Politics of health / PM's talk of health care 'revolution' fools nobody
The facts on the ground tell only of deteriorating services.
Faced with harsh criticism targeting his planned health care budget cutbacks, Prime Minister Benjamin Netanyahu hurriedly issued a proper Zionist response. Claiming that "in the past three years the government executed a revolution in health care for the benefit of Israeli citizens," the Prime Minister's Office on Sunday listed the government's achievements in this area: A wage agreement with doctors and nurses; setting up of emergency medical outposts in 12 Negev and Galilee communities; the addition of 960 hospital beds, following a decade in which not even one was added; the establishment of a new medical school; and the introduction of subsidized dental care for children. The statement concluded: "The basket of health services provided by the state and the health maintenance organizations won't be harmed."
Did he say a revolution in health care? A good dose of sarcasm is needed to make such a statement. It doesn't take special expertise in this field to grasp that rather than a revolution, we have experienced erosion in health resources over the last few years, and that the system is undernourished and on the brink of collapse.
Being hospitalized several days and getting stuck in corridors or the ER without gaining admission to a ward, or even just visiting a family member, is enough to see what's happening. Just try scheduling a visit to a specialist or a test at an HMO and being given an appointment several months away. Or just walk around the wards at night and watch the one doctor on duty run between patients, or sometimes between different departments. Either way, that would be enough to see what Netanyahu isn't admitting: There isn't any revolution here, but rather devolution.
It must be admitted that everything mentioned in the statement from the Prime Minister's Office occurred under the current administration: The additional beds were provided for - although many haven't been put into use yet for bureaucratic and budgetary reasons. The wage agreements were signed, the dental treatment was inserted into the basket of services, and a medical school was established. All this is fine and dandy, but it doesn't even begin to fill the yawning health budget gap, estimated at a cumulative NIS 9 billion, that's been widening since the National Health Insurance Law took effect 17 years ago, a gap placing us at the bottom of OECD rankings with regard to innumerable parameters of public health care.
The policy of devolution has been implemented by all governments, including Netanyahu's. Here's how it works: A steady erosion in compensation paid to HMOs for their rising costs, along with demographic creep - a widening gap between the growth and aging of the population on the one hand, and the budgeting of HMOs on the other. Netanyahu may have already forgotten that in a recent ruling, the High Court of Justice pointed made the unprecedented statement: "The right of Israeli citizens to health care, as designed and enshrined in the National Health Insurance Law, is slowly being rendered meaningless in view of the systematic erosion of HMO budgets."
If we were populists, we would say that none of this can be seen by cabinet ministers and Knesset members who always receive the hospital treatment reserved for VIPs. So let's just say that facts seen on the ground can't be obscured by meaningless talk about revolutions.