MK Yaakov Litzman Sept. 16, 2010 Emil Salman
Former Deputy Health Minister Yaakov Litzman Photo by Emil Salman
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Deputy Health Minister Yaakov Litzman seeks to increase the health tax by 0.5 percent to support geriatric insurance for all citizens, he announced yesterday. The new product would be offered by the four health maintenance organizations.

Today, geriatric nursing is not included in the health basket and is not the responsibility of the HMOs. Only low-income families receive funding from the Health Ministry.

Although 64 percent of Israelis have geriatric nursing-care insurance, mostly through extended insurance programs offered by the HMOs, these schemes are only a partial response to patients' needs and block them from moving among HMOs.

Litzman made his announcement at a conference of the National Institute for Health Policy. He said geriatric nursing care would be the next reform in the health-care system, following his support for publicly sponsored dental care for children last year.

In May 2008, the state comptroller criticized the state of geriatric nursing care in Israel, citing the split between rehabilitative treatment and nursing care.

Under the current system, rehabilitative treatment falls within the purview of the HMOs, but if a patient is beyond rehabilitation, he is moved to privately-sponsored nursing care, with only the most impoverished families getting state support. If the patient's state deteriorates further, he is defined as requiring advanced nursing care, and responsibility moves back to the HMOs.

Proposals for moving responsibility for people requiring geriatric nursing care to the HMOs have been on the table since 2004, but the comptroller said in 2008 that these proposals were based on flawed financial data.

Three years ago, the health minister at the time proposed a rise in the health tax by 0.3 percent to support geriatric nursing-care insurance for all citizens. A survey by the Gertner Institute found that most people would support an increase in the health tax by NIS 20 to NIS 50 for this goal.

Health-care officials were skeptical yesterday on whether Litzman would be able to push the reform through. "Generally, government policy is to reduce the tax burden, including the regressive health tax," one official told Haaretz.

"So the treasury opposes raising the health tax. Including more services in the health services basket - something that could cost hundreds of millions of shekels a year - will be decided on according to the government's priorities."

Meanwhile, Health Ministry Director-General Roni Gamzu announced yesterday the goals of the ministry's new four-year plan. The program seeks to bolster public medicine in Israel, reduce inequality in health care, and improve service awareness at medical institutions across the country.

Gamzu said the ministry would promote legislation to ensure that more funds are added to the health basket every year, extending the operating hours of public hospitals and improving service at hospitals with the help of opinion polls.

A Haaretz report earlier this year led the ministry to set up a committee to consider establishing guidelines for medical tourism in state hospitals, to ensure that treatment for such patients does not come at the expense of Israelis treated in the public health-care system.

The ministry will also begin taking steps to reduce smoking and salt consumption. According to the ministry, an average Israeli consumes 10 grams of salt per day, while most Western countries have managed to bring this number down to 7 grams. Gamzu said the move would be pursued in cooperation with food manufacturers.

The ministry said it would also act to check the growth of private health insurance policies in Israel. Gamzu said the percentage of Israelis buying such policies could grow from the current 35 percent unless the ministry takes action.