Israel May No Longer Be Able to Be So Soft on Medical Tourism

A television expose has uncovered corruption among doctors, which adds to concerns that Israeli patients are the odd ones out.

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Two things make the investigative report by the “Uvda” television program Monday night so shocking: the names and the timing. The doctors who star in the exposé – not to their benefit – really are stars of the Israeli medical profession. They’re the best-known doctors at Tel Aviv’s Ichilov Hospital, excellent surgeons sought by patients from all over the country – and the world. Hospital directors would pay a lot to have them on their team.

Two of them, Prof. Zvi Ram, the head of neurosurgery at Ichilov, and Dr. Yossi Paz, the chairman of Ichilov’s doctors’ union and a top heart surgeon, were even active  in the summer-of-2011 doctors’ protest that pushed to strengthen the public health system. Paz even has the reputation of being a whistle-blower, having exposed a number of corruption affairs at Ichilov.

The second factor of the exposé is the timing. The revelations are like a bomb hurled into the lap of Health Minister Yael German’s committee on improving the public health system. The committee is currently discussing the regulation of the medical tourism industry and the private medical services offered by public hospitals. Based on the information coming out of the meetings, the committee’s members, especially chairman Eugene Kandel, plan to be liberal regarding medical tourism. But this might not be so easy after the “Uvda” exposé.

Medical tourism has long stopped being an esoteric business that provides small change to hospitals. It’s now their fastest-growing business, as hospitals invest great effort and resources in attracting medical tourists. They give them swift access to tests and treatments along with Russian-speaking aides if necessary. They say all this is being done to increase depleted budgets; this way, hospitals can buy more equipment and hire more people, improving care for Israeli patients.

But others say the treatment of medical tourists comes at the expense of Israeli patients, and these voices are growing in sync with the phenomenon of medical tourism. Meanwhile, the “Uvda” exposé proves that there’s an additional price: corruption among some of the doctors.

For years, committees, conferences and Health Ministry officials have been discussing regulations for the medical tourism industry, but they haven’t made key decisions. In the meantime, hospitals’ income from medical tourism has crossed 500 million shekels ($143 million). Some departments are collapsing under the strain, and no one is really supervising what’s going on.

A letter from Ichilov’s director, Prof. Gabi Barbash, to hospital doctors is a good example. On the one hand, it states that it’s forbidden to charge payments for a medical tourist outside the fee paid to the hospital. On the other hand, it tells doctors they’re allowed to provide consultations to medical tourists in return for payment at their private clinics. They can even send them for treatment at Ichilov after the “consultation.”

The medical tourists themselves appear in the “Uvda” report as somehow outside the process revolving around them. A string of interested parties seems to be trying make money off them – brokers in their own countries, Israeli hospitals and related industries, and sometimes even the doctors.

And few medical tourists are oligarchs or the family of oligarchs; they’re middle-class people from countries where the medical system is in bad shape, where people are often forced to sell their possessions or hold a charity drive to pay for treatment in Israel. As someone who knows the medical tourism industry from up close has said: “Sometimes they leave here with such a difficult experience of exploitation that it does Israel more damage to its image than good.”

A hospital in Israel. Credit: Moti Milrod

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