mayhem. In contrast, 20 years ago, the entire month of August 1989 passed without a single criminally-inspired murder. There were heroin busts and arrests for foreign currency smuggling. A police chase resulted in the accidental death of a three-year-old Tel Aviv girl. A Knesset committee learned that prostitution was unchecked; another panel heard that thousands of children had been abused. In addition to horrific violence associated with the first intifada, there was also the occasional attack by groups of Israeli Arabs inside the Green Line - robbing passersby (in Haifa) and throwing stones at strolling couples (in Acre). A Gaza Palestinian accused of raping and killing a Jewish boy was on trial for murder.

There was also religious violence, with Jerusalem haredim clashing with police (in Har Nof) in "defense of the sanctity of the Sabbath."

Though this country has never been a Shangri-La, it has known comparatively little violent crime of the kind that makes a person think twice about going out for a walk.

IT MAY be true that Israel's murder rate is now comparable to other advanced societies, as police insist. For instance, according to the Central Bureau of Statistics, there were 171 murders in Israel (population 7.4 million) during 2008. In New York City (population 8.3 million) there were, by comparison, 523 killed last year. London (7.5 million) averages around 170 homicides annually.

Comparing crime rates across societies is unsatisfying. Zionist sensibilities are not assuaged because Israel's murder rate is on par with London's. True, we are no longer a small and comparatively homogeneous country. Still, who wants "natural growth" in our murder rates, in line with an increasing population?

Israel is not immune to the ills that affect other advanced societies - teenage binge-drinking, desensitizing computer-generated virtual violence; brutality peddled as entertainment, laissez-faire parenting and adolescent ennui.

A PUBLIC policy debate is under way about how to address a situation perceived to be deteriorating.

Part of the solution is more effective and efficient management of police resources. For instance, in certain districts, community-based policing can provide some of the answers - especially when cops who know a neighborhood walk the beat. Decision-makers still need to decide whether it's best to give municipal officials jurisdiction over local crime-fighting, or empower regional police commanders to do the job.

We need to be hiring more police. Currently there are 2.65 cops for every 1,000 Israelis (in Italy, the ratio is 5:1). But quality matters as much quantity. Starting officers' salaries are woefully low; we need to raise the pay scale of police and strengthen their professionalism.

Enhancing personal security also requires appointing prosecutors and judges who put public safety first, and a Finance Ministry prepared to spend astutely on the criminal justice system, including the Prison Service. Above all, it requires leadership from Prime Minister Binyamin Netanyahu.

Since criminal behavior permeates all strata of society, tackling it requires a multi-faceted approach. For instance, youthful boredom in the Arab sector can perhaps be ameliorated by mandating community service.

One way to re-instill decency and civility as requisite values of Israeli society is for mukhtars, business leaders, politicians, rabbis, media personalities and other elites themselves to behave as if the children of this country are watching. Because they are.

Hosni Mubarak in Washington

In February 1982 when Hosni Mubarak made his first visit to Washington as Egypt's president, it was Ronald Reagan who was waiting for him in the White House.

There were many visits in the intervening years, though Mubarak avoided coming during most of George W. Bush's tenure, miffed at administration demands for democratization.

Now, Mubarak, age 81, is back.

Washington-Cairo relations are again on track; US pressure for reform is less heavy-handed and less public. Mubarak will meet with President Barack Obama on Tuesday, and is scheduled to see American Jewish leaders today. Cairo views the visit as an opportunity to reclaim its place as America's key ally in the Arab world.

The two issues topping the agenda - just as they did 27 years ago - are the Palestinians and economic ties. Bilateral trade today stands at $8.4 billion; annual US aid is pegged at $2b. On economics, the Egyptians are pushing for more non-energy sector trade. They also want to decrease (from 11 percent) the amount of goods produced by Israeli companies participating in the Egypt-US-Israel Qualified Industrial Zones - duty-free gateways to the American market.

MUBARAK will be pushing Obama to present yet another international plan to solve the Arab-Israeli conflict and echoing with gusto the Obama administration's call for a construction freeze over the Green Line. Of course, it would be far more helpful were Cairo - and Washington - to urge Mahmoud Abbas's Palestinian Authority to return to the bargaining table and respond constructively to Binyamin Netanyahu's seminal Bar-Ilan address of two months ago.

The settlement freeze issue is a diversion because in any final status agreement, Jewish communities on the "Palestine" side of the border would be relocated to the Israeli side. Egypt should instead be pressing Abbas to negotiate as if he really wanted a Palestinian state. This means dropping unrealistic demands for an Israeli pullback to the 1949 Armistice Lines; finding a mechanism to share Jerusalem (Israel has proposed several ideas); accepting that "Palestine" will have to be demilitarized, and abandoning calls for the so-called Palestinian right of return to Israel proper.

Egypt has been working to promote a Palestinian national unity government that has the support of both Fatah and Hamas. In Washington, Mubarak needs to hear that harmony among the Palestinians will be meaningful only insofar as it leads to reconciliation with Israel, an end to terror and a commitment to fulfill previous Palestinian commitments. Cairo appears to be playing a helpful role in indirect talks between Israel and Hamas aimed at freeing Gilad Schalit. And since Egypt faces a dual threat - from Sunni jihadists connected to al-Qaida and from Shi'ite Iran's infiltration of the Palestinian cause via Hamas - it is wise to be trying harder to stem the flow of weapons from Sinai into Gaza.

However, in urging Arab Gulf states to reject the administration requests that they improve relations with Israel, Cairo is being decidedly unhelpful, especially since it should be in the vanguard of building trust between the Arab world and Israel. It is being reckless in its plans to redirect worldwide concern over Iran's quest for nuclear weapons, to Israel's non-threatening nuclear program at next month's UN General Assembly session.

Plainly, Cairo does recognize the menace the Iranian regime presents to Egypt and the region. It has quietly allowed an Israeli dolphin-class submarine and missile cruisers to transit the Suez Canal - a clear signal to Teheran. It continues to crack down on the Muslim Brotherhood, saying that some of its members have been spying for Iran while others have been accepting money from Hizbullah.

ARGUABLY, Mubarak's regime could have done more to institutionalize representative government without jeopardizing its own stability. In squashing the reformists, the regime has forced opponents to coalesce around Muslim extremists. Twenty percent of the parliamentary opposition are "independents" associated with the Brotherhood.

We can't predict whether Mubarak will seek reelection in 2011. But when he leaves the scene it is in Israel's highest interest that his successors uphold Egypt's peace treaty obligations.

Israelis have long regretted Mubarak's insistence on a "cold peace" rather than one that would have served as a template for genuine reconciliation between Arabs and Israelis. We would be delighted if he yet changed course

'Rescue' as process

'Rescuing' Ethiopian Jews


The Soviet Jewry movement helped shape the Jewish identity and Zionist commitment of Diaspora activists, taking precedence over family, work and school. There were nighttime vigils and Sunday marches. London Jewish ladies chained themselves to the gates of the Russian Embassy. University students smuggled holy books to refuseniks.

When the Soviet empire imploded in 1990 and the iron gates were opened, 600,000 Jews left for Israel. This was the single biggest wave of aliya in Zionist history. The country had to house the new arrivals. It had to provide work, retrain them, teach them Hebrew and support them in the difficult transition to a new way of life.

Israelis were swiftly disabused of the notion that the immigrants would all be clones of the heroic figures they had come to "know" - Shpilberg, Zalmanson, Sharansky. Most were mere mortals. Some had intermarried; many were Jewishly illiterate. Soon enough, prejudice against the immigrants denigrated them as "welfare cheats, frauds, goyim and sluts."

How much easier to "Save Soviet Jewry" than selflessly share our space and resources with them!

And yet their absorption is largely a success story.

BUT IF Russian-speaking Jews have suffered prejudice, Ethiopian Jews have fared much worse. The Ethiopians had no mythical heroes to offer us. Beta Israel were simply our unfortunate brethren and we felt obliged to help them - hence Operation Moses (1984) and Operation Solomon (1991).

Other Ethiopians, some with dubious ties to Jewish civilization but with family connections to those already here, continued to trickle in. The community is pressuring authorities to bring in other relatives left behind.

Our country has been generous in providing for Ethiopian absorption; and selfless volunteers have taken up the cause of helping the Ethiopians acclimate. As a community-organizing effort to reconnect Ethiopian olim crammed into city apartment blocks with the land, an innovative group called Earth's Promise has been developing a string of garden plots in Beersheba, Hadera and elsewhere.

The Jewish Agency sent three Ethiopian teens to Turkey last week to attend an international space camp run in partnership with NASA.

But for many of the 100,000-plus Ethiopian olim, the transition from an agrarian milieu to a technologically advanced urban society has not been smooth. The older generation arrived here battered by dislocation, civil war and famine. Many households are dysfunctional, strained by changing gender roles and a yawning generation gap in which traditionalist parents feel alienated from their Hebrew-speaking offspring. Crime, truancy and domestic violence are all too prevalent. Formerly honored elders have been disempowered by Israel's jealous religious establishment.

With their family and communal structures torn asunder, it is remarkable that so many Beta Israel have managed to thrive. Some of the younger generation blend in comfortably at fashionable Tel Aviv nightspots; others have been warmly embraced by the Orthodox. There are now Ethiopian broadcasters and an Ethiopian member of Knesset. This summer even saw the release of the first ever Israeli-Ethiopian film, Zrubavel, by director/screenwriter Shmuel Beru.

Unfortunately, Ethiopians remain the victims of those who imagine themselves racially superior. Last week, for instance, an Egged driver allegedly refused to open the door of his bus to an Ethiopian college student; when she finally managed to board, he harangued her with slurs.

It is, however, not racism when schools in socio-economically deprived areas decide to limit the enrollment of Ethiopian children, fearing that a demographic "tipping point" might force the exodus of other youngsters. In any case, Ethiopian students bunched together in poorly performing schools would be unlikely to achieve success. Many require intensive and costly remedial, educational and social services. One solution might be for schools in more affluent areas to set aside scholarships for Ethiopian students.

Hebrew University Africa expert Steven Kaplan recently told The Los Angeles Times that "even after 30 years," he could not say with "any real confidence" that "we've turned the corner for the second and third generations of Ethiopians."

Part of the reason is the immensity of the challenge; the other is Israelis' failure to internalize the idea that "rescuing" Ethiopian Jews - even more than "saving" Soviet Jews - is not a lightning operation, but a process that demands persistence.

Shabbat shalom

Haredi violence...again

Reflexive violence


What is it about the sub-culture of a not inconsiderable number of haredim, primarily those belonging to sects adhering to social insularity and theological extremism, that makes them habitually turn to violence when frustrated? Rather than hold a peaceful protest, lobby elected officials, or seek relief via litigation, too many of those associated with the anti-Zionist Edah Haredit, a constellation that encompasses Satmar, Toldot Aharon, Toldot Avraham-Yitzhak, and elements of the Breslav, Dushinsky and Munkacs sects, reflexively - so it seems - turn to thuggery and intimidation. So do some other haredim.

The latest instance took place Sunday night when Jerusalem Mayor Nir Barkat was leaving a non-political meeting at the home of the "Admor of Kalib," Rabbi Menachem Mendel Taub, in the Ezrat Torah section of town. He was set upon by dozens of stone-throwing Satmar ruffians. After the mayor's security detail whisked him to safety, Barkat declared that he would not cave-in to violence.

He was referring to haredi opposition to his decision to provide free public parking near the Old City on the Sabbath. Despite initial, tacit approval from ultra-Orthodox municipal council members, haredi demagogues incited against the garage opening on the dubious grounds that it violated the religious-secular status quo. The car park is actually blocks from the nearest haredi district. And police had recommended its opening to accommodate the influx of vehicles heretofore scattered helter-skelter outside the Old City walls.

In pledging not to give into violence, Barkat could just as easily have been talking about the rioting that followed the arrest of a haredi mother accused of trying to starve her son to death. Extremist haredim reacted with nights of stone-throwing and property destruction.

With commendable alacrity, mainstream haredi leaders - Hassidic, Litvak and Sephardi - on the city council stridently denounced Sunday's assault on Barkat. Unfortunately, they've allowed themselves to be browbeaten into coming out against the car park opening.

The Edah Haredit, for its part, said it planned to "demonstrate" outside Barkat's home, office and at the disputed facility - possibly on weekdays as well as Saturdays. Rabbi Tuvia Weiss, a leading rabble-rouser, rejects any compromise "over the holiness of the Sabbath." Read: "We will continue to desecrate the holy day 'in order to save it.'"

WE WORRY that the authorities will - Barkat's rhetoric notwithstanding - ultimately find a "compromise" that essentially rewards the extremists. Doing so would send a terrible signal about the character of the capital.

We note that the court ultimately released the allegedly abusive mother to house arrest - just as the rioters had demanded. A legal observer we respect has argued that police could have separated the mother from the endangered child without taking her into police custody. Perhaps. But for those raised in a sub-culture that disparages outsiders, rioting - not reasoned dialogue - is the default response to not getting your own way.

There's no point in reminding the extremists that halacha obligates them to adhere to the law of the land - dina d'malchuta dina. They shamelessly engage in Talmudic sophistry to justify their immoral, unethical and anti-halachiac deportment.

The larger issue for us is the character of Jerusalem. Observant Jews of all stripes, and good number of secular residents too, appreciate the fact that Jerusalem slows down for the Sabbath. There is a dramatic drop in traffic; most businesses are closed. Public transportation comes to a halt. The calm is good for the soul and the environment.

Frankly, extremist haredim are giving Jewish observance a bad name. In one neighborhood, locals opposed the opening of a mikve (ritual bath) to be used by the entire community out of fear that it would draw haredim to the area.

Most Jerusalemites value tradition while rejecting religious coercion. Their ideal is a city whose neighborhoods are mixed - not one of Balkanized enclaves.

Whether the issue is Shabbat parking, gender-segregated buses, or the equal application of the law, we urge authorities to hold firm. And we appeal to mainstream haredim, the majority of whom, we fervently trust, do not identify with the tactics of the extremists, to at least speak out for tolerance even if their consciences do not allow them to advocate pluralism.