To:
Mr. Ehud Olmert
Prime Minister
Jerusalem
Re: Private health insurance and the systematic destruction of the National Health Service in Israel
We are writing to you to request your personal intervention to resolve the ongoing conflict between the Ministry of Finance and the Ministry of Health, to prevent the replacement of the national health insurance with private health insurance funds, and the resultant ongoing violations of the basic legal right to life, bodily integrity, and health.
The National Health Insurance Law was enacted to provide a health safety net through the provision of medical care and medication to every patient, whoever they are, irrespective of their financial situation, as required by the “principles of justice, equality and reciprocity”. However, over the past few years, since the enactment of the law, we have witnessed a consistent disregard for the obligations that are inherent to this festive undertaking by the State.
The Israeli government has taken steps that have steadily eroded the basket of services and medications provided by the national health insurance. The Knesset, for its part, has endorsed repeated reforms that have reduced the level of State funding for the basket, and has placed the burden squarely on the shoulders of the patients who require the drugs and medical treatment. Concurrently, the upgrading of the basket to reflect the growth and aging of the population, as well as technological developments, was prevented. More and more life saving drugs and vital health services are excluded from the basket, and the provision of others has become dependent upon an individual’‘s personal financial contribution, which in many cases is beyond their financial means.
A person suffering from a serious disease is no longer automatically entitled to medication that can save or lengthen his or her life, or maintain a minimal quality of life, unless he or she has the means to finance it.
A similar situation of neglect and lowered standards exists in Israel’‘s hospitals. Patients whose condition requires intensive care are dispatched to regular wards, something that has been proven to reduce their chances of survival. An absence of standardized procedure and adequate personnel in the wards is causing the medical staff to collapse under an excessive workload, and patients are not receiving basic medical treatment they require to improve or cure their medical condition. Overcrowding and inadequate manpower also contribute to the spread of infections and diseases to which numerous patients are falling victim. This level of neglect and dysfunction also characterizes the status of medical research, which in the past was the flagship of Israeli medicine and ensured future medical care.
Currently, after years of premeditated corrosion of the basket, which has turned hospitals into overcrowded bacterial incubators, the Ministry of Finance and the Ministry of Health offers us a cruel choice between privatization or death. Health funds (Kupot Holim) offer supplementary insurance, in addition to the national health insurance that, for those who can afford it, provide the drugs and medical care that can save lives or improve a patient’‘s quality of life. Families who cannot afford to pay for these private supplements cannot guarantee their children adequate medical care. The same is true of the elderly who represent one of the poorest sectors in the country and suffer, naturally, from multiple medical conditions, but cannot pay the exorbitant prices demanded of them.
The Ministry of Health`s authorization for these supplementary health insurances reduces any chance of extricating the National Health Service from the serious situation it finds itself in after years of deliberate neglect by the Ministry of Finance. The combination of these factors seriously undermines the legislative purpose of the National Health Insurance Law and the principles of “justice, equality, and reciprocity” upon which the law is based. These factors also violate the right to life, bodily integrity, dignity and health, which are protected by the Basic Law: Human Dignity and Liberty.
Whatever current disagreements exist between the Ministry of Health and the Ministry of Finance, in the final analysis it is the government that has overall responsibility for the National Health Service. The government and the Prime Minister are ultimately responsible for saving the crumbling health system, and for preventing the systematic and deliberate violation of basic legal rights.
An additional consideration, beyond the severe infringement of an individual’‘s dignity and basic human rights, is the dangerous sliding of the national health system into a black hole that is liable to result in the complete breakdown of social solidarity. From bitter experience of third world societies, it is apparent that this lack of social solidarity has a dire effect on the level of resilience a society is able to exhibit in the face of internal and external threats.
In order for us to be able to plan future action, we would be extremely grateful if you could advise us of what steps the government intends to take to ensure that medication, hospital care, and other vital health services will be included in the national health insurance, rather than ad hoc private health insurances, or at the very least, to guarantee that the aforementioned are not denied to individuals who cannot afford private health insurance.
Respectfully
Adv. Avner Pinchuk
last updated : 28/03/07
