Editorial

Healing the Health Care System

File photo: The oncology wing at Haifa's Rambam Medical Center.
Hagai Frid

A cancer patient with an active illness who sees his oncologist once every two months for 15 minutes “because that’s what’s allocated”; revelations that “the field of radiation [treatment] in Israel is a catastrophe – radiation physicians aren’t allowed to retire, and if they leave, it is only to move to another hospital.” These are only two of the worrying comments made by Prof. Ido Wolf, the director of oncology at Ichilov Hospital in Tel Aviv and an adviser to the Israel Cancer Association. He made them to the citizens’ commission investigating Finance Ministry policy and the collapse of state medical coverage. 

The failure regarding oncology treatment is not an isolated case. This past winter there was serious overcrowding in the country’s hospital wards, emergency rooms and community clinics. In recent years, the country’s splendid public health care system has seen long lines and a heavy burden on its services. The situation is expected to get worse in the coming years as the number of elderly – a group that uses the medical system at about three times the rate of the average Israeli – increases by about 300,000 people.  

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National health care expenditure in Israel is among the lowest in the Western world, at 7.3 percent of GDP compared to an average among OECD countries of 8.9 percent. In addition, while in most Western countries, health care expenditures are increasing substantially to address the aging of the population and the development of new medical technologies, in Israel health care expenditures have remained unchanged for years.

When Prime Minister Benjamin Netanyahu is confronted with these figures, he is quick to brandish data on Israelis’ impressive life expectancy and low rate of infant mortality. Such figures, however, do not reflect the problems with service, the system’s reliance on private funding and the dismal future awaiting patients in an era in which the average age of the population is rapidly increasing.

Improving medical services requires changing the system of funding the country’s HMOs and adjusting it to the growth rate and the aging of the population; add hospital beds; and ensuring proper budgeting to cover increases in state-funded medications in an era of expensive and sophisticated technologies. And that’s in addition to national planning that will ensure that the funding is allocated in such a way that it increases the output of the system. It is important to ensure that the funding goes to help patients rather than to the pockets of doctors whose salaries have increased by tens of percent over the past decade.

At a time when government budget cuts will be necessary, any spending increase will have to come from across-the-board cuts to the other government ministries rather than increasing the health care tax. Yaakov Litzman, the outgoing and future deputy health minister, recently stated that he will demand to raise the health budget as part of coalition negotiations. One would hope that he will stand by that demand with at least the same fervor that has in recent years marked his demands on the issue of religion and state.

The above article is Haaretz’s lead editorial, as published in the Hebrew and English newspapers in Israel.