The Prime Minister's Office seeks to expand medical tourism in Israel, to the chagrin of the finance and health ministries, which fear that more medical tourism will mean less service for Israelis.
The ministries say local hospitals are already overcrowded and understaffed, and there is not enough room in medical wards. But medical tourism reaps nearly NIS 500 million a year for Israel, and both public and private hospitals take part.
Many medical tourists come from the former Soviet Union. An estimated 30,000 patients come to Israel every year for treatment; cancer treatments make up 80% of the market.
Last week, the director general of the PMO, Harel Locker, met with senior officials from the finance, health and tourism ministries. He asked the participants, including Deputy Health Minister Yaakov Litzman, to put together a plan to increase medical tourism.
Not everyone involved is bullish on the idea.
"The [health] system is already operating at full capacity; there are no empty wards with extra doctors," said a senior health official. "So if we bring in more patients it will come at the expense of Israeli patients."
In addition, because of the high prices the tourists pay - much higher than what Israeli hospitals are reimbursed for by the state or health funds - officials worry that hospitals will give preference to foreigners. This will lead to distortions in the allocation of resources, said the senior official.
The ministries also fear that increased private medical care for tourists will lead to inflationary wages for doctors, which could upset the delicate balance keeping the health system functioning.
Litzman has his own recommendation on the matter: Take private medical tourism out of the public hospitals and move it exclusively to private medical centers. The goal is to prevent medical tourism from cutting into the operations of the public system - as is happening today, said sources close to Litzman.
"The matter is still under examination," the PMO said.
The hospitals with the largest revenues from medical tourism are the largest hospitals in general, such as the Hadassah medical centers in Jerusalem, Sheba Medical Center in Tel Hashomer, Rambam Medical Center in Haifa, Ichilov Hospital in Tel Aviv and Assouta Medical Center in Tel Aviv.
State hospitals took in NIS 240 million in revenues from medical tourism in 2011, based on figures the Health Ministry provided TheMarker. This was a 50% increase over 2010, when the figure totaled NIS 168 million.
These figures do not include private hospitals or those belonging to Clalit Health Services, such as Hadassah, Assouta or Beilinson Hospital at the Rabin Medical Center in Petah Tikva. These hospitals are estimated to take in more than twice as much from medical tourism as the public ones do.
The amounts paid by foreigners are about 50% higher than what the hospitals receive for treating Israelis. In addition, tourists usually pay immediately, or in advance, and the hospitals do not have to wait months for reimbursement.
Medical tourism also brings in hefty revenues for the Israeli tourism industry, as most patients are accompanied by family members who then stay in hotels and spend elsewhere, often for extended periods. Most of the medical tourism industry operates via agencies, often over the Internet.