'Resolving doctors' labor dispute won't fix healthcare'

Taub Center report identifies reduction in efficiency in health system, expressed through medical services inflation, access to services.

By JUDY SIEGEL-ITZKOVICH
Doctors demo311 (photo credit: Marc Israel Sellem)
Doctors demo311
(photo credit: Marc Israel Sellem)
No matter how the current doctor labor dispute is resolved, an agreement is unlikely to fix fundamental problems that the Israel Medical Association insists on solving before halting sanctions, suggests Prof. Dov Chernichovsky, a senior health economist at Ben-Gurion University and researcher at the Taub Center.
He wrote a chapter on the country’s medical system as part of a wider report the Jerusalem institute is issuing on Wednesday that also takes in economic and social problems in Israel.
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Chernichovsky identified a reduction in efficiency in the health system, as expressed through relative inflation for medical services and reduced access to healthcare for certain parts of the population. In addition, a change in the capitation formula instituted by the government to strengthen medical services in the periphery has not worked, increasing gaps between outlying areas and the center of the country rather than shrinking them, the health economist wrote.
As an example, he cited evidence of increasing levels of infant mortality among Beduin in the Negev, countering a trend in recent years of lower infant mortality among this population.
Chernichovsky said that the Israeli health system is “at a crossroads” between rejoining leading Western countries with better healthcare, or becoming “Americanized” – a process that the US is now trying to escape – with health systems that offer less-developed healthcare.
Although in recent years Israelis – especially haredim and Arabs – have expressed high satisfaction with their medical care, signs of cracks have begun to show in satisfaction levels due to the shortage of doctors, dearth of specialists and overcrowded facilities, he wrote. A government policy encouraging higher demand for health services resulted from a serious decline in state spending on health and a major increase in out-of-pocket expenditures.
The 6% increase the government proposed for the funding of doctors in the periphery will not be effective, he charged, suggesting that unless changes are made, the “pull” to the center of the country will make the periphery even weaker.
Private medical facilities manned by physicians who also work at public medical facilities has caused much harm by reducing the quality and amount of medical services in public hospitals, Chernichovsky contended.
He urged that the national expenditure on medical care be increased by around 9.5% by 2020, with state spending returning to the level the country enjoyed in 1995. He also called for giving everyone the right to choose hospital specialists and receive a second opinion by an expert of his choice, and for improving the wages and conditions of medical residents.