Here in Israel the problem is even worse. We have a national health
insurance, and healthcare is usualy not payed for directly (you pay an
amount every month, but you don't pay doctors, physical therapists, speech
therapists etc.), so poeple expect everything concerned with healthcare to
be free. Of course bf help is not covered by the health insurance.

 There are doctors, and other hcps, who also do private practice, but these
are only for the very affluent, or in very special situations - before a
very complicated operation, or when there is no solution to a health problem.

 Another problem is that the only bf support that has been available here
for years is LLLI, which is for free, of course. Only in the last few
months the first IBCLC has been hired by a hospital, just to be an LC. In
most hospitals the L&D nurses give some kind of nursing instructions, and
if the mothers are lucky one of the nurses is an IBCLC, who is "allowed" to
help nursing mothers in her spare time. Most hospitals won't let LLLL into
the maternity wards.

Some IBCLCs have started to work in private practice, and I have already
heard comments like "did you know she was asking for MONEY?". The same is
true for my (MD) advice - many mothers expect it to be for free, even
though I don't see them in my family medicine practice, where I have 5-7
minutes for a patient.(Though some do ask me to see them in private
practice). Once a very known writer of childrens' books here in Israel
called me and asked me to see her daughter and her granddaughter, she came
to my home the same evening, I sat with them for more than an hour, and she
didn't even ask if she had to pay, or didn't offer one of her books for my
children. She just assumed that I do this for free.

The truth is, that so far I have been giving telephone advice for free, and
usualy I don't see the mothers, but I have been getting so many calls that
I am considering to start a private practice for bf problems. Of course
only the most difficult cases, who didn't get a "free" solution to their
problems, will come and see me, or an IBCLC in private practice.

Mira Leibovich, MD

>many people feel that they should try the "free" sources, such as
>breastfeeding support groups, hotlines, email help venues, etc., first.
>Having a baby is expensive, and it is hard to convince people that the
>money for an LC is well spent (even though it OBVIOUSLY is if you check the
>numbers).
>
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