Israel’s Yad Sarah has prescription for U.S. health care system
A new Congress and a new administration are reassessing the efficacy of America’s health care system — and exploring solutions to contain rising costs while delivering better care. They could be well served by looking to a small nation thousands of miles away and one organization that has transformed that country’s health care landscape: Yad Sarah.
Yad Sarah is the State of Israel’s largest volunteer-staffed organization. We take care of anyone in the country after a hospital stay — whether they are a factory worker, a first-time mom, a senior in hospice, a young adult with a broken leg, or a top business or political leader.
The United States might be able to learn from Yad Sarah’s unique model for home health care delivery. Take our signature service: free or low-cost loans of medical equipment — wheelchairs, crutches, oxygen machines — which are available at local branches around the country or delivered to patients’ homes for a few dozen shekels or less. It developed organically and modestly, with our founder, Uri Lupolianski, and his wife, Michal, distributing vaporizers to sick children from their Jerusalem apartment. As the years passed, their ability to help care for people grew to more than 100 branches with thousands of volunteers.
This is much more efficient and cost-effective than the U.S. system, where only those with insurance have access to devices at home, those devices are often discarded after a short period of use, and the devices don’t always arrive in a timely manner. For instance, when my mother-in-law left the hospital and came home to stay with my family, Medicare paid for and sent a wheelchair. She never used the wheelchair and was rehospitalized 10 days later, passing away after a month. For three years, I looked unsuccessfully for someone who could use the wheelchair — no hospital, doctor’s office or other medical caregiver would take it.
Yad Sarah works to give people in Israel access to medical resources for next to nothing, in a way that ultimately reduces stress on the national medical system while increasing the quality of care received. Half of Israel’s families have used one of our services at some point in their lives. Our annual budget of $23 million — drawn almost entirely from philanthropic contributions — saves the Israeli economy $400 million each year in health care costs.
Of course, a volunteer-based program like Yad Sarah cannot work for a country of 300 million people the same way it does for a country of 8 million. But that doesn’t mean a similar program in the U.S. — whether implemented by nonprofit organizations or governmental agencies — couldn’t have a transformative effect. Recycling programs for durable medical equipment could allow for more agile, efficient and cost-effective health care.
Implementing innovative programs has a domino effect: After establishing our lending service, we followed with our home hospitalization program. It allows individuals to be under the care of family members, whether they are in hospice, suffering from a chronic condition or recovering from a severe short-term illness. Most patients would rather have the dignity and comfort of being at home — and they tend to experience less stress, fewer health complications and faster rehabilitation.
The United States might be able to learn from Yad Sarah’s unique model for home health care delivery.
Not only does the home hospitalization make patients more comfortable and drastically reduce costs, it also addresses the chronic overcrowding of Israeli hospitals, where patients too often are lying in hallways, being released prematurely, and dying from infections they receive in those hospitals — 4,000 each year. While the U.S. and other developed countries have home hospitalization programs, none is run by volunteer-staffed organizations, a key element that enables us to ensure everyone has access to these programs in a timely and cost-effective manner.
Yad Sarah’s other programs are just as effective at supplementing Israel’s medical system to make care more efficient. This includes driving sick or injured people to medical appointments, offering therapeutic programs at day rehabilitation centers, and supporting families coping with domestic violence. We also provide an emergency alarm response service, which offers peace of mind for nearly 20,000 homebound, frail and isolated older adults; free legal information and representation for elderly people at risk for abuse; after-school programs for children with disabilities; and free dental care for adults living in poverty.
This all started with one couple lending out vaporizers in one city. But making part of health care a public, volunteer-supported endeavor serves Israel well. Yad Sarah saves hundreds of millions of dollars and vastly increases patients’ quality of life. We are true partners in ensuring the health and well-being of Israel’s citizens — the elderly widows, the young children, revered politicians, the brave soldiers and, yes, our volunteers and donors themselves. As the U.S. considers how to address our health care challenges, Yad Sarah’s experience can shed light on important lessons.
ADELE GOLDBERG is the executive director of Friends of Yad Sarah.