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Maccabi joins other health care funds in raising fees for consulting doctors
By Ronny Linder-Ganz

Private consumption on healthcare in Israel, one of the highest in the world, continues to soar. The Kupat Holim Maccabi health maintenance organization raised its policyholder participation fee (deductible) for a number of services, joining the wave of price increases already implemented in HMOs Clalit and Meuhedet in May. For instance, the price of a visit to a general practitioner or gynecologist has gone up from NIS 6 to NIS 7. The price increase does not apply to medicines.

The State Health Insurance Law enables HMOs to readjust deductibles once a year, based on any increase in the healthcare cost index. Healthcare costs this year have risen steeply by 3.89%, due among other things to an arbitration ruling over doctor fees, which provided for a 24% increase to doctors' salaries.
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Kupat Holim Leumit is the only HMO that has not increased its deductibles, although it has received formal authorization to do so. A spokesman for the HMO said it has not yet decided when rates will be increased, or by how much.

In addition, with the rise of VAT rates from 15.5% to 16.5%, participation fees for drugs are set to rise by a total of NIS 20 million annually.

The Health Ministry is not pleased with the rising cost of participation fees, which are already placing a very heavy burden on HMO members, and in some cases even preventing them from receiving care. Nevertheless, the adjustment is an automatic one that the ministry is obliged by law to approve.

Deputy Health Minister Yaakov Litzman, who has said more than once that he would act to reduce participation fees, said that the matter is under review. "The ministry intends to implement major changes in the charging of participation fees, and will shortly be publicizing its position," Litzman announced.

"The law provides for an automatic mechanism that allows HMOs to increase fees even if they have experienced no actual increase in their expenses," a high-ranking source in the health ministry said. "Unfortunately, there is no opposite mechanism to protect consumers, for instance, a mechanism for automatic adjustment of the healthcare basket."
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