Ministries distance themselves from lower patient copayments

Report implicating Finance, Health ministries appears to have been buried.

February 11, 2010 23:01
2 minute read.
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Hospital generic 224.88. (photo credit: Ariel Jerozolimski [file])


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The report of a Finance/Health Ministry panel established to address the state comptroller’s assertion that Israelis pay out of their pocket 43 percent of all health costs – among the highest rates in the world – appears to have been buried by both ministries.

The committee was headed by Dr. Dror Goberman, who is in charge of the Health Ministry’s community medicine branch, and was comprised of an equal number of Health and Finance ministry representatives. Their document of recommendations called for lowering copayments charges by patients for a wide variety of services; requiring the health funds to inform their members about maximum payments, exemptions and discounts for people who meet the criteria; and setting up a mechanism that will keep copayments from rising further. In 1995, the public had to cover with copayments only 33% of health expenditures.

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The Health Ministry did not allow The Jerusalem Post to interview Goberman or higher officials, and the Finance Ministry refused to allow reporters to interview Treasury representatives on the committee after the existence of the report was published in Haaretz on Wednesday.

Instead of dealing with the principles of the proposed reform, a Treasury spokeswoman said that two of the three Health Ministry representatives favored using NIS 40 million to provide free vaccinations and other well-baby care in tipat halav clinics – a service that has long been free in most countries for decades because it is for the benefit of the population to control infectious disease. She said that Deputy Health Minister Ya’acov Litzman was in favor of this expenditure. The Health Ministry did not make the committee’s recommendations public.

The Treasury denied reports that the committee’s recommendations were “buried” or that Finance Ministry officials had told Health Ministry officials they must not publicize the document because they feared implementation would require large additional allocations for health. The Finance Ministry spokeswoman said the Treasury did not object to the Health Ministry spending the NIS 40m. for cancelling tipat halav fees or to eliminate other copayments in the future as it saw fit, but it would not agree to expand the sum.

She added that the version of the Goberman Report presented by Haaretz was “not the same as that presented to the Treasury as the official version of the committee members coming from the Health Ministry.

Although the government had appointed the whole committee to make recommendations, this version of the document was not presented to the Treasury as the official position of the Health Ministry’s representatives on the committee or of the ministry itself.”

Ben-Gurion University health economist Prof. Gabi Bin-Nun, who left for academia after decades in the Health Ministry, said that the cancellation of tipat halav fees, giving free seasonal flu shots and reducing copayments at the health funds’ late-night urgent-medical care centers, “were welcome but only a drop in the ocean.”

He added that copayments have become an “alternative funding system” for covering the costs of important health services, having serious negative social influences and putting a regressive burden on the poor. There are many Israelis who cannot get decent health care because they can’t cover the copayments for medications and services out of their own pocket, said Bin-Nun.

“The deputy health minister doesn’t need more committees to recommend what has to be done. What is needed now is to make decisions.”

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