Fertility Treatments and the Economy, a View from the US

Last week we discussed how economics can affect fertility and we
saw how a powerful lobby of Puah and several secular groups was
able to keep fertility treatments offered by the Kupot Cholim.

This week I wanted to look at another connection between money
and children, but this time presenting the situation as it
stands today in America. Unlike Israel, most Americans' health
insurance does not cover fertility treatments and the cost of
these treatments can be staggering. Treatments can be over
$20,000 and even much more, all with no guarantee of success,
so couples can spend their entire life savings in order to have
one child.

In recent years, some American citizens have sought ways of
lessening these costs and one common way is fertility tourism
where couples travel overseas to places where treatment is
cheaper in order to cut costs. There is quite debate raging
as to whether this is recommended or not, but for Jewish
couples the option of coming and doing treatment in Israel
is attractive. Indeed, in a recent New York Times article,
Puah was mentioned as being one of the organizations that
has been involved in cases of fertility tourism.

While fertility treatment is not free for couples who do not
hold Israeli citizenship and who pay Kupat Cholim, even done
privately, it is much cheaper than the equivalent treatment
performed elsewhere.

While we believe that often the best is for a couple to
undergo treatment in a place where they are surrounded by
family, friends and a support system, in a place where
they know the system and feel comfortable, still we have
helped many couples come to Israel and have treatments done
here.

This is not for everybody, but the couples who have been
through this and have become pregnant are delighted. They
received top class care and for a fraction of the cost
that it would have been in the US or other places.

At a recent conference, a friend of mine who runs a clinic
in the US that deals with high end treatments, admitted to
me that business has been slowing down; as the economy
nosedives we may see this more and more. In such circumstances,
the options of doing treatment in Israel becomes a more sought
after option and the Puah Institute is proud to provide couples
who seek this option guidance, help and halachic supervision.

Let us hope and pray that no one will need such treatment,
but if they do, then we pray that finances will not be an
insurmountable obstacle.

The Puah Institute for Fertility and Gynecology in Accordance
with Halacha is based in Jerusalem and helps couples from all
over the world who are experiencing fertility problems. Puah
offers free counseling in five languages, halachic supervision,
and educational programs. Puah has offices in New York,
Los Angeles and Paris. To contact the Puah Institute please call
1-800-071111 in Israel or in the US 718-336-0603.
Visit our website: www.puahonline.org

Don't Give Up

Yosef and Yehudit had great dreams and hopes for their future together. They were both idealistic and wanted to build a special home in a special place for the Jewish people and so they moved to a yishuv in Gush Katif in order to join the unique community there.

They were so happy and this only increased when Yehudit became pregnant and gave birth to a baby girl. All seemed well and the couple were delighted when Yehudit became pregnant soon afterwards with a boy. 

When the boy was born he also looked healthy, but it did not take too long for the dream to burst. The doctors noticed that Yosef and Yehudit's son did not react to stimuli in the normal way. They ran a battery of tests and it was discovered that he was suffering from a very serious medical condition that affected his reactions and his learning abilities. 

Yosef and Yehudit were concerned and they decided to look into the condition deeper, they had themselves checked and found that they were both carriers of a serious genetic mutation. They quickly realized that this may have affected their daughter as well, who was then also tested and was found to have a somewhat milder form of the condition. As she got older her symptoms became more pronounced and Yosef and Yehudit found their home now filled with two children with serious learning disabilities and special needs. 

In the midst of all this, the Israeli government made the decision to withdraw unilaterally from Gush Katif and within a few months they were homeless and remain so until today.

The Puah Institute has accompanied this couple since they discovered their son's condition and the Rabbi who dealt with them has spoken to them numerous times and guided them through all of their personal trials. 

Yosef and Yehudit underwent a treatment to try and have a healthy child, but after having great expectations, the treatment was not successful and even suggested that they would need more invasive treatment. The couple were distraught and again the Rabbi at Puah was called upon to give them hope and not allow them to give up.

They underwent two more treatments until they were successful - a couple of weeks ago they celebrated the birth of their healthy baby boy together with many of their old friends from the yishuv and, of course, the Rabbi from the Puah Institute. 

Fertility Treatments and the Economic Crisis

Once, in an interview for a Californian newspaper, I was asked whether, in light of the difficult security situation in Israel, people were undergoing less fertility treatments. I answered an unequivocal no, that maybe the opposite is the case, that a worthy answer to war and terror is to have more children. In fact, sometimes we find couples who lost a child who come to have another child feeling that this is their best response to their loss.

However, the present economic crisis has added a dimension to fertility treatments around the world and I would like to discuss this over the next couple of weeks.

We will speak about the situation abroad next week, but I would like to concentrate on Israel in this column.

The current law in Israel is that the Kupat Cholim (the Israeli equivalent of an HMO) is required to pay for most fertility treatments until the couple have two children. While there are other countries in Europe that offer some insurance coverage for fertility treatments, Israel's is still a unique situation. When we compare this with the US where couples can pay thousands of dollars for treatments and can expect to pay tens of thousands of dollars in order to achieve a healthy child, it is truly remarkable.

In addition, this has catapulted Israel to the forefront of fertility treatments; doctors have a tremendous amount of experience with difficult cases and unusual circumstances not often seen in other places around the world.

This law that offered fertility treatment through the Kupat Cholim has been in effect since there has been a Health Ministry and was passed in 1995. However, recently there was talk of changing this law and making fertility treatments available only through private clinics, or at least severely limiting the accessibility of treatments. 

This would have changed the dynamic of fertility treatments in Israel and would have prevented thousands of couples from ever holding their own children, ever dressing them up for Purim, ever shepping nachas at their Bar or Bat Mitzva. Several secular fertility support groups mobilized in order to explain to the politicians the importance of not changing the law and of encouraging demographic growth. The Puah Institute joined with them to form a strong alliance that cut across party and religious lines and it may have been this incredible unity that was able to keep the law as it remains to this day.   The Puah Institute for Fertility and Gynecology in Accordance with Halacha is based in Jerusalem and helps couples from all over the world who are experiencing fertility problems. Puah offers free counseling in five languages, halachic supervision, and educational programs. Puah has offices in New York, Los Angeles and Paris. To contact the Puah Institute please call 1-800-071111 in Israel or in the US 718-336-0603.                

Visit our website: www.puahonline.org