New Rules Could Kill Medical Tourism, Hospitals Charge

New policy could spell death knell for medical tourism at public hospitals, directors warn.

Public hospital directors took the Health Ministry to task Thursday over its recent directive stipulating that doctors cannot charge extra for treating foreign medical tourists than they receive for treating Israelis.

In a letter to the ministry, the chairman of the association of hospital directors said the policy could even be the death knell of medical tourism for the country’s public hospitals.

The ministry policy was instituted last week to eliminate any financial incentive to favor treating foreign patients over Israelis. It followed a Channel 2 expose allegedly showing doctors at Ichilov Hospital, Tel Aviv, demanding additional, under-the-treatment-table payments from foreign tourists.

In a letter to the ministry in his capacity as chairman of the hospital directors, Dr. Eran Halperin – who heads the Rabin Medical Center in Petah Tikva – called the policy “populist,” saying that “in one fell swoop [medical tourism] will be seriously harmed and perhaps even collapse.”

The policy directive, he added, will also make it impossible for the country’s public hospitals to compete with private hospitals here. “Our physicians will continue to treat them, but not in our [public] hospitals,” Halperin wrote. “Most of the medical tourism treatment is carried out in the afternoon [after regular hours] and in no way comes at the expense of Israeli citizens. On the contrary, your directive will cause additional anesthesiologists and surgeons to gravitate to the private health-care system along with the funding that is currently at the disposal of the public as a whole.”

“Medical tourism has grown significantly in recent years and I see this growth as something problematic also being pushed by business interests,” Health Ministry director general Dr. Ronni Gamzu said last Monday, at a session of the Knesset Labor, Welfare and Health Committee. He said the country’s public-health system favors the growth of medical tourism because it provides an additional revenue stream for hospitals and doctors, but added that “stringent regulation” was needed.

“I cannot rule out that what we saw on [Channel 2 program] ‘Uvda’ does not exist in other places as well,” Gamzu said. “When surgeons make three to four times more for operating on a tourist than for operating on an Israeli citizen, what does that do to the frequency with which Israelis are operated on in the afternoon? What does that do to the [health] system?”

The new directive bars surgeons or other doctors from accepting a higher payment for after-hours medical care at public hospitals from a foreign medical tourist than is charged for a local payment. (Israelis operated on earlier in the day through the public-health system do not pay these sums, in any event.)

The new policy also bars foreign tourists from paying extra to be assured treatment by a specific physician.

Halperin, whose Rabin Medical Center is comprised of Beilinson Hospital and Hasharon Hospital, said the result of the new policy will be that tens of millions of shekels in revenue will be diverted to private hospitals such as Assuta Medical Center in north Tel Aviv.

“If there is a management failure at Ichilov, it should be addressed and the doctors involved should be investigated by the police rather than punishing the entire system,” Halperin wrote. “If they force me to pay a surgeon 2,500 shekels ($716) for an open-heart surgery [on a foreign tourist], when for the same surgery he gets paid five times that at Assuta, it’s clear what he will choose.”

Nir Kafri