Treasury pushing for fifth health fund to compete with others.
By JUDY SIEGEL-ITZKOVICHPublished: JUNE 24, 2010 00:24Advertisement
Just a week before subsidized dental care is provided to children through the age of seven, the Finance Ministry is insisting that a fifth health fund – “for dental care only” – be established to compete with the four existing comprehensive health funds.The Treasury says the arrangement will allow private dentists to supply treatment to young children as well as those working for the four health funds. However, there is no explanation why an additional health fund – a private one – needs to be set up for this purpose instead of a voucher system or another mechanism to allow parents to take their children to any provider they wish.The Health Ministry spokeswoman said Wednesday that Deputy Health Minister Ya’acov Litzman and the ministry opposed the establishment of a private health fund. She said the four health funds carried out their responsibilities in an “excellent way.”A fifth health fund for dental treatment, however, “is not connected to a fifth (and private) health fund for all medical services. It would allow private dentists in independent clinics to compete with public health fund dentists and prevent their moving to a closed market that would harm the level of dental care,” she stated.“It is unthinkable that private dentists would be barred” from offering their services, which would be the case under the existing system, the spokeswoman said.Prof. Gabi Bin-Nun, for many years the Health Ministry’s chief economist and currently a professor of health economics at Ben-Gurion University of the Negev, charged Wednesday in a letter to MKs that the proposal was “just the Treasury’s way of introducing through the back door” a fifth, private health fund for all health services.This, maintained Bin-Nun, would steal the wealthy, healthy and young away from the four funds and cause severe damage to the public insurers and to the principle of equity.The government bill for a fifth health fund for dental care was presented recently and passed on its first reading. Bin- Nun sent Wednesday’s letter to MKs on the Knesset Labor, Social Affairs and Health Committee, which will meet on Monday morning to discuss the government bill.The Finance Ministry spokesman claimed that a fifth health fund would be required to meet all the demands borne by the four public health funds for providing quality dental care to young children around the country in an equitable and accessible way. He stated that a fifth insurer would be established only for child dental care and not to provide all the medical services that Clalit, Maccabi, Meuhedet and Leumit have been providing under the 1994 National Health Insurance Law. He said a new insurer would not have to be for-profit.The Maccabi Health Services spokesman, meanwhile, said it was in favor of competition, but did not believe that a fifth fund would be required to meet the same criteria as the other four. In any case, the vast majority of Israelis have been shown in surveys and studies to be satisfied or very satisfied with their services.Bin-Nun wrote to the MKs that most people supported Litzman’s initiative to introduce dental care, even if only to small children and not the elderly, to the basket of health services. But setting up a fifth health fund was not needed and would be very harmful, the BGU economist said.“This proposal lacks all economic, social and medical logic and is meant only to promote sectorial interests and serve in the future as a platform for a future fifth – and for-profit – health insurer,” he said.Such a system does not exist anywhere in the world, Bin- Nun declared.The best way for a company to make profits in health services, he continued, is to choose its customers carefully to exclude the elderly, sickly and poor. This would bring about a return to the old health system, before National Health Insurance was established, under which “undesirable” people were refused membership. The Treasury, especially during Binyamin Netanyahu’s terms as prime minister or finance minister, has tried for years to establish a fifth, for-profit health fund.A vast majority of the National Health Council voted to oppose the establishment of a fifth health fund for dental or other services.
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