Kupat Holim, Dr. Isaac Max Rubinow, and the American Zionist Medical Unit's Experiment to Establish Health Care Services in Palestine, 1918-1923

Bulletin of the History of Medicine

Volumn 72, Issue 1, 1998, Pages 28-46

  Shvarts, Shifra ^a   Brown, Theodore M ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HEALTH SERVICE; HISTORY; HUMAN; INTERNATIONAL COOPERATION; ISRAEL; JEW; NATIONAL HEALTH SERVICE; RELIGION; TRADE UNION; UNITED STATES;

HEALTH SERVICES; HISTORY, 19TH CENTURY; HISTORY, 20TH CENTURY; HUMANS; ISRAEL; JEWS; JUDAISM; LABOR UNIONS; MEDICAL MISSIONS, OFFICIAL; STATE MEDICINE; UNITED STATES;

EID: 0032016383     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: 10.1353/bhm.1998.0057     Document Type: Article

References (63)

1. Over the past hundred years, the geographical region of the present State of Israel has been known by several names: "Sanjak Jerusalem" (Jerusalem Region) during the Ottoman period until 1918; "Palestine" during the British Mandate years (until 1948); and "Eretz Israel" (Jewish Palestine), as it is called by the Jewish community itself and in Zionist circles. For simplicity, the common name Palestine is used throughout this essay.
2. "Kupat Holim" in Hebrew means "Sick Fund." The origin of this name is the German "Fabrikkrankenkassen," the nineteenth-century workers' sickness funds, established in 1884 by Chancellor Otto von Bismark as part of German National Social Insurance. See Donald W. Light, Stephan Liebfried, and Florian Tennstedt, "Social Medicine vs. Professional Dominance: The German Experience," Amer. J. Pub. Health, 1986, 76: 78-83; Richard H. Shryock, The Development of Modern Medicine: An Interpretation of the Social and Scientific Factors Involved. Reprint (Madison: University of Wisconsin Press, 1979), pp. 281-402; Shifra Shvarts, "Who Will Take Care of the Workers? The Establishment of 'Kupat Holim', The Workers' Sick Fund in Israel, 1911-1921," J. Hist. Med., 50: 525-56.
3. "Kupat Holim" in Hebrew means "Sick Fund." The origin of this name is the German "Fabrikkrankenkassen," the nineteenth-century workers' sickness funds, established in 1884 by Chancellor Otto von Bismark as part of German National Social Insurance. See Donald W. Light, Stephan Liebfried, and Florian Tennstedt, "Social Medicine vs. Professional Dominance: The German Experience," Amer. J. Pub. Health, 1986, 76: 78-83; Richard H. Shryock, The Development of Modern Medicine: An Interpretation of the Social and Scientific Factors Involved. Reprint (Madison: University of Wisconsin Press, 1979), pp. 281-402; Shifra Shvarts, "Who Will Take Care of the Workers? The Establishment of 'Kupat Holim', The Workers' Sick Fund in Israel, 1911-1921," J. Hist. Med., 50: 525-56.
4. "Kupat Holim" in Hebrew means "Sick Fund." The origin of this name is the German "Fabrikkrankenkassen," the nineteenth-century workers' sickness funds, established in 1884 by Chancellor Otto von Bismark as part of German National Social Insurance. See Donald W. Light, Stephan Liebfried, and Florian Tennstedt, "Social Medicine vs. Professional Dominance: The German Experience," Amer. J. Pub. Health, 1986, 76: 78-83; Richard H. Shryock, The Development of Modern Medicine: An Interpretation of the Social and Scientific Factors Involved. Reprint (Madison: University of Wisconsin Press, 1979), pp. 281-402; Shifra Shvarts, "Who Will Take Care of the Workers? The Establishment of 'Kupat Holim', The Workers' Sick Fund in Israel, 1911-1921," J. Hist. Med., 50: 525-56.
5. Kontress, 1920, 3(71): 25-26.
6. Uziel O. Schmelz, "The Decline in the Population of Palestine during World War One," in Siege and Distress, ed. M. Eliav (Jerusalem: Yad Ben Zvi, 1991), pp. 38-39.
7. "Hadassah," The Hebrew Encyclopedia (Tel Aviv: Encyclopedia Publishing, 1987), 13: 615.
8. Ibid.
9. Nathan Straus (1848-1931) was a wealthy Jewish businessman from New York City who in addition to general philanthropic work donated money to improve health services in the Palestinian Jewish community. Besides the maternal and child welfare clinics and an eye disease clinic in Jerusalem under Hadassah auspices, Straus also financed a sanitarium for tuberculosis patients. See Index Judaica (Jerusalem: Keter, 1979), p. 317.
10. Minutes of Assembly, Kupat Holim Files (hereafter KHF), file [LA] IV-122-1-18, Lavon Institute-Labor Archive, Tel Aviv (hereafter LILA).
11. "Originally the Unit was planned for two doctors, two nurses and a half-ton of supplies. By the time it got underway, there were twenty nurses, a dermatologist, obstetrician and gynecologist, an orthopedist, pathologist, pediatrician, dentists, a pharmacist, eye-ear-nose and throat specialists and a sanitary engineer" (Marlin Levin, Balm in Gilead: The Story of Hadassah [NewYork: Schocken Books, 1973], pp. 36-37). See also J. Reinhartz, ed., Haim Weizman Letters (Tel Aviv: Bialik Institute, n.d.), 9: 68-99.
12. "Originally the Unit was planned for two doctors, two nurses and a half-ton of supplies. By the time it got underway, there were twenty nurses, a dermatologist, obstetrician and gynecologist, an orthopedist, pathologist, pediatrician, dentists, a pharmacist, eye- ear-nose and throat specialists and a sanitary engineer" (Marlin Levin, Balm in Gilead: The Story of Hadassah [NewYork: Schocken Books, 1973], pp. 36-37). See also J. Reinhartz, ed., Haim Weizman Letters (Tel Aviv: Bialik Institute, n.d.), 9: 68-99.
13. National Health Committee Files, 66/L4, Central Zionist Archive in Jerusalem; Hadassah Medical Organisation, Third Report, September 1920-December 1921 (Jerusalem: Hadassah Medical Organisation, 1922), pp. 40-41, 49-56, 70-73; J. Lee Kreader, "America's Prophet for Social Security: A Biography of Isaac Max Rubinow" (Ph.D. diss., University of Chicago, 1988), pp. 294-300.
14. National Health Committee Files, 66/L4, Central Zionist Archive in Jerusalem; Hadassah Medical Organisation, Third Report, September 1920-December 1921 (Jerusalem: Hadassah Medical Organisation, 1922), pp. 40-41, 49-56, 70-73; J. Lee Kreader, "America's Prophet for Social Security: A Biography of Isaac Max Rubinow" (Ph.D. diss., University of Chicago, 1988), pp. 294-300.
15. Isaac Max Rubinow, Standards of Health Insurance (New York: Henry Holt, 1916).
16. Kreader, "America's Prophet" (n. 10), p. 277.
17. Ronald L. Numbers, Almost Persuaded: American Physicians and Compulsory Health Insurance, 1912-1920 (Baltimore: Johns Hopkins University Press, 1978), pp. 14-26.
18. Kreader, "America's Prophet" (n. 10), pp. 200-1, 298.
19. Hadassah Medical Organisation (n. 10), pp. 38, 43.
20. J. Lee Kreader, "Isaac Max Rubinow: Pioneering Specialist in Social Insurance," Soc. Serv. Rev., 1976, 9: 416-17.
21. Hadassah Medical Organisation (n. 10), pp. 38, 43.
22. Ibid.; Ben Zion Dinur, "Israel during the Year 1923," Meshana L'Eshana [From year to year, bulletin], 1923, pp. 294-97. Dinur noted that the Health Department of the Mandate Government published a report stating that Hadassah was the greatest medical institution in the country, in regard to both the number of patients it served and the scope of its work. According to this report, 70 percent of all Jewish patients hospitalized in Palestine were treated in Hadassah hospitals, and 51 percent of patients applying to clinics were served by Hadassah. The report further claimed that of 57,000 patients who visited Hadassah clinics in 1919, a quarter were non-Jews. See Government of Palestine, Repart on Palestine Administration (London: H.M. Stationary Office, 1922), chap. C-3. The report includes five main topics: Epidemics and Public Health; Hospitals and Dispensaries; Laboratory; Quarantine, Relief, and Lunacy; and Medical Stores. The contemporary British reports often describe the central role played by the Hadassah hospital system in the Jewish community.
23. Ibid.; Ben Zion Dinur, "Israel during the Year 1923," Meshana L'Eshana [From year to year, bulletin], 1923, pp. 294-97. Dinur noted that the Health Department of the Mandate Government published a report stating that Hadassah was the greatest medical institution in the country, in regard to both the number of patients it served and the scope of its work. According to this report, 70 percent of all Jewish patients hospitalized in Palestine were treated in Hadassah hospitals, and 51 percent of patients applying to clinics were served by Hadassah. The report further claimed that of 57,000 patients who visited Hadassah clinics in 1919, a quarter were non-Jews. See Government of Palestine, Repart on Palestine Administration (London: H.M. Stationary Office, 1922), chap. C-3. The report includes five main topics: Epidemics and Public Health; Hospitals and Dispensaries; Laboratory; Quarantine, Relief, and Lunacy; and Medical Stores. The contemporary British reports often describe the central role played by the Hadassah hospital system in the Jewish community.
24. Ibid.; Ben Zion Dinur, "Israel during the Year 1923," Meshana L'Eshana [From year to year, bulletin], 1923, pp. 294-97. Dinur noted that the Health Department of the Mandate Government published a report stating that Hadassah was the greatest medical institution in the country, in regard to both the number of patients it served and the scope of its work. According to this report, 70 percent of all Jewish patients hospitalized in Palestine were treated in Hadassah hospitals, and 51 percent of patients applying to clinics were served by Hadassah. The report further claimed that of 57,000 patients who visited Hadassah clinics in 1919, a quarter were non-Jews. See Government of Palestine, Repart on Palestine Administration (London: H.M. Stationary Office, 1922), chap. C-3. The report includes five main topics: Epidemics and Public Health; Hospitals and Dispensaries; Laboratory; Quarantine, Relief, and Lunacy; and Medical Stores. The contemporary British reports often describe the central role played by the Hadassah hospital system in the Jewish community.
25. Doron Niederland, "The Influence of the Jewish Physicians from Germany on the Development of Medicine in Israel in the Years 1933-1948" (in Hebrew), Katedra, 1983, 30: 114-15.
26. Schedule of Physicians' Salary, Worked Out by the Physicians' Committee of the American Zionist Medical Unit, 1919, file 7/10/111, Hadassah Central Archives (hereafter HMO), New York, N.Y.
27. Hadassah Medical Organisation (n. 10), p. 35.
28. Ibid.; Schedule of Physicians' Salary (n. 20).
29. Ibid.; Schedule of Physicians' Salary (n. 20).
30. Dr. M. Levontin to H. Szold, 5 November 1920, HMO 7/10/111.
31. Ibid.
32. Hadassah Medical Organisation (n. 10), pp. 12-13; Dr. Rubinow's personal correspondence with Dr. Haim Weizman, Zionist Congress, file 5616-10-41, Isaac M. Rubinow Papers, Kheel Center for Labor-Management Documentation and Archives, Catherwood Library, Cornell University, Ithaca, N.Y. (hereafter, Rubinow Papers). See also memoranda on the Zionist Medical Unit, file 5616-11-4.
33. Hadassah Medical Organisation (n. 10), pp. 12-13.
34. Dr. Rubinow's notes, 10 September 1919; 2 March 1920; 13 August 1920; 13 February 1921, Rubinow Papers, file 5616-11-4; Manfred Waserman, "For Mother and Child: Hadassah in the Holy Land, 1913 through 1993," Bull. New York Acad. Med., 1993, 70: 251-74.
35. Today, the Tipat Halav clinics are organized and provide services in a population-based fashion, with each clinic serving a defined neighborhood or rural settlement. The Ministry of Health notifies clinics of all births within their catchment area so that all children, regardless of insurance status, sick fund membership, or even parental initiative, are enrolled. The clinics are operated by teams of specially trained public health nurses. They see children for the majority of well-child visits and are responsible also for immunizations of all children in Israel up to the age of five. See Gary L. Freed et al., "Reform of Child Immunization Service Delivery in Israel, Letter from Beersheva," JAMA, 1995, 273: 1909-12.
36. Hapoel Hatzair, 1919, 13(1): 1. Hapoel Hatzair was published by Hapoel Hatzair (The young worker), a Populist party established in Palestine in 1905.
37. I. Zerthal, Yamim Umaasim [Days and deeds] (Tel Aviv: Machbarot Lesifrut, 1975), pp. 48-49.
38. KHF, file [LA] IV-122-1-18.
39. Kontress, 1919, 2(14): 21. Achduth Haavoda was a Socialist Zionist party, influenced by the thinking of David Ben Gurion, established in Palestine in 1918.
40. Rehovot Branch to Kupat Holim office in Tel Aviv, unsigned letter, 24 November 1919, Ben Gurion Archives, Sede-Boker, Israel.
41. Hadassah Medical Organisation (n. 10), pp. 28-29.
42. Levin, Balm in Gilead (n. 9), pp. 73-75.
43. Ibid., pp. 75-78.
44. Ibid., pp. 81-83.
45. The local Hebrew newspaper criticized the AZMU members' paternalistic behavior and scolded them for speaking English, which the workers' organizations declared an anti-Zionist act: ibid., pp. 73-83; Hapoel Hatzair, 1919, 13(1): 1.
46. The local Hebrew newspaper criticized the AZMU members' paternalistic behavior and scolded them for speaking English, which the workers' organizations declared an anti- Zionist act: ibid., pp. 73-83; Hapoel Hatzair, 1919, 13(1): 1.
47. Hapoel Hatzair Party Central Committee, Minutes of Assembly, 1919, LILA, file [LA] IV-402-119; New Palestine, 1921, 1: 11.
48. Hapoel Hatzair Party Central Committee, Minutes of Assembly, 1919, LILA, file [LA] IV-402-119.
49. Ibid.
50. Ibid.
51. Ibid.
52. Hapoel Hatzair, 1919, 13(1): 1. See also Levin, Balm in Gilead (n. 9), pp. 73-83.
53. Hapoel Hatzair, 1919, 13(1): 1. See also Levin, Balm in Gilead (n. 9), pp. 73-83.
54. Kontress, 1920, 3(71): 25-26.
55. Zerthal, Yamim Umaasim (n. 30), pp. 48-49.
56. Donald Miller, "A History of Hadassah, 1912-1935" (Ph.D. diss., New York University, 1968), pp. 260-63.
57. Niederland, "Influence of the Jewish Physicians" (n. 19), pp. 114-15.
58. Pinkas, 1923, 10-11: 15-17.
59. Kupat Holim-Hadassah Agreement, October 1922, KHF, file [LA] IV-243-1.
60. Shifra Shvarts, "Health Care System in Israel: An Historical Perspective," in Medicine and Health Care into the Twenty-First Century, ed. Shyamal K. Majumdar, Leonard M. Rosenfeld, David B. Nash, and Ann Marie Audet (Easton, Penn.: Pennsylvania Academy of Sciences, 1995), pp. 545-62; Miller, "History of Hadassah" (n. 47), pp. 2-3. Miller noted the shortage of primary sources for the study of the early years of Hadassah in Israel.
61. Shifra Shvarts, "Health Care System in Israel: An Historical Perspective," in Medicine and Health Care into the Twenty-First Century, ed. Shyamal K. Majumdar, Leonard M. Rosenfeld, David B. Nash, and Ann Marie Audet (Easton, Penn.: Pennsylvania Academy of Sciences, 1995), pp. 545-62; Miller, "History of Hadassah" (n. 47), pp. 2-3. Miller noted the shortage of primary sources for the study of the early years of Hadassah in Israel.
62. Rubinow Papers, 1922, file 5616-11-4.
63. George A. Silver, "Love Is Not Enough: Hadassah and Israel's Medical Care Dilemma," Midstream, 1978, 3: 50-56.