(photo credit: Ariel Jerozolimski )
An informal coalition of MKs, patient groups and other organizations has been formed to fight the sections of the Treasury's Arrangements Bill that threaten to increase the inequity in the health system and make it even more difficult for disadvantaged groups to get decent medical care.
Six Knesset members, led by MK Haim Oron, appeared Tuesday at the special meeting initiated by the Physicians for Human Rights-Israel (PHR), the Adva Center (Information on Equality and Social Justice in Israel) and the Association for Civil Rights in Israel. The two-hour event was held in the Knesset lecture hall.
Oron said it was a "scandal" when the Arrangements Bill (an addendum to the Budgets Bill for 2008 that must be passed en bloc) was passed recently on its first reading in the Knesset. Oron said the MKs did not understand what they were voting on (including nearly three dozen sections that will reduce health services) and were not able to discuss the pros and cons in a serious way.
Oron and the organizational representatives said that before the second reading, a public campaign needed to be launched to separate the health clauses from the Arrangements Bill so they could be assessed and discussed as part of the ordinary legislative process.
Among the health-related clauses, said Adva Center Director Barbara Swirsky, were: procedures that will increase the gap between available new medical technologies and those included in the basket of health services; the Health Ministry's cancellation of permission to Maccabi and Clalit Health Services to offer lifesaving medications not included in the basket to the majority of the population who hold supplementary health insurance policies; and the plan to establish a fifth health fund that opponents predict will siphon off wealthy, young and healthy members from the four health funds.
Oron said that the Arrangements Bill also contained a clause that would charge housewives who do not work outside the home a monthly Health Tax; the tax would bring in NIS 500 million a year - which is another tax added on to regressive co-payments.
Those present demanded that the government approve a private member's bill initiated by Oron for the basket of services provided by the health funds to be expanded automatically by two percent every year, without the Treasury unilaterally setting the extra subsidies (next year's basket may grow by only 1.2%). Oron said that if they fought hard, some of the Treasury's decrees could be eliminated from the Arrangements Bill.
PHR chairman Dr. Danny Filk declared that state funding of national spending on health continued to decline, and that a growing number of low-income citizens could not buy lifesaving prescription medications due to the co-payments established when the government cancelled the Employers Tax over a decade ago to help subsidize health services.
All attendees at the meeting agreed that the co-payments for medication and for visiting medical specialists did not serve to eliminate "unnecessary use" of medical services. Instead, they increase medical costs, as patients who cannot afford drugs or visits to specialists will end up with complications and more visits to clinics and need for hospitalization.
Shmuel Ben-Ya'acov of the Israel Patients' Coalition said that not only did Health Minister Ya'acov Ben-Yizri cancel previous permission he had given to Maccabi and Clalit to offer lifesaving drugs to holders of supplementary policies, but the government recently allowed the private insurance companies to do so via much more expensive policies that are out of the reach of the general public.
Prof. Shaul Sofer, a PHR member and Negev pediatrician who teaches at Ben-Gurion University, complained about the "ticking time bomb" of inequity in the number of hospital beds, outpatient services and resources invested in the Negev and other peripheral regions in the country. In the Negev, the rates of smoking, diabetes and overweight leading to chronic diseases are the highest in Israel, he said.
Israel Diabetes Association president Dr. Julio Weinstein said a program to prevent diabetes was modestly funded by the Health Ministry for only a year, after which the ministry halted its support. This is despite the fact that diabetes has been diagnosed in 400,000 Israelis and is undiagnosed in 400,000 more, and failure to prevent complications costs 12% of national health expenditure.
Diabetes can be prevented or delayed in many people who are at high risk, he said. Half of all diabetics' blood sugar levels are not balanced, and it takes years to get beneficial diabetes drugs approved and included in the basket of services.
Meidad Gissin, chairman of ZVI (Israel Health Consumers), argued that the Arrangements Bill's provision to freeze the funding of new hospital beds - even though a Health Ministry report found that 3,000 more would be needed in coming years - will bring overcrowding and poor treatment to patients around the country. The bill would allow discussion of additional hospital facilities to resume only in 2010, and the facilities would take at least five years to be built.
No one from the Treasury was present to defend its policies, and no one defended the broad attacks on the Health Ministry, including Gissin's charge that he expected "the Health Ministry and the health minister to stand up on its hind legs in opposition to the Treasury edicts, but it just signed agreements with the Treasury too easily."