Health groups blast gov’t plan to boost public medicine

Health Minister Ya’acov Litzman and Finance Minister Moshe Kahlon’s program to “strengthen public medicine” has been met with opposition from the Israel Medical Association, the public health funds, public advocacy groups and private insurance companies.

The two ministers called their program – which would make a long-awaited increase in the basket of health services and prevent hospital department heads from having private practices and limit their term – a “historic step.”

The two ministers said that barring the most senior hospital physicians from working privately and working only a certain number of terms would encourage young doctors to eventually take their place.

Department heads and other senior doctors would be “full-timers” and remain at their posts at higher salaries through the early evening rather than leaving for private work in the early afternoons. A professional team will study the economic aspects of the plan and how fast it could be implemented, they said.

The basket of health services has been expanded by only NIS 300 million annually, causing a severe erosion of the new medical technologies added for the public benefit. This will be raised for five years to NIS 550m. a year, of which NIS 50m. will go for genetic testing.

The additional funding will be funded by the government and by putting a tax on supplementary and private medical insurance policies to help balance public and private medicine, they said.

The ministers did not adopt the long-standing recommendation of health professionals that the Treasury expand the budget automatically, with no strings attached, by two percent a year, without the Finance Ministry’s intervention.

Litzman said that while he would not intervene in the work of the public committee that recommends how to expand the basket, he would like them to include in supplementary health insurance policies lifesaving drugs and treat severe diseases that had been left out in the past due to lack of funds.

The IMA, headed by Dr. Leonid Eidelman, castigated the decision about hospital department heads, noting that allowing them to work privately as well was included in labor contracts and would “prevent the public from getting access to the best physicians.” It would also discourage senior physicians from competing to become department heads in public hospitals because they would otherwise be able to work privately after hours.

The Adva Center, Association for Civil Rights in Israel and Physicians for Human Rights-Israel said the decision to add lifesaving drugs to supplementary health insurance policies was “anti-social” because not everyone can afford supplementary policies. It would also discourage the government from adding such drugs to the public basket, the public advocacy group argued. This, said the three organizations, would result in two baskets, a public and limited one, and another other for the rich. It will also cause unnecessary growth in national expenditure, they argued.