Sheba Medical Center: Nation’s largest health fund discriminating against us

"We are buying fewer services, but for the right reasons," says Clalit spokeswoman.

By JUDY SIEGEL-ITZKOVICH
clalit hospital 88 248 (photo credit: Ariel Jerozolimski)
clalit hospital 88 248
(photo credit: Ariel Jerozolimski)
Sheba Medical Center in Tel Hashomer, the country’s largest tertiary hospital, claims that Clalit Health Services, the country’s largest health fund, is “discriminating” against it by referring 11 percent fewer patients for treatment there.
“Clalit is preventing hundreds of its members from receiving continued medical treatment at Sheba,” said the hospital, which added that the health fund refuses to give the “Form #17” referral slip to members, including oncology and cardiology patients and sick children, to receive treatment at Sheba.
Hospital director-general Prof. Zeev Rotstein said he felt terrible seeing “patients wishing to continue their treatment with us who get absolute refusal from Clalit. I hope the situation changes so that the good of the patient will again be foremost among decision-makers.”
He gave an example of a woman who received a recommendation to undergo mitral valve surgery in her heart. But Clalit, said Rotstein, “prevented this and referred the patient to surgery owned by Clalit. Sometimes, the health fund sends patients to the [private] Herzliya Medical Center, of which Clalit is a partner, which is located far from the patient’s home and thus causes logistical problems.”
Asked to comment, Clalit spokeswoman Michal Kiselstein said that Sheba must understand that “healthcare has in recent years undergone many changes.”
She continued that because of expanded services within community medicine, the availability of urgent care centers, and more available access to MRI scanners outside of large medical centers, “fewer patients have to go to hospital emergencies.”
“In addition, less heart surgery is needed because of preventive care,” Kiselstein said.
“Such as pills to lower cholesterol and hypertension, more people exercising, fewer people smoking and angioplasty instead of open-heart surgery.”
Sheba will have to get used to the situation, she said. “It needs income, but no patient is harmed or refused treatment.
They get it in other hospitals closer to them. We are buying fewer services, but for the right reasons.”