Israel, a nation with a forceful religious lobby and a conservative prime minister, is poised to offer its female citizens some of the most liberal abortion coverage in the world.
The nation’s Health Ministry commission, led by Dr. Yonatan Halevy, last week announced its state-subsidized “health basket,” the package of medications and services that all Israeli citizens are entitled to under the nation’s health care system. It was approved by the cabinet on Sunday. The health basket is analyzed and amended on an annual basis, and among the many additional treatments to be offered to Israelis in 2014 are free-of-charge abortions for women ages 20-33.
Israel has always had a liberal stance on abortion, allowing women facing medical emergencies or those who are victims of rape or abuse to receive subsidies to help them terminate their pregnancies. Outside of those regulations, women can apply for abortions for reasons ranging from an emotional or mental threat caused by the pregnancy or for not being married to the baby’s father. All women who seek to end a pregnancy must appear before a three-member committee to state their case, but 98 percent of requests are approved. Women under the age of 20 or over the age of 40 were also previously eligible for subsidized abortions, regardless of the reason.
With the newly amended health care package, however, funding will now be available for more than 6,000 additional women seeking to terminate their pregnancies, at the cost at some NIS 16 million ($4.6 million). No medical reason for the abortion is required.
Halevy, director general of Shaare Tzedek Medical Center in Jerusalem, rejects the idea that the health commission’s move is in any way radical, and is quick to point out that the boost in abortion funding is but one small piece of several alterations to Israel’s state-sponsored health care, ranging from mental health care to the treatment of diabetes and beyond.
“We want large families in Israel. We definitely encourage birth,” he says. “But when pregnancy occurs and it is undesired or inadvertent, I think we should supply the means to end the pregnancy properly.”
Among Israel’s religious right wing, there have been low grumblings of protest against the new law, but for a nation where a woman’s hemline or her seat on a public bus can set off a firestorm, the response has been surprisingly muted.
Dr. Eli Schussheim, chairman of the pro-life group Efrat, likened the decision to theft, saying that by allocating funding for non-medically necessary abortions, the committee “is stealing… from sick people… and giving the money instead as a prize to 6,000 negligent women.”
His sentiments were echoed by Rabbi David Stav, head of the relatively liberal Tzohar group of Orthodox rabbis, who said there is “no question” that in the absence of a medical emergency, abortion is against Jewish law.
It is highly unlikely, however, that Israel will soon see protests that even come near those that target abortion clinics in the United States, where the legality of pregnancy termination remains one of that nation’s most polarizing issues. A backlash of societal shaming against abortion-seekers — such as in Spain, where some 60% of women are prompted to pay for the procedure privately rather than collect the available government funding — is also highly improbable.
The number of nations that now take a stance as liberal as Israel’s on abortion can be counted on one hand. In Canada, abortion is legal at any stage of a woman’s pregnancy, and those performed in hospitals (but not in private clinics) are for the most part covered by insurance. In Slovenia, abortion has been free since 1977, and in 2006, a government minister who tried to limit funding to only those women whose lives were at risk was promptly asked to resign his post.
While Israel may seem an unlikely party to such liberalism, global legislation on abortion proves that when it comes to the life of a fetus, a nation’s politics do not always jive with its attitude toward the controversial procedure.
Some stalwartly left-leaning nations are surprisingly rigid on their abortion laws, including Sweden, where women have only the first 18 weeks of their pregnancy to apply for the procedure before being barred except in cases of mortal danger. And in Russia, a nation whose conservative stance on issues like gay rights has prompted roiling protests ahead of the 2014 Olympic Games in Sochi, there are more abortions performed each year than there are live births.
The women set to benefit from the expansion of abortion benefits, Halevy says, will be those who need it most: single women, young women who are unable to ask their parents for the funds, or those who fall pregnant as the result of an extramarital affair but are financially dependent on their husbands. While he concedes that there have been some knee-jerk statements against the ruling, he says that “once you explain who the candidates are who are set to benefit from it, I didn’t hear much opposition.”
And he rejects the idea that easier access to abortion will create a laissez-faire attitude toward pregnancy, saying, “There is emotional and physical drama to pregnancy. I don’t believe someone would get pregnant just because her abortion could be financed.”
Despite the media focus to the abortion issue, Halevy says that what is radical about the new health care package – and is being lost in the din of debate – is sweeping new coverage for a range of oncological medications, and a cutting-edge, forward-thinking approach to mental health care, including the addition of a new and sorely needed treatment for schizophrenia that previously had to paid for out of pocket.
Other areas that have received a boost in funding are treatments for prostate cancer, diabetes and osteoporosis. The committee came to their recommendations after spending three months poring over more than 3,600 pages of new medical research from around the globe and then careful analyzing costs, prevalence of need, and recommendations made by Israel’s four health insurance funds as to what was most sorely needed.
“There is no country in the world where its citizens are entitled to public funding for such a wide basket of services,” Halevy says. “With the new mental health package, with some of the oncological diseases like melanoma and lymphona – we have made a lot of progress.”