Vacation In Israel, Come Home Cured

Rachel and her partner had been contemplating artificial insemination for years, but they didn’t actually go ahead with the process until Rachel came to Jerusalem from New York for a one-year teaching fellowship. After some encouragement from another couple that had gone through the process, the decision was clear: they would create their child in Israel, at Hadassah Medical Center in Mount Scopus.

“I wanted a Jewish donor who lives and serves in Israel, and has his family living there, so that if my child ever wishes to search for the donor someday, my child will be led to Israel, which is religiously and ideologically important to my wife and me,” Rachel told The Jewish Week, asking that her real name be withheld for privacy. “Israel is renowned for its fertility treatment, and they don’t play around. They want and plan to get you pregnant as soon as possible, without dragging it out to make more money off of you like they do in the U.S.”

After five trials of regular intrauterine and intracervical insemination, and the assistance of the Gonal-F fertility drug, Rachel, now 14 weeks pregnant, finally conceived at one-fourth to one-fifth of the cost of a similar process in America.

Israel has seen a surge in medical tourism for various procedures in the past few years, yet thus far, experts say that the clientele remains largely concentrated among former Soviet countries and some African nations, where treatment facilities are still inadequate. But in recent years, Israel has begun to broaden its reach to couples like Rachel and her partner, slowly attracting customers from Western European countries and North America. While the medical care in Israel equals or even sometimes exceeds that of the United States and Western Europe, the cost of procedures remains significantly cheaper.

“Medical tourism in Israel has been around for about 17 years, but only in the last year or two has it become part of the Ministry of Tourism’s agenda, the Ministry of Finance’s agenda,” said Ira Nissel, CEO of International Medical Services (med-international.com), which has been guiding medical tourists through Israel for five years — reviewing pathologies and consulting multiple specialists. “We’re trying today to put Israel on the map. But in comparison to India and Costa Rica, the prices are a far cry from what you’d expect there.”

The quality of medical care in Israel, combined with an ideal vacationing environment, is drawing more patients to visit Israel for their procedures — most commonly for oncology, cardiac and in vitro fertilization procedures, according to Nurit Agiv, medical tourism executive at Assuta Medical Center in Tel Aviv. Residents of former Soviet countries, she noted, can easily visit Israel for these procedures because they no longer need a visa to travel there.

“A lot of the doctors had their fellowships here in the United States,” Nathalie Steiner, vice president of marketing at a new medical tourism initiative called Global Health Israel (globalhealthisrael.com), a subsidiary of her father Moshe Steiner’s larger medical equipment distributor, Israel Scientific Instruments, told The Jewish Week during a recent visit to New York. “And compared to India and Costa Rica, you can go out and eat at a lot of good restaurants — it’s a Western culture here.”

Steiner, who is limiting the focus of her fledgling company to IVF procedures for now, aims to target American insurance companies, self-insured private companies and uninsured Americans, who might enjoy the added benefit of a vacation in Israel. Nissel, who says his company has been bringing in patients for IVF treatment for years, estimates that between 85 and 90 percent of these tourists are from former Soviet countries, where IVF is often unavailable, as opposed to Israel, where women can undergo the procedure through age 42.

“You are not sick when you have IVF, so you can enjoy the country,” Steiner said, noting that IVF treatment in most Israeli hospitals will cost tourists approximately $4,000, about a third the cost in the U.S. And while in Israel, tourists can rely on companies like hers to arrange airport transportation and accommodations.

The lighter financial burden can be a huge attraction.

“It’s not the bargain rate of India, but it certainly has a top-notch medical system,” said Laura Carabello, publisher and executive editor of MedicalTravelToday.com, and representative of Nissel’s IMS company in the U.S. “It’s Western medicine, it’s less expensive and they’re getting a lot of traffic from Bulgaria, Eastern Europe, Poland and Hungary — people with serious medical problems that need solutions.”

Costs in Israel are less expensive for a number of reasons — malpractice suits are much less common than in the U.S., according to Steiner, and the standard of living is generally lower, added Agiv from Assuta Medical Center.

“Many Israelis who live for many years in the U.S. prefer to have their medical treatments in Israel,” Agiv said. “The medical standards in Israel are very high, and they’re improving all the time.”

Boaz Liberman, head of Orthopedic Oncology at Sheba Medical Center in Tel Hashomer, agrees. In addition to his Israeli patients, he sees many from Russia, Cyprus and the Palestinian Authority. “The level of medicine that we provide is quite the same as they have at the advanced centers in the States. In my field, usually those surgeries can go up to $300,000.”

Still, Nissel doubts that Americans will be jumping in droves onto Israel-bound planes for their medical care just yet.

“It’s not really a place you’re going to bring Americans to,” he said. “The Jews that live in the U.S. do not come to Israel for medicine, because they trust the medical system in the U.S.”

But others say they already see Americans trickling into Israel’s hospitals.

“There is an increase in Americans, but not enough yet,” Agiv said. “The key issue is [recruiting] the insurance companies — if they will cover the expenses when it’s not an emergency.”

Only three hospitals in Israel currently have official accreditation from the Joint Commission International, a voluntary process that gives them official standing with American health standards: Ha Emek Medical Center in Afula, Meir Medical Center in Kfar Saba and Soroka University Medical Center in Beer Sheva. But a fourth — a large hospital — is going to receive accreditation soon, which will help boost an influx of American tourists, according to Nissel. Also key to bringing in Americans will be President Barack Obama’s health care reform bill, he believes.

“With Obama’s new reform, we’re working on something,” Nissel said, though he was unable to specify what those plans might be.

Depending on the outcome, some experts expect to see an increasing number of Americans seeking specialist medical care elsewhere.

“Health care reform is going to be very positive for Americans because it’s going to significantly reduce health insurance costs,” said Jonathan Edelheit, CEO of the American-based Medical Tourism Association. “But health care reform is positive for medical tourism also, because it will potentially add more queues …”

Edelheit’s organization held a Medical Tourism Conference in Tel Aviv in January 2009 and invited Steiner from Global Health Israel to become their Israel representative.

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