Prior to 1838, there was not one hospital, clinic, or certified doctor, Jewish or gentile, serving the Jewish Yishuv of Eretz Israel. The only medical services at the time—after more than three centuries of Ottoman rule—were those provided by traditional healers, amateur druggists, experts in medicinal herbs, and sellers of talismans and incantations. The primary reason for the absence of certified medical services was the character of the ultra-Orthodox religious establishment in Eretz Israel: communal and spiritual leaders were concerned by the “harmful” influence of Jewish doctors trained at “secular” university medical schools, and whom the powers-that-be within...

In November 1947, all the department heads at Beilinson Hospital, except one, abandoned their posts. They informed Kupat Holim that the mass walkout was in response to the sick fund’s refusal to allow them to engage in private practice. All efforts to coax the doctors to return to work failed, and the hospital found itself corralled within a hopelessly paralyzed system.¹

The walkout occurred six months prior to declaration of statehood. While the department heads’ walkout at Beilinson Hospital was designed to attain better wages and improved working conditions, the revolt in fact generated a broader debate within Kupat Holim...

In November 1947, during the fateful United Nations deliberations at Lake Success, New York, on the establishment of a Jewish state in Eretz Israel, the department heads at Beilinson Hospital resigned. In January 1948, the Military Medical Service (MS) was founded under the leadership of Dr. Chaim Sheba.¹ The newly-established medical framework immediately hired the unemployed Beilinson doctors to fulfill key positions in the administration and organization of the MS. In addition to the department heads who had left Beilinson, Dr. Sheba also recruited Dr. Padeh, one of the regional physicians of Kupat Holim.²

Dr. Sheba’s appointment as head of...

In February 1950, the Kanevsky-Kanev Commission (the Kanev Commission)—established to investigate what shape social insurance in the State of Israel should take—completed its work and presented its first report to Minister of Labor Golda Meir (Myerson). Among the commission’s recommendations was the suggestion that the health system be nationalized. Publication of the report was put off by the Ministry of Finance to prevent pressure on the government’s budget, but the content was leaked to the press and sparked hot controversy. The Kanev Report was only made public three months later accompanied by a clarification that it did not...

Declaration of statehood on May 14, 1948, brought with it mass immigration. Between May 1948 and December 1951, 700,000 immigrants arrived in the State of Israel, doubling the Jewish population of the country (see figure 4.1).¹ Immigration originated from two geographic regions: Europe and the Balkans, and Africa and Asia.² The total number of Holocaust survivors among the newcomers was 330,000—approximately half the immigrants during this two-and-a-half year period. The number of immigrants from North Africa and Asia totaled 370,000—123,300 from Iraq; 48,300 from Yemen; 34,500 from Turkey; and approximately 45,400 from North Africa (see figure 4.2).³

By...

The decision of the Israeli government to place medical services for immigrants in the hands of an independent government-run agency, totally separate from the Kupat Holim system, forced the sick fund to formulate policy and procedures on their further care for immigrants. While Kupat Holim representatives were supposed to sit with Dr. Sheba and representatives of the municipal emergency medical committees to coordinate medical work in immigrant concentrations throughout the country, such cooperation among all the health agents existed only on paper. In practice the Immigrant Medical Service collaborated only with the Military Medical Service, and simply ignored Kupat Holim...

In the last days of 1953, the mayor of Beer Sheva, David Tuviahu, appealed to Moshe Soroka requesting that Kupat Holim establish a general central hospital in the Negev. The rationale behind Tuviahu’s request was that Hadassah asked to withdraw from operation of the town’s small one hundred bed hospital due to its commitment to establish a medical center in Ein Karem in Jerusalem, after the loss of Hadassah’s main Jerusalem facility on Mt. Scopus in the 1948 war. The Ministry of Health had told Tuviahu that it did not plan to build a hospital in Beer Sheva in the...

Kupat Holim and the Israeli health care system underwent a five-stage process that forged their character in the course of the first ten years of Jewish statehood, following the outbreak of the War of Independence in late November 1947 and establishment of the State of Israel in May 1948.

The first stage was the initiative of the Beilinson Hospital doctors to break the institutional framework of working conditions and remuneration based solely on salaried physicians. The struggle led to the secession of the sick fund’s most senior doctors and their absorption within a parallel system taking shape at the same...