The future of dentistry in Israel

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.

When the 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 Law.

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.

THERE IS 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.

The 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.

Mazal went 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 truth.

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.

The author is an American-trained dentist with a practice in Modi’in and Modi’in Illit (for the time being).