Gov't approves copayments for independent psychotherapy

Despite opposition from some MKs and professional groups in the mental health field, the Knesset Finance Committee on Monday decided that people who need psychotherapy techniques not included among treatments at health fund mental-health clinics will have to pay partial out-of-pocket fees to independent therapists.

The proposal was requested by Prime Minister Binyamin Netanyahu, who is also formally the health minister.

The copayments will be NIS 50 for the first appointment and NIS 120 for each subsequent treatment. The copayment for group therapy will be NIS 55 per session. The rates will go into effect on July 1, 2015, the same date that the health funds officially take over mental health care from the Health Ministry.

At present, there are no substantial fees, but queues for treatment are very long.

The committee also decided that for a visit to a clinic psychiatrist, copayments will be charged at the same rate as ordinary copayments for medical specialists and be included in the arrangement, setting a maximum in copayments by family members for each quarter.

Deputy Health Minister Ya’acov Litzman, who presented the request, said that the rates reflected those previously approved for Maccabi Health Services. Outgoing ministry deputy director-general Dr. Yoel Lipschitz, who supervises health funds and supplementary health insurance, told the committee that the copayments involved only those made to independent therapists and not those who work for the health fund. Copayments for mental health care will be the same as those presently collected by specialist physicians treating physical conditions.

But the decision did not please everyone. Abarbanel Mental Health Center social worker Hanna Yitzhaki said that the fees “create discrimination against patients needing psychotherapy. The charge is per visit and not per quarter. It will be easier to give these patients psychoactive medications that will drug them so they won’t have to pay much more for talk therapy. They will avoid going for treatments.”

She added that people with psychiatric problems usually don’t have the means to finance their treatments.

“In countries where treatments are provided privately, many troubled people live in the streets, and this is very harmful to society,” Yizhaki said.

Mordechai Basson, representing families of patients at Abarbanel, was furious about the new regulations and “other bad decisions” in this field over the years.

“Permission for the health funds to charge copayments [for outside therapists] is only a continuation of the policy that harms psychiatric patients.”

Hanna Strum Cohen, the chairman of the Psychologists and Social Workers Forum, complained that such the decision was made so fast.

“These are high prices for those who won’t go to health fund clinics. Has somebody checked how many such clinics there will be and their locations? The rules will create an impossible situation for patients, many of whom will forgo psychiatric treatment.”

Knesset Health Lobby chairman MK Rachel Adatto (Kadima), who is a physician by profession, also voiced her opposition to the charge of the copayments.

Finance Committee chairman Moshe Gafni, of Litzman’s United Torah Judaism party, voiced his support for the prime minister’s request, “which is supported by the deputy health minister,” after Gafni said he checked with Health Ministry personnel.

“This is copayment only for those who are referred to external therapists, and the state will ensure there are enough psychotherapists for patients [at health fund clinics],” he said.