From running marathons to running Israel’s medical system, Ichilov Hospital’s Prof. Ronni Gamzu is now overseeing Israel’s senior living facilities
By David E. Kaplan
While Corona grounded Israel’s traditional Independence Day flyover, it did not stop four training planes taking off and flying over the hospitals throughout the State of Israel in salute to the medical teams who – like our soldiers in uniform – are risking their lives daily.
From my balcony in Kfar Saba, our family watched the planes fly over nearby Meir Hospital and then two of them perform a spectacular vertical maneuver leaving a huge while trail in the sky in the shape of a giant heart.
Residents from balconies draped in the blue and white Israeli flags, clapped and cheered. Everyone knew someone affected by Corona whose lives were dependent on the men and woman to whom the pilots in these planes were paying tribute.
One of the most vulnerable sectors of the population are our seniors and so my thoughts went out to Prof. Ronni Gamzu who I had interviewed back in 2016 for Hilton Israel Magazine and had been pleased to learn had in early April 2020 been placed in charge of the Ministry of Health’s efforts to combat the virus in homes for the elderly. In other words – to oversee senior living facilities throughout Israel.
His appointment followed a number of coronavirus-related deaths in homes for the elderly followed by a public outcry and a High Court petition to which the state was required to respond. The Health Ministry responded – most notably by appointing Prof. Gamzu, the director general of Tel Aviv Sourasky Medical Center aka Ichilov Hospital in Tel Aviv, to coordinate between government departments and formulate a national plan of action.
Within a few days, residents at senior living facilities were being tested around the country. My thoughts went back to that interview looking at the huge heart in the sky.
On the late afternoon of our interview in 2016, this gynaecologist and obstetrician who had brought “over 1000 babies into the world,” had his own to look after – his young baby daughter, Anouk – “our first”. So instead of meeting at Ichilov Hospital, we met in a garden in Ramat Gan, within “easy running distance” to the hospital and his home – whichever emergency might summon him at any moment. The interview proceeded uninterrupted with neither a ‘cry’ from Anouk nor patients.
It was well known that back in 2016 Prof. Gamzu participated in major marathons around the world which invited my first question. His answer proved revealing – a metaphor on his approach to medicine.
Running in the London, Paris, New York and Tel Aviv marathons, explained Gamsu “is very different than running in the Jerusalem marathon which is hilly.” The point the professor was making is that conditions and topography vary, and one must correctly read the landscape and understand its complexity to successfully negotiate “the road ahead”.
Prof. Gamzu has always been focused on “the road ahead”. This would explain how he perceived early in his career, the need to be equipped with a broad and varied education that spread well beyond the discipline of medicine.
Following degrees in medicine at Ben Gurion University of the Negev (BGU) and a PhD in fertility research from Tel Aviv University (TAU), I asked why he felt the need to add to his academic armory an MBA and a degree in law.
“Well, ‘armory’ is the right word,” he replied because “these degrees literally helped me to surmount loads of legalese and achieve goals that I may not have without them.”
During his earlier tenure as the Director General of the Health Ministry (2010-2014), he explained, “we made major progress in expanding the general services covered by our national health insurance. My predecessors in the Health Ministry tried for years without success – always coming up against a bureaucratic wall; not seeing a way forward. With my legal background, I found a way around it.”
“What do you mean by “a way around”?” I asked.
“The standard approach was to look to the Knesset (Israel’s Parliament) to either pass or amend legislation. This is understandable but problematic because of political coalitions and so many competing interests that, to reach consensus about extending provision for any public service, is never easy. Military matters are always easier because they are considered a national existential issue. This is not the case with social services. This is unfortunate as the issues from education to public medicine are no less existential to the wellbeing of a nation.”
So, with his legal training, “I buried myself in reading all legislation pertaining to national medical coverage and realised that we did not need to proceed through the Knesset – we could bypass it, as there were pre-existing regulations that permitted us to proceed forward. In this way, we made major breakthroughs that have dramatically changed the lives of Israeli citizens.”
Can you cite examples?
“Yes, we expanded our general health services to include mental health issues that had been limited, and dental care that had been mostly private, and prohibitively expensive. Under the new plan, family doctors started referring patients with emotional and mental problems – such as depression, phobias or panic attacks – to psychiatrists, psychologists and other therapists for treatment, without themselves writing prescriptions for psychiatric drugs, as they did before.”
With regard to extending dental services, he explained:
“Dental hygiene is no less important than other areas of personal health. Periodontal or gum disease that ranges from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth, affects too many Israelis of all ages. It is important to treat at a young age so that teeth are not lost in early adulthood. Whether gum disease is stopped, slowed, or gets worse depends a great deal on how well people care for their teeth; this requires regular diagnosis by professionals and this is where we came in, making it affordable to those who had previously neglected their teeth – not because they felt it was less important – but because they felt they could not afford going to private dentists and hygienists.”
Under the new system, Gamzu explained, “they still pay but considerably less with the result that dental health has now become affordable – not the luxury of the wealthy, but a right to all. The new system of dental cover is now more in line with the fundamental egalitarian philosophy of Israel’s founding fathers.”
Asking what specifically he meant by this, Gamzu replied, “Well Israel can be truly proud of not only its superlative cutting edge medical services but of how we provide this quality service to all our citizens at affordable costs to the recipient.
For this, Gamzu said “we are indebted to the founding fathers of the modern State of Israel.” Combining the traditional Jewish concern for all people with an emphasis on societal needs, “the Zionist Movement in pre-state Israel, regarded public health as a top social, political and economic priority. By the time Israel declared its independence in 1948, we already had a national health infrastructure in place.”
Gamzu cited as examples “Tipat Halav (Mother-and-child care centers) administering vaccinations to new-born babies and counseling parents on proper care for their infants, and Kupot Cholim (Health insurance funds) offering day-to-day consultations with doctors and specialists, and insured members for hospitalization.”
With medical cover a challenge in any society, “and we see how it dominates debate in US elections,” I asked how will Israel sustain its special features of affordable cover to all?
“You are right; it is a challenge of our public health system and it’s a challenge that I am committed to,” answered Gamzu. “However, we have seen that even with Israel’s transformation from a socialist to a capitalist economy, some of our most cherished values remained intact because it’s part of our ethos and ingrained in our culture. As future needs arise as was the case in extending services for mental and dental health, so we need to be on guard and adhere to our founding principles.”
“Do you think Israel can teach the world about its concept of Public Health?” I enquired.
“Sure, and we do. Israel has been a pioneer in the practice of Public Health, and we host many visitors – particularly from the developing world – keen to learn of how Israel developed its system of Public Health. Just so we understand, while medicine treats the health needs of an individual, Public Health (also known as public or social medicine) deals with the health requirements of society as a whole and despite absorbing wave after wave of immigrations, bringing with it a host of medical challenges, Israel has one of the world’s healthiest populations with one of the highest average life expectancies in the world.”
I reflected on that 2016 interview as I gazed from my balcony on this Corona Yom Ha’atzmaut upon the giant heart in the sky over Meir Hospital and thought that despite our enormous challenges, we can be thankful for Israel’s unique health system.
There is a reason why Jews, when toasting, prefer to say “Le’Chaim” instead of “Cheers”.
After all, what can be more important to cheer about than “to Life”?