Doctors protest arrangements bill

Physicians charge it will cause ‘further health system decline’

By JUDY SIEGEL-ITZKOVICH
doctor protest 311 (photo credit: Marc Israel Sellem)
doctor protest 311
(photo credit: Marc Israel Sellem)
Dozens of physicians spent their time off on Thursday demonstrating under the hot sun opposite the Prime Minister’s Office, in a last desperate attempt to head off the Finance Ministry’s economic arrangements bill, on which the cabinet was expected to vote after midnight.
The doctors, organized by the Israel Medical Association, said the health-related features of the bill – which is attached to the 2011/2 draft state budget – was meant by the Treasury to “politicize” the health system rather than improve it.
“It is an especially cynical effort that either ridicules [medical professionals] or demonstrates a lack of understanding of what is going on,” said IMA chairman Dr.Leonid Eidelman.
One of the proposals in the bill would give non-doctors the right to supervise hospital departments and units, whose heads would have to report on how much money – rather than how many lives – they have saved, said Eidelman. Another would transfer control of the standard of training of medical specialists – which is now supervised by the IMA’s Scientific Council and comprised of eminent physicians – to Health Ministry political appointees and bureaucrats.
“Politicians will intervene, and saving money rather than choosing the best treatment for the patients will be the rule,” Eidelman said.
Under the bill, patients who do not show up (or show up on time) for doctors’ appointments would be fined up to NIS 50 each time. They would have to make another appointment with a doctor, who would determine whether they were too sick to come – adding to the doctor’s bureaucratic burdens.
“We want to treat our patients and not hand out fines. And this will definitely hurt the poor,” said Dr. Yitzhak Bar-Or, a family physician and chairman of Clalit Health Services’ central region doctors committee.
In addition, money obtained from government hospital doctors’ research would be taken by the state rather than shared with the doctors, thus discouraging them from conducting research, the IMA chairman said.
“We are in the middle of negotiating this point as well as a new contract, and the Treasury has already decided,” he said.
Prof. Raphael Udassin, chief of pediatric surgery at Hadassah University Medical Center in Jerusalem’s Ein Kerem, who came in a white baseball cap and coat to demonstrate with colleagues, said the Treasury clearly wanted to take control of the medical system and make decisions based on finances rather than on what was best for the patient.
Eidelman declared that “the health system is sick and declining. In many places, we are not giving good care. We are diagnosing diseases too late and giving improper treatment – all because of the terrible patient burden due to doctor and bed shortages. The government wants to save money at the expense of the patient, who will pay more.”
Many hospital doctors now have to work 12 to 14 overnight shifts a month in addition to their regular work, he said.
A senior anesthesiologist at a government hospital in the North charged that Deputy Health Minister Ya’acov Litzman “has not been fighting for us. We don’t see eye to eye with him. He should be defending the doctors and fighting for the health system. The Treasury makes the decisions for him.”
He noted that the shortages were much worse in his hospital in the periphery than at those in the center of the country, which were suffering from serious problems as well.
Many other demonstrators also voiced severe criticism of Litzman, who at the Knesset Health Caucus on Wednesday maintained that the next state budget would offer some pleasant surprises for the health system.
Dr. Yitzhak Ziv-Ner, chairman of the government doctors union, said that while other Western countries continually expand medical technologies and services, in Israel they are constantly cut back. The economic arrangements bill stipulations regarding health, he said, must be voted down by the cabinet because “it contains only decrees that will cause the health system to decline even more.”
A Treasury spokesman denied IMA’s charges and said the bill offered changes that would improve the system. The IMA objected merely because it wanted to stay in control, the Treasury spokesman said.