A non-citizen of Israel who arrived Monday morning at Rabin Medical Center in the 41st week of pregnancy - due to give birth - left the hospital after she says it asked her to pay NIS 11,295 for admittance to the emergency room. After inquiries by Haaretz, the medical center Tuesday admitted her to the ER, where doctors began inducing birth.
The woman, Zhanna Lachkova, 36, from Petah Tikva, is in the process of obtaining an Israeli resident's permit. Currently, she is classified a tourist, and has a Russian passport. With her husband Constantine Lachkova, an Israeli citizen who works in construction, she arrived at the medical center's emergency room expecting that her baby's birth would be induced on the recommendation of a gynecologist. When she reached the emergency room, she says officials demanded that she pay an admittance fee of NIS 11,295.
The Rabin Medical Center stated: "Our review indicates that Ms. Lachkova reached the hospital in circumstances where neither she nor her husband said that she was in labor, and there was no demand that she see a medical professional. The couple asked to clarify costs connected to care procedures at the hospital."
The Lachkovas say when they heard the price, Constantine said he didn't have enough cash on hand, and the two were directed to the hospital's accounts department to work out a payment schedule. At this stage, Zhanna, despite being on the verge of giving birth, had not been admitted for medical care. In the accounts department, the couple was asked to make the steep payment via credit card or check. Constantine says that "when we said there was no way we could raise this sum, we left the hospital. I don't have a clue as to what we will do."
A demand that a payment be made prior to admittance to an emergency room appears to contradict Health Ministry directives, which stipulate that medical facilities must attend to patients directed to emergency room care, even if they cannot make advance payment for services. The directives allow a hospital to demand payment from a tourist who lacks health coverage available to Israeli citizens, but such payment can be exacted only after medical treatment.
Ministry officials stated on Tuesday that "under law, any patient who reaches the emergency room is entitled to be examined by a physician, and this includes a pregnant woman. In a medical emergency, and in the case of a birth, a patient is entitled to immediate treatment without any preconditions, and a hospital is not allowed to make care conditional upon financial arrangements. In the case of the referral of a patient who has no health coverage, as in the case of a tourist, and in circumstances where a pregnant woman is not in labor and needs non-urgent care, a hospital is entitled to demand advance guarantees of payment equivalent to the cost of birth care."
The couple turned on Tuesday to Kav La'oved, Worker's Hotline, for assistance. The NGO's Osnat Ziv explained that "in the case of birth, it often turns out that the cost will be covered subsequently by the National Insurance Institute, and so the demand for payment in advance stirs antagonism. This is an Israeli citizen who is the spouse of the pregnant woman, and so he can be contacted in the future, so the hospital's behavior seems peculiar."
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