Civil rights groups urge bolstering public health system

The Association of Civil Rights in Israel and the Physicians for Human Rights-Israel presented to Health Minister Yael German Wednesday a position paper for combatting the “creeping privatization and commercialization” of the public health system.

By JUDY SIEGEL-ITZKOVICH
Health Minister Yael German 370 (photo credit: Courtesy Knesset)
Health Minister Yael German 370
(photo credit: Courtesy Knesset)
The Association of Civil Rights in Israel and the Physicians for Human Rights-Israel presented to Health Minister Yael German Wednesday a position paper for combatting the “creeping privatization and commercialization” of the public health system.
The suggestions were meant as input for the committee on bolstering the public system that German heads and is supposed to produce recommendations in a few months.
The two liberal organizations, ACRI and PHR-I, stated that the public health system has “advantages over the private one, both economic and egalitarian.”
The suggestions, the organizations said, “would make it possible for patients to benefit from the advantages of private healthcare, but without paying anything extra.”
The two voluntary bodies said that “creeping privatization and commercialization” of the public health system has been occurring in recent years. The result, they said, is that the public has lost faith in the public system. Money from health taxes and other public resources are flowing into the pockets of private companies; however, the amount of out-of-pocket expenditures in both systems has been increasing, while the economically disadvantaged are getting less healthcare.
In the nine-page position paper, the organizations demanded a correction of the budgetary erosion of the public system. Supplementary health insurance policies held by 80 percent of the public through their own health funds must be integrated into the public basket of health services and turn into a progressive health tax.
Consequently, all patients could choose their own surgeon or specialist to receive a second opinion.
They added that the harmful links between the public and private systems must be cut, especially by severing the health fund from their private subsidiaries.
Wage contracts must make it possible for doctors to earn decent salaries in the public systems alone, without having to moonlight in private clinics and hospitals, the position paper said.
They presented the Canadian model for full-time physicians who can work for a public hospital only if they commit themselves to a full-time job there without working a second job elsewhere.
Patients in the public system, the paper continued, would be allowed to choose their doctor, consultant for a second opinion or a surgeon with full transparency; those selected would get extra pay.
A state program to shorten lines for treatments and another to reduce the gaps in accessibility and waiting times would be established. More money would be invested in primary and preventive medicine.
Anat Littwin, head of ACRI’s residents department, said she was worried over calls to allow private medical service (Sharap) in the state and Clalit Health Services hospitals, legal only in Jerusalem’s voluntary hospitals.
“We fear it will be done out of an interest of profitmaking and not to improve patient health,” she said. “The German committee has a real opportunity to carry out a basic repair of the health system and return it to the path that existed” when the National Health Insurance Law was passed in 1994, said Littwin.
Rami Adut, the Right to Health Project Coordinator at ACRI, said that every shekel spent on private medical treatment is much more wasteful than a shekel spent in the public system. Even worse, “private money in a public system causes it to behave like private health insurance. The time has come to restore the public health system, the insurers and the hospitals, to the whole population and insure that every person receives the treatment he needs, with the aim that he be healthy and not that others profit,” he said.
Prof. Nadav Davidovitz, a member of PHR-I, added that the growth rate in private health expenditures is among the highest in the world.
“It erodes the principles of the National Health Insurance Law, especially the principle of equality,” he said. “There is a big difference between the health of the wealthy and the poor.”
Davidowitz said he believed strongly in the recommendations.“ Many academics participated in preparing the position paper, and we believe that it is an applicable solution that will restore public faith in the system.”