Not-for-profit dental HMO gets Knesset committee support

The Knesset's Labor, Welfare and Health Committee yesterday threw its support behind a bill that would establish a new health maintenance organization to provide dental care to children.

The legislation, which is sponsored by the government, will now go to the Knesset plenum for a vote on second and third readings, after which, if approved, it would become law.

Unlike an initial proposal, according to its current formulation, the new HMO would not be a for-profit entity. Instead, it would be set up purely for public benefit, and would be subject to all of the obligations that the four existing HMOs are required to abide by, including that it have branches nationwide and not discriminate among patients.

As currently drafted, the bill also stipulates that no insurance company or party that controls an insurance company can own the new dental HMO and no personal patient information from existing HMOs would be transferred to the new entity. The new dental health maintenance organization is to be established within four months.

Since the beginning of the month, the state has been funding dental care for children up to age 8, provided through the existing HMOs.

An agreement between the Health Ministry and the Finance Ministry provides for the gradual expansion of state-funded dental care, which is to include children up to age 14 by 2013.

The bill approved in committee would enable parents to opt for state-funded dental care either from their current HMO or from the new entity. If the bill passes as currently drafted, the new organization would also be authorized to offer supplementary coverage for a fee for treatment, such as orthodontia, that is beyond the dental care included in the state-mandated plan.

In light of the restrictions on the new dental care entity, industry observers think it likely that the new HMO will be run by the Israel Dental Association itself. According to Rami Adut, who coordinates the issue of access to medical care at the Association for Civil Rights in Israel and heads the public coalition on dental care: "Though there is still the potential that private parties with a financial interest will enter the public health system, the members of the [Knesset] committee and the professional staffs of the government ministries should be praised for accepting most of the reservations to the bill proposed by the coalition and seeing to it that there was proper regulation over a fifth HMO and equal dental services for all."

He added: "We will stand guard to make sure that within a few years we don't find that the [new] HMO is skimming off the cream and is composed of well-off doctors dealing with well-off clients and operating primarily in the center [of the country]."

The chairman of the Israel Dental Association, Yitzhak Chen, said: "This is an important decision for the State of Israel, through which the country's children will be able to receive the best treatment from the best dentists without additional cost."