Health Council endorses Litzman’s reform plan for geriatric nursing

Worries remain about Treasury opposition and expected delays.

By JUDY SIEGEL-ITZKOVICH
Health Minister MK Ya’acov Litzman at Magen David Adom conference, December 28, 2015 (photo credit: Courtesy)
Health Minister MK Ya’acov Litzman at Magen David Adom conference, December 28, 2015
(photo credit: Courtesy)
Each of the few dozen members of the Israel Health Council who listened on Sunday to Health Minister Ya’acov Litzman’s and ministry officials’ explanations of his proposed geriatric nursing reform was in favor of it – except for young Treasury bureaucrats who were not at the meeting in the Health Ministry to explain their views.
The reform, which was first proposed more than three decades ago – when the average Israeli lived to reach 70 or so – would raise the health tax by about half a percent and give everyone basic coverage to geriatric care in decent surroundings.
Private insurance is curtailed in most cases before the customer needs it, and geriatric nursing insurance policies sold by the four public health fund have so many limitations and loopholes that few get what they expect when they need help.
Litzman reiterated that his United Torah Judaism party would leave the coalition if the government did not approve the reform.
The Finance Ministry opposed the initiative, saying it would excessively raise public health spending.
Litzman joked that he was “worried” that even his predecessor (and political foe) Yesh Atid MK Yael German has praised him for the reform initiative.
With the aging of the population, shortage of suitable geriatric institutions, doctors who specialize in diagnosing and treating the aging and nurses, experts say the country faces a catastrophe unless it prepares to care for them.
In a few years, the elderly will comprise 15 percent of the population.
Health Ministry director- general Moshe Bar Siman Tov, a former senior Treasury budgeting official, said that, according to a recent poll, the vast majority of Israelis are willing to pay higher health taxes if a geriatric reform is implemented. “It must have a soft landing so there is not a great crisis in a few years. Just look at the demographics. It is very clear that if we don’t prepare for this, we won’t succeed,” said Bar Siman Tov.
Nir Kedar, a senior (but young) deputy director-general for strategic and economic planning in the Health Ministry who has been working on the reform for years, said that there are more than 200,000 Israelis who are hospitalized in geriatric institutions or needing help from family members or hired caregivers at home.
Every year, this number grows by some 5,000. Financial help from the National Insurance Institute is minimal and does not cover the needs of most of them.
The bureaucracy involved in getting help or in hospitalizing relatives in institutions is huge, said Kedar. More of the system should be public, he continued, and the elderly and disabled must be helped to remain at home as long as possible for their own and for the country’s own economic good.
Grown children are forced to produce documents showing their earnings and income to determine how much they must contribute to their parents’ upkeep in institutions.
There is no continuity of care, and a dozen or more institutions are involved in the process, he bemoaned.
The aim of the reform is to make the public health funds responsible for geriatric care, said Kedar, just as they have taken over the job of psychiatric care in addition to general medical care. In addition, there must be incentives to build more geriatric and high-level geriatric facilities, train professional caregivers and nurses and give incentives to young doctors to specialize in geriatrics, he said.
Members of the Israel Health Council, who represent public, professional and voluntary organizations, said that the elderly undergo humiliation to get assistance; that the lack of geriatric beds means elderly patients unnecessarily lie in much-more-expensive general hospital beds; that hip fractures that cause sudden disability and death can be prevented in many cases; and that in other countries, geriatric nursing professionals have to be well-trained and licensed, which is absent here.
The council unanimously voted in favor of the Health Ministry pursuing the reform.