Welfare NGOs: State Must Slash Health Co-payments

Social welfare NGOs are lobbying the Health Ministry to lower the co-payments charged by the state health maintenance organizations.

The state health maintenance organizations charge some of the highest co-payments in the world, social welfare NGOs say, prompting them to lobby the Health Ministry to lower them.

HMO patients pay a surcharge to visit doctors, receive medical exams and purchase prescription medication.

NGO representatives said they are upset the state has yet to put forth a plan to reduce co-payments, despite a 2007 government decision to do so. A panel of health and finance ministry experts has yet to agree on the language of such a reform.

In February, Haaretz revealed that the Health Ministry's director of community medicine, Dr. Dror Guberman, wrote a report proposing to reduce co-payments gradually.

He suggested that HMOs exempt patients from co-payments for their first three months of hospitalization; reduce co-payments for households with more than one chronically ill member; reduce fees for breast cancer screenings and pediatrician visits for children under age 5; and cancel all fees for obese patients seeking nutritional consulting with a dietician. The full report has not been published.

Recommendations made public

Earlier this month, representatives of Physicians for Human Rights, the Association for Civil Rights in Israel, and the Adva Center demanded that Deputy Health Minister Yaakov Litzman release the panel's recommendations to the public so that they could be discussed in an open forum.

Later this week, the organizations plan to present to the Knesset an alternative proposal that calls for gradually reducing co-payment rates. The first stage would be to completely do away with co-payments for services such as vaccinations and cancer screenings, including mammograms and colonoscopies. The second phase calls for exempting the chronically ill from all co-payments, and doing away with fees for prescription medications and family doctor visits.

In 2007, Israel's largest HMOs raked in a total of NIS 2.077 billion in co-payments. The NGOs say co-payments could be canceled, and that the money could be made up by increasing health taxes and fining polluters. Activists say that reducing co-payments would ease the financial burden on poor families while encouraging the ill to seek medical care.