Gap in health services between well-off, poor widens

15% of financially disadvantaged residents had to forgo treatment for a child, compared to 4% of those living in well-established communities.

By JUDY SIEGEL-ITZKOVICH
poor person 298.88 (photo credit: Ariel Jerozolimski)
poor person 298.88
(photo credit: Ariel Jerozolimski)
It is becoming increasingly difficult for the economically disadvantaged in the cities and the periphery to take advantage of their rights, as "guaranteed" in the National Health Insurance Law. Twenty-nine percent of them claim in a new survey that they cannot get medications from their health fund that are in the official basket of health services and drugs. A representative sample of 950 adult Israelis in the center and periphery of the country as well as of the middle class and the poor responded to the survey by the Geocartography Institute, conducted for the Israel Medical Association. The results are evidence to increasing inequity in the health system, despite the principle of equity set down in the National Health Insurance Law of 1994. The gaps between the financially well-off and the disadvantaged are increasing, the survey found. Twenty-eight percent of residents in the North had to forgo a visit to a medical specialist (for whom copayments are charged) during the past year, compared to 11% of the general population. Fifteen percent of residents of cities and the periphery who are financially disadvantaged had to forgo treatment for a child, compared to 4% of those living in well-established communities. Twenty-one percent of residents of the North and 17% of those in areas of economic disadvantage said they did not buy medications they needed because they couldn't afford them, compared to 17% in 2008 and 13% in 2007. Fully 21% of northern residents and 15% of those in a low socioeconomic locality had to forgo medical care for their children, compared to 9% of the general population and 4% of the well-off sectors. Similar figures were found among those who take care of elderly relatives. Almost half of those who had to forgo medical care because they could not afford it said their health had declined in the the past year; this 49% rate was compared to only 37% who said this a year ago. Sixteen percent of respondents said they did not receive a necessary medication from their health fund that was not in the basket of health services and could not get it even from their supplementary public health insurance policies. Among the financially disadvantaged, 22% said they could not get such medications. Two-thirds of those patients who did not get drugs that were outside the basket bought the medication themselves. But in disadvantaged areas, 52% said they were unable to buy such drugs, compared to the 82% of the financially solid who were able to purchase such drugs out of their own pocket. Sixteen percent of those surveyed said their health fund refused to supply them with medications that were in the basket of health services. Three percent argued with the health fund and received it. In low socioeconomic areas, 29% said that their health fund refused to supply them with a medication that was included in the basket. Finally, almost seven in 10 polled said they were skeptical about the government's claims that it would expand the basket of health services by adding new lifesaving and life-improving drugs. Nearly two-thirds said they were worried that the financial burden of buying medications and paying for health services would increasingly fall on them.