State Comptroller Micha Lindenstrauss is about to drop a bombshell on the health system. Sources inform ''Globes'' that, as part of a special report due to be published soon, he will recommend considering the complete abolition of private medicine in Israel, or at least greatly restricting it.
Ministry of Health officials already have very strong reservations about some of the recommendations, including raising insurance premiums and patients' participation in the cost of medical procedures at private hospitals.
Lindenstrauss is reportedly worried that private medicine is accessible and too cheap for many policyholders through supplementary health insurance policies, which unnecessarily raises individuals' spending on healthcare, due to needless procedures through the private healthcare systems.
Lindenstrauss's criticism was partly influenced by the doctor's strike last year, which failed to provide a solution to the hospital administrators' main contention that is not possible to stop senior doctors going to private hospitals in the afternoon for extra pay, except by cancelling supplementary health insurance or diverting its use to government hospitals. There has been a sharp rise in surgical procedures at private hospitals in recent years alongside a drop in procedures done at government hospitals.
Hospitals' income falling
These trends have hit the incomes of government hospitals, and created a bypass route known as "medical tourism": a private practice for all intents and purposes within the walls of government hospitals intended only for foreign patients, and which often comes at the expense of Israeli patients. It seems that Lindenstrauss will criticize medical tourism as well and its effect on Israeli patients.
Sources say that the Ministry of Health is already readying to deal with Lindenstrauss's report. Earlier this week, ministry director general Prof. Ronny Gamzo appointed a special team to examine the consequences of the fact that Maccabi Healthcare Services owns 100% of private hospital network Assuta Medical Centers Ltd., and Clalit Health Services owns 40% of the private Herzliya Medical Center. One line of argument at the ministry, which apparently is in line with Lindenstrauss's criticism, hold that the health funds' ownership of private hospitals creates an incentive to send insured patients to them for private care.
Other Ministry of Health officials believe, however, that transferring the private hospitals from health funds to private investors is liable to strengthen private medicine. "A purely private party will want to maximize profits, and it will do so through more aggressive marketing," a ministry official told "Globes". He added, "No one says that the way to strengthen public medicine is by destroying private medicine."
If the health funds are forced to sell their holdings in private hospitals, Maccabi will be the main victim. Maccabi, through Assuta, owns 70% of the licenses for private operating theaters. The other licenses are held by Herzliya Medical Center, Elisha Hospital in Haifa, the Tel Aviv Medical Center Hospital, the MRB Medical Center in Bat Yam, and others.
Health Ministry's two hats
Gamzo is also preparing for the expected counter-arguments from Maccabi and Clalit. In a letter to the ministry team he appointed, he explicitly states that their appointment was made "with attention paid to the potential conflicts of interest of the ministry and health funds' ownership of government and private hospitals."
This clarification was made in view of the repeated criticism by the health funds that the Ministry of Health wears two hats: on one hand, it is the regulator, while on the other hand, it is the owner of government hospitals and has a clear interest in strengthening them.
The fact that all the team members are Ministry of Health officials is already a source of criticism in the health system.
Published by Globes [online], Israel business news - www.globes-online.com - on January 19, 2012
© Copyright of Globes Publisher Itonut (1983) Ltd. 2012