Other health funds upset over Maccabi's stats

Clalit Health Services, Kupat Holim Meuhedet and Kupat Holim Leumit have complained to the Health Ministry.

macabi 88 (photo credit: )
macabi 88
(photo credit: )
Clalit Health Services, Kupat Holim Meuhedet and Kupat Holim Leumit have complained to the Health Ministry and to coordinators of the National Health Indicators System over Maccabi Health Services' publication of its own statistics on preventive medicine and treatment of chronic illnesses. The Maccabi statistics, which generally show improvement in its performance but do not break down results according to its members' socioeconomic and geographic data, were mailed to all members via the Maccabiton newsletter and published on the health fund's Web site (www.maccabi4u.co.il) a few months ago. Health Ministry director-general Prof. Avi Yisraeli recently called on all four health funds to abstain from publishing their own data unilaterally, as no mechanism has yet been worked out to put the statistics in perspective by giving socioeconomic and geographical data available from the Central Bureau of Statistics. The head of the Health Ministry-endorsed project, Prof. Avi Porath, who is a senior physician in the Clalit-owned Soroka-University Medical Center in Beersheba and part of Clalit's medical policy branch, told The Jerusalem Post that Maccabi's unilateral release of its own data "has endangered the whole project," because the other health funds are angry and liable not to cooperate voluntarily. The ministry, which wants to see how well the insurers are screening members for chronic diseases and preventing those diagnosed with them from developing complications, has encouraged the health funds to treat the disadvantaged in cities and developments as they do higher socioeconomic groups. But the national data released, and the figures provided by Maccabi, represent only national averages, and do not reflect prevention, diagnosis and treatment in specific areas. Porath's report, issued by the Israel Institute for Health Policy and Health Services Research at Tel Hashomer and the Israel Health Council, was published Sunday on the ministry's Web site at www.health.gov.il/Download/pages/public-report-English-2002-2004.pdf) in the form of a 62-page report. The new report, covering 2002 to 2004, looked at the health funds' diagnosis and treatment of diabetes and cardiovascular disease; asthma in children; use of mammography to detect breast cancer in women; and immunizing high-risk populations against influenza. Porath said he hoped in the next report to get unanimous approval by the health funds to put the data into a socioeconomic perspective and to expand the number of reportable health indicators. This would determine whether the insurers were making sure their poor and elderly members and those in the periphery received the same care as their more economically advantaged members in the center of the country, he said. Although Maccabi "jumped the gun" with its self-publication of statistics, Porath said the new report was a major achievement, as he was aware of no other country in the world that had published health indicators on a national basis. In the US, and even in Scandinavia, health maintenance organizations release health statistics "in a way that flatters them, giving what they choose to look good," he said. Maccabi Health Services director-general Prof. Yehoshua Shemer, a former Health Ministry director-general, was proud of his health fund's data. His spokesman, Ido Hadari, said Maccabi advocates "full transparency of health fund data, and if other health funds have a problem with that, apparently they prefer not to expose their own data." Hadari denied that Maccabi's release of its own data was meant to attract members from other health funds. "It will not bring one new member," he said. "But clinics and staffers who know their performance is being monitored will naturally improve, and that will benefit our members." Hadari said Maccabi released its data before Yisraeli issued the warning to health funds against unilateral release of their statistics. "We can't remove it from out Web site because it is already in the public domain," he said.