Nothing signifies Israel’s return to politics as usual more than the return of budget battles to the headlines. And as usual, Israelis hear mainly about the issues over which vested interests hire lobbyists and PR agents. The stars of the news reports are mainly the farmers’ protest against the import reform and the proposal to tax soft drinks. “But why raise the tax on Coca-Cola Zero Sugar?,” Interior Minister Ayelet Shaked reportedly asked, shocked, during the cabinet deliberations.
But with all due respect to Coca-Cola’s stubborn fight over its profits from the sale of sugar, much less attention has been paid to a different reform, one that could adversely affect about half of Israel’s population: women.
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The Finance Ministry included in the Economic Arrangements Bill (supplementary legislation to the state budget) a proposal that would add to the list of medical specialties requiring a referral from the patient’s primary care physician dermatology, ophthalmology, orthopedics, otolaryngology (ear, nose and throat) – and gynecology – or the payment of 20 shekels ($6.20) for the first visit to the specialist in a quarter, in addition to the monthly health insurance premium. This, in order “to create a barrier to the excessive demand for consulting medicine.” Barrier! Excessive! Indeed, how “excessive” on the part of women to seek health care for their organs.
That is, treasury officials believe it makes sense to tax all women, through either monetary or bureaucratic means, for basic medical services. This scandalous reform is one of the few to be removed at the last minute from the draft budget, even before the Knesset phase. But not out of the recognition that it is a bizarre tax on having a uterus. Rather, it was eliminated because the medical establishment – mainly general practitioners – doesn’t want the additional bother.
In the end, however, it was decided that the matter of an additional fee be left to Israel’s four health care providers, which are now likely to adopt it.
Gynecology is not the same as orthopedics. Women need this service regularly and frequently. This is not “consulting” medicine, it is primary care. One outrageous example of this is the Israeli protocol according to which a woman who takes birth control pills has to renew her prescription every three months. As Ronny Linder previously reported, the protocol is not only about the welfare of the patient, but also the desire to charge her for the quarterly service. There is no medical examination in this regard that is carried out every 90 days, only the automatic signature of a doctor who looks at nothing but the screen.
The implication of the new proposal is that now the gynecologist might now also demand a referral or additional payment every three months from every woman who needs the pill. The proposal will also increase inequality in the health system, as it will pose a burden to the women for whom 20 shekels is not a negligible sum. Women may also make fewer life-saving doctors’ visits because of the need to involve additional physicians in sensitive issues along the way to seeing the gynecologist.
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In recent years, the struggle against the so-called pink tax has intensified. While it gets its name from the premium that manufacturers often charge for products, often colored pink, that are marketed specifically to women, even when they are identical to the “male” versions, the pink tax also refers to sales tax levied on period products such as pads and tampons.
Unlike Cola Zero, Israel’s female population does not employ a lobbyist, but the Briah Found, which addresses the need to adapt the health care system to women’s needs, has joined with the Israeli Society of Obstetrics and Gynecology and the National Council for Women’s Health to fight the proposal. There is no reason for the health maintanance organizations to approve this draconian tax on wombs. It is no less important than the sugar in cola.