If you think you're paying health taxes to ensure quality medical care for yourself and your immediate family, you are partly mistaken. Tens of millions of shekels a year in health taxes - collected by the National Insurance Institute and allocated among the insurers - are used to provide free or discounted medical care, supplementary health policies and medications to staffers and pensioners of three of the four public health funds and and even let them jump queues for diagnosis and treatment ahead of you. But that is not all: Their first-degree relatives (parents, children and siblings) are also considered "personnel" who enjoy these same benefits. The only insurer that does not grant these inequitable benefits is the Maccabi Health Services. In his 115-page chapter on the Health Ministry, the State Comptroller castigated administrators for numerous shortcomings, not only for not preventing the health funds from providing staffers with these costly benefits. Other shortcomings were: inadequate rehabilitation of mental patients in the community, deficient testing of semen in hospital sperm banks, allowing some health funds to inequitably distribute big-ticket medications, and granting expensive medical care to people from the former Soviet Union who pretended they were immigrants and then went back home. The National Health Insurance Law that set the national health system in motion in 1995 was aimed at prohibiting discrimination against some and the granting of extra benefits to the privileged. Before it began, the Clalit, Meuhedet and Leumit health funds offered special benefits to their staffers and personnel's first-degree relatives. But in the last twelve years, the ministry not only failed to reduce these unfair extras; even those benefits that were not part of wage agreements were allowed to grow, the comptroller noted. Health Ministry negotiations over economic recovery programs with two health funds that ran a deficit would have been a natural occasion to demand cancellation of such benefits, the comptroller suggested, but this was not done. The comptroller also said he had received reports over the years of preference in treatment and free care given by government-owned hospitals to senior staffers and their relatives. These cases raise issues of conflict of interest and clear ethical problems, he said, but nothing was done to halt the practice. All these should be "rooted out" of the health system, the comptroller demanded, especially since they are so widespread that they discriminate against ordinary patients. The possibility of requiring hospital staffers to report to hospital managers when a relative is treated free and to require hospitals to inform the Health Ministry when senior staffers get preferential treatment should be considered, he said. After hearing the criticism, the ministry thanked the comptroller for bringing the subject to its attention and said it would halt these benefits "in accordance with its legal authority." Other problems that the report found:
The Health Ministry has failed to transfer responsibility for psychiatric care to the health funds, a move planned for 1995. In the meantime, mental health services fall between the cracks; patients move from one institution to another, without continuity of care and therapists.
Semen for artificial insemination and in-vitro fertilization is collected without proper safety checks or medical histories of the donors. For example, not all sperm banks performed tests for HIV and other conditions in would-be donors at all or as often as required.
At least two health funds distributed to patients effective, but expensive, drugs in either a haphazard or a preferential manner.
Over the past few years, hundreds of purported new immigrants from the former Soviet Union came to Israel, ostensibly to settle, but in reality only to receive free or subsidized health care and then leave. Many of these were not even entitled to be immigrants under the Law of Return, the comptroller found.