IMA demands that patient copayments be abolished

Medical association says the poor often forgo treatment because of the costs involved.

By JUDY SIEGEL-ITZKOVICH
Pills 311 (photo credit: Courtesy)
Pills 311
(photo credit: Courtesy)
The Health Ministry said Monday that it is waiting for the recommendations of a special committee investigating the effects of reducing or cancelling the public’s copayments for medications and a variety of health services before deciding its position on the matter.
The Israel Medical Association this week issued a call to ministry director-general Dr.
Ronni Gamzu to gradually cancel out-of-pocket payments, based on many studies showing that poor people often forgo medical care because they can’t afford them.
IMA secretary-general Leah Wapner said that the Israel Health Council and other groups advocate the cancellation of such payments, which have steadily increased since the National Health Insurance Law went into effect in 1995.
The argument of the Treasury, which opposes cancellation, is not only that copayments are a steady source of income for the health system but that they also minimize “overuse” of the health system caused by taking “unnecessary” prescribed medications and undergoing tests that are “not needed.”
Wapner said that copayments have stopped serving as a means to reduce “overuse” of healthcare and turned into a barrier to basic healthcare for many Israelis, thus causing health to decline and eventually costing the system more to treat.
Copayments, she added, “enlarge the social gaps and harm the principle of equity” laid down by the National Health Insurance Law.
Advocates of cancellation maintain that abolishing copayments would contribute more to public health than adding new drugs and other medical technologies to the basket of health services.
All health funds charge about NIS 20 per quarter for a visit to a specialist, while Maccabi Health Services charges also for seeing a general practitioner or pediatrician.
About a tenth of the general public admits that they have not gone for a necessary visit to a doctor, while almost a fifth of the lower socioeconomic groups say they forgo going to the doctor because they can’t afford it.
This has been confirmed in surveys by the Myers-JDCBrookdale Institute, the Central Bureau of Statistics and the IMA.
Other copayments are for medications, visits to hospital outpatient clinics and diagnostic institutes and treatment at child development centers. The maximum per-capita copayment for medications used by the chronically ill is as high as NIS 864 per quarter.
Israelis’ out-of-pocket medical expenditures constitute 43% of national health expenses, compared to less than 18% in the United Kingdom and 22% in France.