The overhead costs – on marketing, operation and administration – for supplying
supplementary health insurance comprised 28 percent of all income from members
who hold such extra policies from Kupat Holim Leumit and 25% from Kupat Holim
Meuhedet. This compares to the more-efficient Maccabi Health Services, 13%, and
Clalit Health Services ,16%.
The statistics were disclosed in a new
annual report on supplementary health insurance compiled by the Health Ministry
and an independent accountancy firm for publication on Monday.
the supplementary health insurance plan of Maccabi – the second-largest public
health fund – was found to be in deficit for the second year in a row, and its
managers were instructed by the ministry’s deputy director- general, Dr. Yoel
Lipschitz, for supervision of the health funds to reach a balanced budget in the
All four health funds offer their members different types of
supplementary health insurance beyond the basic coverage required as part of the
National Health Insurance Law. According to the report, in 2010, 73% of
residents hold some supplementary health insurance from their health
The main benefits of paying for supplementary health insurance are
operations not included under the health basket and choosing one’s
Medications not in the official basket of health services are
not provided under supplementary health insurance policies. Fully NIS 865
million, or 38% of the health fund’s supplementary health insurance policy
income, went for operations and choice of surgeons, in private hospitals or
public hospitals with legal Sharap [private medical service] services.
surprising finding in the report is that fully 60% of those who receive
allotments for disability or old-age with income supplements have supplementary
These holders apparently regard the basic health
insurance coverage as inadequate and want additional coverage for their
Until now it was widely thought that those on the lower rungs
of the socioeconomic scale do not usually take out supplementary health
insurance. Lipschitz told The Jerusalem Post on Sunday that among the 27% who do
not hold supplementary insurance are an unknown number of wealthy residents who
do not need it and enjoy expensive private health coverage instead.
report was prepared by Revital Topper-Haver Tov of Lipschitz’s office and Dafna
Ravid-Barzily of the Barzilay & Co. accounting firm.
According to the
authors, residents paid NIS 2.878b. for their supplementary health insurance in
2010 compared to NIS 2.585b. in 2009. The average annual payment was NIS 507 in
Clalit, NIS 531 in Maccabi, NIS 532 in Meuhedet and NIS 558 in Leumit.
the nearly 8 million Israeli residents, 5.578m. had supplementary health
insurance from their public health funds in 2010 – a 2.1% increase over the
previous year. Clalit’s supplementary insurance holders grew by a significant
34% in 2010, followed by 9% in Meuhedet, and by 3% each in Maccabi and
According to ministry regulations, health funds‚ supplementary
health insurance programs must be balanced; they may not be in deficit, at least
over an average of three or four years in a row, and if they enjoy a surplus,
they must plow the extra funds into their regular healthcare services.
Maccabi, which had deficits of NIS 21m. in its supplementary health insurance in
2010 and NIS 39m. in 2009, Lipschitz instructed the health fund not to continue
to do so next year.
Asked to comment, Maccabi management said “the report
shows that our Maccabi Zahav plan is the most worthwhile and efficient of
Maccabi leads with the highest percentage of members who take
advantage of this plan; 92% of payments for this return to members for
additional treatments and service.”
In addition, Maccabi said the charges
for this policy are the lowest of the four in almost every age group. The health
fund added that many holders of its supplementary health insurance plans use it
for extra care for fertility treatments and ultrasound scans for pregnant women
that are not covered by ordinary health insurance.
Maccabi to increase the efficiency of its supplementary health insurance plans,
examine which services are not widely used and not to raise its premium without
Maccabi told the ministry it accepted a three-year plan to
cover its deficit.
Only a minority of holders of Meuhedet’s top-level
(more expensive) Si supplementary health insurance plan actually received
benefits, as the “benefits” are not practical and not widely used, Lipschitz
said. So if the Si plan is not made more realistic and attractive, the ministry
could force the health fund to cancel it. Holders of this policy should check
carefully to determine whether they are getting their money’s worth, Lipschitz
Meanwhile, Leumit said that on January 1, it expanded its care for
preserving the dental health of children up to 18 if their parents hold Leumit
Zahav supplementary health insurance. The treatment will be provided at 300
private dental clinics around the country, as Leumit does not have its own
dental clinic subsidiary.
A copayment of NIS 20 will be charged per
child; this Leumit program offers more options than the plan instituted by the
ministry for children up to the age of 10.
Leumit said its plan has
“computerized national objective supervision of the professionalism of dentists,
care and prices” – the ministry’s plan is not supervised by independent
authorities outside the ministry. However, the ministry gave Leumit approval to
launch its new dental program.