Israeli Minister Wants Doctors to Decide Benefits, Not National Insurer

Over the years thousands of complaints have been lodged about the way the NII committees handle applications

wheelchair
Dreamstime

Social Affairs Minister Haim Katz is in favor of a bill by which the disabled would no longer have to appear before a medical committee to determine the disability benefits they are entitled to. Such decisions would now be with an applicant’s doctor, not a committee at the National Insurance Institute.

The private member’s bill, proposed by MK Miki Rosenthal (Zionist Union), is to come up for a vote Sunday at the Ministerial Committee for Legislation and has won Katz’s support over the vehement opposition of the NII. The vote might be postponed for a few weeks until understandings can be reached between the institute and the Social Affairs Ministry.

According to the bill, disabled people applying for benefits will be able to submit documents to the NII signed only by their own physician. An NII committee would only be able to summon the disabled to appear before it in unusual circumstances that will be outlined in the law.

In only a few minutes, the doctors who serve on an NII committee decide a person’s disability level, and consequently the monthly payments that person is entitled to. Each year some 300,000 of such committee meetings are held.

Over the years thousands of complaints have been lodged about the way the committees handle applications, citing an attitude of suspicion and disrespect among committee members, as well as decisions for low allowances without an explanation. In 2010, a state comptroller’s report found that more than half the cases in which appeals were lodged the appeals were found justified and the decisions were changed.

The NII committees are “outmoded, clumsy, costly and humiliating,” Rosenthal told Haaretz. “This is one of the most notorious intersections between citizens and the National Insurance Institute. No expert has ever been found who can explain why a person with a chronic and incurable disease has to drag himself again and again to appear before a humiliating medical committee.”

One of the main arguments against the NII committees is a concern about conflicts of interest. The NII pays out the benefits, which ostensibly could be a reason to keep the payments low. The NII also appoints the doctors to the committee and pays them, which could affect their decisions.

A panel appointed to examine the issue recommended that a main problem with the committees was their members’ dependence on the NII. The panel recommended placing responsibility for determining benefits to an outside body that would come under either the courts administration or the Health Ministry.

Katz said he understood the NII’s objections to the bill, “and we’ll deal with this when the legislative process begins and the ministry supports the private member’s bill in the ministerial committee. The bill corresponds to the policy I have outlined in the National Insurance Institute to ease and speed up the bureaucracy for citizens receiving the service.”

But according to the NII, involving the physician could lead to a conflict of interests in which “the primary physician will have trouble resisting illegitimate pressure” by patients, the NII’s legal adviser, Amos Rosenzweig, wrote in a position paper.

The bill addresses this matter, including penalties for submitting misleading information including suspension of the doctor’s medical license, a fine and even imprisonment of a physician for filing such information.

In the United States and Canada, the personal physicians of the applicants are the ones who decide eligibility for benefits and carry out the necessary tests in their office. In Switzerland, Germany and Spain the tests are carried out by an independent physician.