Medical Residents Call for End to Supplementary Health Insurance, Letting Hospitals Cover Services

IMA decides to resume sanctions, while continuing negotiations with the Finance Ministry.

The medical residents raised a new demand yesterday, calling on the state to take supplementary insurance policies away from the HMOs and to let state hospitals provide these services instead, for a fee.

This comes in the midst of the Israeli Medical Association's labor sanctions, which began in April. The IMA decided this week to resume sanctions, while continuing negotiations with the Finance Ministry. On Tuesday the Supreme Court granted the doctors and the treasury one more week to negotiate.

Jerusalem protests
Michal Fattal

The residents said these services would be cheaper if they were provided at hospitals.

Dov Chernichovsky, a health economics and policy professor at Ben-Gurion University, joined the protesting residents yesterday and called the Finance Ministry's offers to the doctors "a deceit."

"In recent years [the government] has dried up the public health system, and one of the ways to repair this is by making the HMOs' [supplementary] services available to the entire public through state-run hospitals," said Chernichovsky, speaking at a news conference held by Mirsham advocacy group of medical residents.

Currently, 80 percent of Israelis have supplemental medical insurance that they purchase through their HMOs, on top of the standard state medical insurance. The supplemental insurance often includes items such as dental care.

Chernichovsky called for canceling the HMOs' supplemental insurance programs and letting hospitals offer the services they cover instead. The services could be financed by raising the health insurance tax, he said.

This would give the final 20 percent of the population access to the services. Their care would cost about NIS 800 million, he said.

The residents said this was not tantamount to demanding private medical services in public hospitals.

"Once these services are provided in a state-run hospital there won't be duplication of infrastructures, thus reducing their cost," said Dr. Yona Weissbuch, head of Mirsham. "Also, there are doctors who are willing to earn less so that they can give patients these additional services at state-run hospitals instead of commuting to private hospitals to do so."

"We think this is the solution, a revolution to end the gaps in public health. This will encourage new young doctors, who are reluctant to become specialists. We want to stay in the public system, we didn't come here to get rich," he said.

Chernichovsky said the hospitals would charge for these services, but that this would not be private medical care.

"Even when you buy medication, you pay for it. The fee doesn't make it private ... carrying out the care at public hospitals would lower costs," he said.

A source involved in the negotiations between the doctors and treasury officials said the residents' demand was sparked by interested parties.

"This is a new demand and it has nothing to do with the reasons for their resignation. There is no intention of addressing it in the talks," the source said.

Dr. Zeev Feldman, a senior official behind the IMA's labor sanctions, said, "The residents are proposing a grandiose plan that cannot be advanced without setting up a professional committee to examine it."

Health Ministry director general Ronni Gamzu convened the hospital directors yesterday and told them to exercise restraint and refrain from aggressive moves like those the residents were making.

As part of the protest, more than 1,000 medical residents have resigned nationwide, effective as of September 4. Dozens of specialists have joined them.

The residents are demanding a starting wage of NIS 50 per hour instead of the current NIS 23.50.