Health fund protests higher hospital charges

Clalit Health Services petitions High Court of Justice for a rollback of the increase.

health operation surgery 88 (photo credit: Courtesy)
health operation surgery 88
(photo credit: Courtesy)
After the Health and Finance ministries raised - by nearly 5 percent - the per-diem hospitalization rate that the health funds pay hospitals for treating their members, Clalit Health Services last week petitioned to the High Court of Justice for a rollback of the increase. The country's largest health insurer said the hike would cost it NIS 350 million to NIS 400m. a year. Clalit maintained that according to its calculations, based on the world economic crisis and the drop in prices, the per-diem hospitalization rate should actually have been reduced by 0.54%. The Health Ministry said on Thursday that it had not yet received Clalit's brief to the court and when it did, it would respond to the justices. Clalit charged that the government hospitals had failed to apply efficiency measures and cuts to reduce their expenses, and that they should not be "rewarded" by greater reimbursement for treating health fund members. The health fund, which insures a bit more than half of the population, said it was forced by the government to give the state hospitals over half a billion shekels in discounts; such discounts hadn't been demanded from the other three health funds, Clalit said. The largest health insurer said that by being both the owner of government hospitals and the ministerial authority that sets per-diem fees, the Health Ministry had an inherent conflict of interest that "violates the National Health Insurance Law." Maccabi Health Services, the second-largest health fund, has also presented its objection to the rates rise before the court. The insurers say they were not asked to present their views before the two ministries decided on the new rates.