The Workers' Health Fund in Eretz Israel

The Workers' Health Fund in Eretz Israel: Kupat Holim, 1911-1937

Shifra Shvarts
Copyright Date: 2002
Edition: NED - New edition
Published by: Boydell and Brewer,
Pages: 356
https://www.jstor.org/stable/10.7722/j.ctt7zsv0p
  • Cite this Item
  • Book Info
    The Workers' Health Fund in Eretz Israel
    Book Description:

    The history of Kupat Holim, the health organization of workers in Israel, began at the 2nd Convention of Jewish agricultural workers in Judea in December 1911. Due to the lack of health services within the economic means of the workers, and the refusal of the farmer-employers to extend health services to their employees, the Jewish agricultural workers in Eretz-Israel -- at that time, a distant province of the far-flung Ottoman empire -- decided to establish a workers' health fund (kupat holim in Hebrew). In the years 1912-15, two funds similar to the ones in Judea were also established in the north and center of the country. In the first years, the health funds did not provide workers with medical assistance on their own. Only in 1913, with the outbreak of the First World War, were the health funds transformed from insuring organizations into ones that provided medical assistance services themselves. With the establishment of the General Federation of Labor (1920), the health funds were amalgamated into a single organization -- the Federation's Kupat Holim (1921). The unification of Kupat Holim ultimately determined the organization's future -- transforming it from a small, local, temporary body with a few dozen members into a national entity and a key factor in health services in Israel to this day. This volume seeks to describe the growth of Kupat Holim up to the point where it was transformed into a central health organization in Israel; its relationship with its parent-organization, the General Federation of Labor and its rivalry with its competitor in the health field, Hadassah; its evolution from an organization solely for laborers to one open to all; the efforts on the part of Kupat Holim during the British Mandate (1918-1948) to bring about legislation for a compulsory health insurance law; and the formulation of the basic principle that underlie the work of Kupit Holim to this day -- the principle of national and social responsibility for the provision of equal health services to all. Dr. Shifra Shvarts is the head of the Health Systems Management Department of the Faculty of Health Sciences and School of Management at Ben-Gurion University.

    eISBN: 978-1-58046-613-4
    Subjects: History, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-v)
  2. Map of Eretz Israel (Palestine) 1914
    (pp. vi-vi)
  3. Table of Contents
    (pp. vii-viii)
  4. Illustrations
    (pp. ix-x)
  5. Foreward
    (pp. xi-xii)
    Y. Petersberg

    On the eve of the one-hundredth anniversary of its founding, the Kupat Holim Clalit—the General Health Fund of the past and General Health Services today—is in the midst of a revolutionary process that involves fundamental and significant changes in the way it will function and the direction it will take in the future.

    From solely a “workers’ sick fund,” theClalithas been transformed into a “general multi-scope organization” that encourages a healthy lifestyle among its members, and views them as full partners in their own health maintenance. The fact that the name of the organization was changed...

  6. Acknowledgments
    (pp. xiii-xiv)
    Shifra Shvarts
  7. Note on Sources
    (pp. xv-xvi)
  8. INTRODUCTION: Kupat Holim Then and Now
    (pp. 1-6)

    Kupat Holim—whose full name in Hebrew is Kupat Holim Ha-Clalit or the General Health Fund but is referred to in this volume simply as “Kupat Holim”—originally defined itself, in 1911, as “the emissary of the organized working public in the Federation of Labor in matters of health in Israel.” Its role was to extend medical assistance to its members, their families and parents; extend financial assistance to its members in times of illness; organize the workers’ health matters; and serve as social-medical insurance for the working public in Israel.

    Although the majority of the citizenry of the state...

  9. 1 Health Services in Eretz Israel (Palestine) in the Nineteenth Century
    (pp. 7-19)

    Up to the year 1837, there was not one hospital, clinic, or even one certified physician in the Jewish community¹ in Eretz Israel² under Ottoman Turk rule. Seventy-six years later—in 1913 on the eve of the First World War—there were already sixteen hospitals operating in the country, ten of them in Jerusalem. Among the sixteen facilities, ten were Jewish hospitals, five situated in Jerusalem. The Jewish medical community was organized within the Hebrew Medical Federation with headquarters in Jaffa. Three health funds operated in the Galilee, Judea, and Samaria and tens of certified Jewish doctors practiced medicine throughout...

  10. 2 The Workers’ Health Fund: Ideology and Beginnings, 1903-1914
    (pp. 20-54)

    In December 1903 the first group of survivors of the Kishnev Pogrom,¹ together with members of the Jewish Defense Group from Hommel² in Russia arrived in Jaffa. Their arrival signaled the beginning of the Second Aliyah. The Second Aliyah, the second major wave of Jewish immigration spurred by modern Zionism, continued until the outbreak of the First World War in 1914 and brought a total of some thirty-thousand persons to Eretz Israel.³ Most of the members of the Second Aliyah were absorbed within the Jewish community in Jerusalem and in the new urban sector, first in Haifa and Jaffa, later...

  11. 3 The Workers’ Health Fund in the First World War
    (pp. 55-69)

    At the beginning of August 1914, Germany declared war on Russia and the First World War broke out. Although Turkey had not yet entered the war, the impact was immediately felt in the Yishuv, at the time a community of some 85,000 Jews. The Yishuv was cut off from its principle wellsprings of financial support in Jewish communities in Europe, first and foremost in Russia, creating immediate economic pressure that was a source of growing concern. With a freeze on financial activity declared by the Turkish government, the situation further deteriorated, thrusting the New Yishuv in the cities and Jewish...

  12. 4 Health Services in Eretz Israel in the Nineteenth Century
    (pp. 70-92)

    In late 1917, after issuance of the Balfour Declaration and following the conquest of the southern part of Eretz Israel by the British army, the political and economic situation of the Yishuv as a whole took a turn for the better. New ideas and agents of change swept the country with new outlooks and initiatives that had a great impact on the Jewish Yishuv. The workers’ health funds were also influenced by these changes. Hadassah (The American Zionist Women Organization) came to the aid of the Yishuv, and from this point forth, left its stamp on the development of health...

  13. 5 The General Health Fund of Workers in Israel: Kupat Holim
    (pp. 93-112)

    In December 1920, at the general convention of workers convened in Haifa, the General Federation of Workers in Eretz Israel was founded. The decision to establish the Federation of Labor brought an end to a period of fragmentation and struggle between rival camps within the labor movement in Eretz Israel, and with it, the split into two workers’ health funds. The Achdut Haavodah Health Fund and the Hapoel Hatzair Health Fund were amalgamated into one united general health fund—the General Health Fund, Kupat Holim.

    The convention resolution stated:

    The General Federation unites all the laborers and workers in Eretz...

  14. 6 According to Needs or According to Ability: Kupat Homlim, 1924-1930
    (pp. 113-176)

    From the beginning of 1924, when the Fourth Aliyah began to arrive in Eretz Israel, Kupat Holim had to address the central issue that was to accompany it throughout its history¹: how to continue operation in the face of constant financial difficulties and a large deficit. Dealing with this challenge forced Kupat Holim to address core questions concerning its functioning.

    Financing problems and difficulties underwriting the health fund accompanied Kupat Holim’s operation almost from the outset. The small number of dues-paying members in the fund’s first years (1911–1914), economic crisis during the First World War (1914–1918), the years...

  15. 7 Confrontation and Cooperation between Kupat Holim and Hadassah, 1920-1930
    (pp. 177-201)

    In August 1918, the American Zionist Medical Unit (“the Unit”) began its operations in the health field in Eretz Israel. The medical mission headed by Dr. Rubinow “championed full socialization of medical services, and therefore began to establish a centralized medical service, based on a national network of hospitals and clinics all subordinate to the central management of the organization.”¹

    The first attempts of workers’ organization in Eretz Israel to establish a working relationship with the Unit, which they called simply “Hadassah” in their conversations and correspondence, began shortly after its arrival. In a letter to members in Rechovot, members...

  16. 8 The Emek (Jezreel Valley) Hospital
    (pp. 202-224)

    In April 1930, the new Emek (Jezreel Valley) Hospital was opened on the slopes of Mount Moreh near Afula city. The inauguration ceremonies were attended by the heads of Kupat Holim, representatives of Zionist institutions in Eretz Israel and from abroad, a crowd of residents of the Valley, and the laborers who worked on construction of the hospital. None of the participants in festivities imagined that the opening of the hospital would mark an important turn in the development of Kupat Holim for years to come, and was destined to impact on the structure and role of Kupat Holim and...

  17. 9 Kupat Holim and the British Mandate Government
    (pp. 225-248)

    In January 1930, Kupat Holim and the Federation of Labor presented a detailed proposal to the Mandate government for legislation of a compulsory health insurance law. The proposal was accompanied by a memorandum with a draft proposal formulated by a special joint committee of the two organizations. Members of the committee were the jurists Israel Barshira (Bashrovker), Chaim Eretzisraeli-Gavrieli from the Federation of Labor, and Yitzhak Kenivsky-Kenev from Kupat Holim. The proposal called for the government, the employers, and the workers to pay progressive compulsory health insurance, based on salary. The insurance would be managed by the high commissioner who...

  18. 10 Kupat Holim and the Federation of Labor: Reciprocal Membership and Joint Dues
    (pp. 249-290)

    The first health funds were established with the mission of meeting the health needs of Jewish agricultural workers in Eretz Israel, and the agricultural laborer played a core role in shaping Kupat Holim’s “process of becoming.” The ordinances and resolutions set forth by the Judea Worker’s Health Fund stipulated that “workers and crafts persons who work by themselves will [also] be accepted”¹ as members.

    The intention was agricultural workers only. This rule was also at the foundation of the health funds established by workers in the Galilee and Samaria between 1912 and 1915. Class distinction was an important pillar in...

  19. Epilogue: Summary and Conclusions
    (pp. 291-300)

    The history of Kupat Holim reveals a singular experiment, the work of members of the Second Aliyah who founded a health organization that embodied in its founding principle prescripts for a health insurance plan and social values of justice and equality as the members of the Second Aliyah perceived them.

    The first health funds for workers were established in order to remedy the poor state of health of agricultural workers and remedy the lack of health services accessible to all. At the outset, the health funds had to find an immediate solution to burning health problems and only afterwards were...

  20. Notes
    (pp. 301-318)
  21. Glossary
    (pp. 319-326)
  22. Works Cited
    (pp. 327-330)
  23. Index
    (pp. 331-340)