The Association for Civil Rights in Israel (ACRI) and Physicians for Human Rights (PHR) submitted a position paper to the German Committee this morning laying out a detailed plan to improve the public health system in a manner that will allow patients to enjoy the advantages of private services without incurring additional payments. The public committee, chaired by the Minister of Health Yael German, is currently discussing alternatives for improving the public healthcare system.
The position paper surveys the trend of deprivation, privatization and creeping commercialization in the public healthcare system – a trend that HMOs and public hospitals play a central role in. As a result, the public has lost faith in the public healthcare system, tax revenues and public resources flow to the pockets of private companies, and health expenditures – both of middle class households and the national expenditure – are rising, along with the gap in quality and availability of health services received by those who can pay versus those who cannot.
The position paper enumerates several steps required to improve public heath services and reduce the need for private fee-based services. These steps include:
1. Stemming the erosion of the public healthcare budget, as per a recent decision of the Supreme Court.
2. Assimilating supplementary insurance into the basic public entitlement package by changing it into a progressive health tax, so that services like choosing a surgeon and getting a second opinion will be available to everyone in the public healthcare system.
3. Putting an end to the harmful interplay between the public healthcare system and the private sector, and generally separating the HMOs from the private companies that own them.
4. Initiating employment agreements that allow doctors to earn enough from their work in the public healthcare system alone (i.e. without the need to supplement their income in the private sector). The paper cites the Canadian model under which doctors working in hospitals are paid for every hour of work. Alongside this, the paper proposes allowing patients to choose a doctor (surgeon or specialist) in the public system without incurring additional payments in a manner that will reward highly sought-after doctors, while maintaining full transparency.
5. Establishing a government plan to reduce waiting times and reduce gaps in access and availability.
6. Investing in primary and preventative medicine.
According to Anat Litvin, Director of the Residents of Israel Department at PHR, “we are troubled by voices calling for support of private medical care in public hospitals and concerned that this is being motivated by profit and not the wellbeing of the patients. The German Committee has a real opportunity to overhaul the healthcare system in Israel and return it to the path it was on when the National Health Insurance Law was legislated – a law based on the equitable sharing of the country’s health resources. ”
Rami Adut, Coordinator of the Right to Health Project at ACRI: “Every shekel spent in the private sector is much more wasteful than the same shekel spent in the public system. Worse, private money inside the public system causes it to behave exactly like a private insurance company. The time has come to return the public system – HMOs and hospitals – to the public as a whole and ensure that every person receives medical treatment motivated only by the patient’s health and not the profits of others.
Dr. Nadav Davidovich, board member at PHR and Chairman of Center for Health Policy Research in the Negev: “The growth rate of private expenditure on health care in Israel is among the highest worldwide. This process undermines the principles of the National Health Insurance Law, especially the principle of equality. The continuing erosion of the public system’s funding creates unacceptable gaps in health care between rich and poor, between the center and the periphery, and among different groups in the population. Our position paper proposes a solution to stop the processes of privatization and the intermingling of the public and private sectors that ultimately harm the population’s health. Many leading figures from academia and civil society were partners in the formulation of the solutions, which we believe to be implementable ones that will restore faith in the public healthcare system.”
Related Materials
ACRI and PHR’s Position Paper (in Hebrew).
“Between Realization and Dehydration” – An ACRI Report into How Israeli Governments Drained Social Services (in English).
