Health system budget to be both cut and expanded

There is no high-quality and equitable medicine without additional investment, says medical official.

Health Minister Yael German 370 (photo credit: Courtesy Knesset)
Health Minister Yael German 370
(photo credit: Courtesy Knesset)
After the budget vote on Tuesday morning, Health Minister Yael German said she was very pleased with the result, although NIS 150 million in cuts were made to the health budget, an additional NIS 1 billion was allocated to expand economic resources for the financially troubled public health system.
The four public health funds, and the ministry itself, were the main benefactors and are charged to carry out obligations in the community and hospitals. The insurers will receive a total of NIS 100m.-140m. in compensation for demographic changes (older members with more disease).
In addition, the health cost index will change to make compensation for the funds more realistic compared to their costs, German said.
“This arrangement gives an appropriate answer to the recent ruling of the High Court of Justice on updating financing of the health funds,” she added.
The basket of health services will be updated during the next two years by NIS 300m. each time – the same as in the previous three years, but it will not be cut.
Health experts have insisted that the basket be updated by an automatic two percent each year (this would double the expenditure to cope with the aging and expansion of the population), but the Treasury vetoed the idea.
As for the per diem rates for hospitalization, German said a “historic agreement” was reached with the Treasury to “promote prices in the general hospitalization system using only external indices.”
This, she said, “is a significant breakthrough that will contribute to the independence of hospitals.”
Despite Treasury threats to increase co-payments for prescription medications and other medical services, they will not be hiked.
German said that between 2013 and 2018, the ministry’s development budget will increase by NIS 380m. This money will be used to build more hospital facilities and finance manpower and equipment, not only in general hospitals but also psychiatric institutions.
An additional 185 psychiatric beds will be provided under this agreement.
Money was also provided to increase the number of medical students by 50 next year. This will bring their number in the five university medical schools to an unprecedented 850 annually.
The minister said that in the last six weeks since she took office, she became convinced that she must work hard to strengthen the public health system, invest in weak populations and narrow socioeconomic gaps. Additional financial sources for the system, especially for the health funds, will “improve service to the people. I am aware of the existing shortage and the many challenges that we face, but I believe the budget brings a message of development, growth and the strengthening of the public health system.”
Israel Medical Association chairman Dr. Leonid Eidelman said after the budget was finalized that “there is no doubt the public medical system needs much more funding to meet our needs. The details made public provide only a partial answer. On the one hand, we welcome the increase in funding to the public insurers, the hike in the number of medical students and cancellation of higher co-payments by the public. On the other hand, we see that what one hand gives, the other hand takes. It seems that the basket of health services will not be increased, and that the ministry’s budget will be cut by NIS 150m.”
The result, said Eidelman, is that “the economic program for health is really inadequate. As we warned in the past, there is a need to invest no less than NIS 3b. more to try to reach the rates in the leading OECD countries. If not, patients will remain in the corridors, they will wait long periods for operations and other medical procedures and we won’t be able to take advantage of the most advanced medical technologies. Without additional investment, there is no high-quality and equitable medicine.”