The Health Ministry’s claims that it is beginning to reduce the gaps in health
services between the Center and the periphery and is increasing northern and
southern residents’ access to quality care are seeing no support in the field,
according to a new study released for publication on Tuesday.
report by the Taub Center for Social Policy Research in Jerusalem, senior Taub
Center and Ben- Gurion University health economist Prof. Dov Chernichovsky
reached the conclusion that “what existed up to now is what will be; there has
been and will be no change that will improve the
Chernichovsky stressed that the gaps in the accessibility and
quality of health services in the far-out areas of the country – including
Jerusalem, where many residents are as poor as those in the periphery – are
constantly getting worse, and nothing the government has promised in the field
of healthcare is making the situation any better.
Starting January 1, the
ministry changed the way funds should be allocated: Not only will elderly
Israelis be worth more to the health funds, but more money will go to health
funds with more women – who cost the health system more than men do – and to the
North and South.
However, Chernichovsky, in an examination of what has
happened so far and how the system is organized, told The Jerusalem Post that
there seemed to be no intention of decentralizing the system of the health funds
so that a total of NIS 2 billion – or 10 percent – a year would go to local
districts in the periphery.
Instead, he said, the money would go to the
same place – the health funds’ headquarters in Tel Aviv.
“From there, the
needed money is not getting to the periphery,” he said.
mechanism for actually moving the money to the periphery and inducing more
doctors to work in the North and South is absent and therefore not considered
serious, the major government rearrangement in healthcare is not taking place,
Chernichovsky declared that more decision-making on health
and allocation of resources must be done on the district level – a bottomto- top
mechanism instead of the longtime, theoretical top-to-bottom one that has left
the periphery weaker and less healthy, with lower income and higher infant
mortality, for example.
He added that including all areas in the South,
such as wealthy suburban areas around Beersheba, in the “periphery” was not
useful, as the socioeconomic condition of residents there was very different
from those in the actual periphery. A real mechanism for decentralization would
ensure a significant increase in hospital beds in the periphery compared to the
Center, and genuine encouragement for doctors to move to the outlying regions
and work for incentive pay, he said.
“Nobody is willing to pay, in the
North and South, the salaries that doctors can get in Tel Aviv or Herzliya or
the most expensive Jerusalem areas,” Chernichovsky said.
He also accused
the government of failing to carry out significant change regarding the
periphery. He included the Health Ministry, but did not name names.
was all much ado about nothing,” he said about the January 1 health fund
Although the ministry received the Taub Center
information from the Post on Monday, no comment was available by press
Meanwhile, the Israel Medical Association released a survey showing
that 15% of medical residents change their specialties over the course of their
In response, IMA chairman Dr. Leonid Eidelman said, a fair was
held at BGU to attract residents to the periphery. More than 20 medical
specialty associations, including those in neurosurgery, psychiatry, pediatrics,
orthopedics, obstetrics and anesthesiology, were presented to encourage young
medical school graduates to enter specialities needed in outlying areas.
However, the actual number of those convinced to do so was not released.