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Against the backdrop of labor unrest among the country's doctors, it appears the public health system as a whole will end 2011 with one of the most serious deficits ever seen in the field in the country's history. It is also expected to be the worst since the Public Health Law was passed in 1995.

The country's largest health maintenance organization, Clalit, is expected to finish the year with a NIS 700 million deficit, which is about NIS 500 larger than last year's shortfall. The second-largest HMO, Maccabi, which managed to maintain a balanced budget over the past decade and barely did so last year, is expected to end 2011 with a NIS 300 million deficit, as is the Meuhedet HMO. The fourth and smallest HMO, Leumit, is looking at a NIS 150 million deficit this year.

Among the increased costs that the HMOs have been forced to face have been the increased sums they have paid for hospital stays by their patients. The rates were increased to cover salary increases provided to doctors in 2007. The recent agreement signed between the Finance Ministry and the Israel Medical Association is expected to further increase the fees paid by the HMOs for hospital stays.