(photo credit: )
The directors-general of the four public health funds accused the Finance and Health ministries on Thursday night of "misleading" the cabinet and the public last week by claiming that more money would be allocated to health next year, when in fact allocations would be cut by about half a billion shekels.
The health fund heads held an unusual meeting at Maccabi Health Services' headquarters in Tel Aviv and released a statement affirmed by each of them: Zev Vurmbrand of Clalit Health Services, Dr. Ehud Kokiya of Maccabi Health Services, Shmuel Mualem of Kupat Holim Meuhedet and Nissim Alon of Kupat Holim Leumit.
Maccabi Health Services alone expects to lose NIS 170 million next year due to Treasury cuts, while the whole public will have to pay more for medications, visits to medical specialists and other services. Queues for medical treatment will lengthen and fewer medications will be available, the health fund directors agreed.
They decided unanimously to demand an urgent meeting with Prime Minister Ehud Olmert over the Treasury's plans to cut its funding of the insurers' services, which will "put all the health funds into serious deficit."
At separate press conferences presided over earlier this month by Health Minister Ya'acov Ben-Yizri and Finance Minister Ronnie Bar-On, the Arrangements Bill with over 300 changes in government policies was presented, as was a three-year agreement to expand the basket of health services by "NIS 350 million annually" through 2010.
But the health fund directors maintain that the basket, which is supplied by the health funds and expanded with Treasury subsidies, will grow by only NIS 275 million a year, and their demands for automatic updating of the basket by 2 percent annually will be shelved until the next decade at least. In addition, the Treasury has vetoed any expansion of hospital beds until at least 2015.
The health fund directors said their best hope to fight the government's plans is to lobby in the Knesset. The Arrangements Bill was passed by the cabinet, but it has yet to be passed by the Knesset.
The directors-general did not discuss other Treasury-initiated proposals affecting the health system, as they don't have identical positions on them. The demand that three-quarters of each health fund's board of directors be appointed by the Finance and Health Ministries and become paid staffers rather than volunteers is opposed by Maccabi and Meuhedet, which fear outside political control.
But Clalit and Leumit, whose boards have significant representation by the labor federations that used to own them outright, would prefer government-appointed board members to their present ones.
The Treasury also intends to restrict the wages of the health funds' directors-general to NIS 55,000 gross and to limit that of senior officials to a set percentage of the director-general's salary, which, according to Maccabi, will make it impossible for it to advance deserving workers and to attract highly qualified experts from outside.
The power to control wages would be given to Treasury wage chief Eli Cohen.
In addition, Maccabi and Clalit are furious at the Treasury for persuading Ben-Yizri to cancel permission the Health Ministry granted in April for their supplementary health insurance policies to cover life-saving and -extending drugs not included in the basket. These plans were carefully forged with Health Ministry input over a year, but because private health insurance companies were losing customers due to Maccabi and Clalit competition, Ben-Yizri reversed his policy two weeks ago and barred supplementary policies from offering extra medications. Maccabi argues that 80% of the population has supplementary health insurance, and that of the remaining 20%, some 820,000 people are too poor to afford it. Maccabi has even suggested that those who do have supplementary policies be asked to voluntarily pay NIS 2 a month each to extend medication coverage to the economically disadvantaged, but detractors of this idea say it could induce the Treasury to use it as a precedent to demand more taxpayer money to cover services that should be supplied by the government.
Another initiative announced by the Treasury and encouraged by some government hospital directors is to allow the establishment of a fifth health fund to "increase competition," but the Treasury said the new insurer would be based on several of the large hospitals in the center of the country. Some of the health funds, which worry that the competition would attract their wealthier members in the center of the country, contend that the hospitals would never be able to offer health care on an equitable basis to residents around the country, especially in the periphery, and that a new insurer would not offer patients freedom of choice to go to another hospital for service.