UCSF

In 1994 Israel passed the National Health Insurance Law (NHIL), guaranteeing universal and equal healthcare services to all citizens. Universal healthcare, while unprecedented in Israel, did not have a significant impact on the country's Jewish majority. Yet for minority citizens such as the Bedouin community in the southern Israel, the NHIL transformed access to medical services, increasing insurance coverage from 60% to 100%, and changing the patient demographic in the regional hospital. Nonetheless, since 1995 when the law was implemented, disparities in health outcomes between Jewish and Arab citizens in the country have widened.

Healthcare reform took place within a geo-political landscape that continues to marginalize its Arab citizens. Thus the paradigm of equality of healthcare intersects with national policies that create a differential citizenship in Israel. This dissertation, Producing Equality: Citizenship, Science, and Medicine in the Negev/Naqab, examines the impact of Israel's National Health Insurance Law as a site to understand how Israel's policies of inclusion and exclusion of Bedouin Arab citizens become entangled. My work highlights the tensions that exist between expansive and technical medical care that the state allocates to its Bedouin citizens, and the limited financial and political support the Bedouin community receives from the government in other spheres. Healthcare in southern Israel provides an important site to study the active production of the boundaries of citizenship, medicine, and reconfiguring of discrimination. I argue that the emphasis on scientific discourse in the medical arena ignores the social and political problems that place much of the Bedouin community in poor health. Therefore social, political, and historical questions that are central to understanding health disparities in the region remain beyond the scope of what providers view as relevant to their work. This bounding of medical care allows for the continuation of discriminatory policies towards the Bedouin citizens, while permitting the state and healthcare providers to assert they provide equal care to all patients.