The future of dentistry in Israel
Over the past three years, because of the policies of the Health Ministry, I have come close to bankruptcy.
The Jerusalem Post Photo: Bloomberg
For three years now, self-employed dentists have been prevented from treating
children under the National Health Insurance Law. Selfemployed dentists make up
85 percent of the dental manpower in the country. Only about 15% of dentists
work for the health funds or other public health institutions.
government decided, in 2009, to socialize dentistry for children, they had to
decide how to implement it.
Most dental facilities in the country were
private. These clinics were established and paid for by private dentists with
their own funds. The government understood that it would be ridiculous for the
public health sector to spend billions of shekels establishing public dental
clinics all over the country, when the infrastructure already existed, although
under private ownership.
The government made a decision to allow
participation of private dentists in providing public health dentistry, from
within their private clinics. They legislated the establishment of a Private
Dentistry Health Fund, which would be the mechanism that would allow any private
dentist to treat the children covered by the National Health Insurance
There were a number of reasons for this legislation. First of all,
to limit the damage to the private dentist, who otherwise would lose all his
young patients to the health funds. Secondly, because of the already existing
infrastructure, it would not be necessary for the public sector to invest in new
clinics. With all the private clinics, there already exists a geographic
distribution of clinics all over the country.
Thirdly, freedom of choice
for patients when choosing their dentists would be maintained.
only one problem with this scenario: The Health Ministry never established the
Private Dentistry Health Fund.
Therefore, for the past three years,
selfemployed dentists have been prevented from treating children under the
National Health Insurance Law, thereby suffering financially. The ministry,
instead of taking responsibility itself for establishing the Fund, decided to
issue a tender, calling on the private sector to do so.
Of course it
would be a non-profit enterprise, and the private group would have to invest
some NIS 23 million to be accepted by the ministry.
The only group to
come forward was the Israel Dental Association, whose raison d’etre is to
support dentistry in Israel. For three years the ministry has rejected the
applications of IDA-supported groups who applied to set up the Fund, supposedly
for financial reasons.
Last month, Dr. Yitzhak Chen, the chairman of the
IDA, told me that a group with the backing of Assaf Harofeh hospital had made a
formal application to be allowed to set up the Fund. Dr. Chen told me that this
was the final test; there is no way the ministry could reject this group on
financial grounds, as the hospital has ample funds.
Therefore, if the
application is rejected, the reasons must have nothing to do with the finances
of the group, but with the very idea of a Private Dentistry Fund.
application was rejected.
The ministry has refused to implement an
Israeli government decision. It would be nice to know why.
AT A cabinet
meeting in July 2012, Prime Minister Binyamin Netanyahu was made aware of the
fact that the Dental Fund was never established. He questioned Deputy Health
Minister Ya’acov Litzman about this, and then (reportedly in anger) gave the
responsibility over to his chief of staff, Harel Locker. He gave him one month
to take care of it – in July 2012.
It is now March 2013, and the Dental
Fund still does not exist. A few meetings were held, but the Health Ministry has
not budged. It seems the Prime Minister’s Office does not have the power to make
the Health Ministry implement a government decision.
I have been in
contact with individuals in the Prime Minister’s Office. I have been told by
them that they are working on it. I have asked for specific information on the
subject, and was told that I should ask Dr.
Chen, as he was my
representative in the government. When I corrected the young lady, saying that
Dr. Chen has no connection to the government, but is the head of the IDA, she
got all flustered and transferred me to a woman named Mazal.
on to scream at me for bothering them.
She forbade me to call again, and
hung up on me.
I then proceeded to call the IDA and I spoke to the
administrative director. She told me the IDA has come to the conclusion that
private dentistry in Israel is finished, and that now the IDA must fight for the
rights of dentists to at least maintain their private offices while performing
mostly public dentistry.
I am the owner of two small private clinics, one
in a haredi area. I have invested a lot of money in these clinics. Over the past
three years, because of the policies of the Health Ministry, I have come close
to bankruptcy. The ministry basically stole my patients and transferred them to
the health funds.
I have the right to know what the intentions of the
ministry and the government are with regard to dentistry in Israel. If the
ministry truly intends to eliminate all private dentistry, then dentists have
the right to know. Instead of acting in a dishonest and duplicitous manner, the
ministry, under the leadership of Director General Ronni Gamzu, should have made
its intentions public three years ago. Instead of playing games with peoples’
livelihoods, he should have had the moral integrity to come clean with the
Had I known three years ago what I know now, I could have saved
myself a lot of aggravation, and more importantly, a lot of money.
author is an American-trained dentist with a practice in Modi’in and Modi’in
Illit (for the time being).