Public Health News

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Thursday, May 8, 1997

Israel, The World's Second
Healthiest Country

JERUSALEM (May 8) - Despite dire warnings by politicians and doctors of the medical system's impending financial collapse, Israel is the second healthiest country in the world, according to a statistical analysis compiled by the Economist Intelligence Unit in London and published in the Healthcare International quarterly.

Only Sweden came out ahead of Israel in the analysis, which weighted a dozen different health care indicators, rather than just relying on life expectancy. The criteria included deaths from cancer, infections, and heart and respiratory disease, the HIV infection rate, the number of doctors and nurses per 100,000 residents, immunization rates, and maternal and infant mortality figures.

The report notes that Israel has a very high rating "even though this particular state is a regular target for terrorist attacks." Road accident rates were not included in the calculation.

Twenty-seven developed and developing countries were surveyed according to these measures...
By JUDY SIEGEL, Jerusalem Post.

Wednesday, March 5, 1997 26 AdarI 5757

Health Ministry Cuts Hit Voluntary Groups

JERUSALEM (March 5) - The Health Ministry is cutting back its allocations to a variety of voluntary organizations, including ERAN (emotional first aid), which receives thousands of calls from people in distress.

Last week, it was learned that the ministry is canceling its allocation to Amcha, the organization that provides emotional support for Holocaust survivors and their children.

Health Ministry spokesman Effie Lahav did not say how much would be cut and how many organizations would be affected. But he said that due to severe budgetary problems, organizations that received funding last year could not continue to be funded this year.

"We prefer to buy services rather than to support voluntary organizations," he said. "At the same time, the ministry is examining its policies regarding funding of these groups."

ERAN, the emotional first aid volunteer organization, is in danger of having to significantly cut services if the Health Ministry doesn't come through with the NIS 1.2 million expected this year, said Nava Perry, ERAN's director-general.

NIS 600,000 is slated to come from the ministry's mental health department, and the other NIS 600,000 via the ministry's committee on voluntary organizations. Its total budget for 1997 is nearly NIS 2m. ERAN also raises funds from foundations, private contributors, and local authorities.

 
In 1996, its budget was NIS 1.7m., of which NIS 1m. came from the ministry.

Perry said that the service's 700 volunteers and 20 paid professionals save the health system a significant amount of money by helping to prevent mental breakdowns and suicide attempts.

In the case of Amcha, the government was providing only 5 percent of its total annual budget anyway, but to director Jonathan Lemberger, it's what the cut says that troubles him. "We have been stating for a long time that the amounts of money we've received are absolutely ridiculous and are an embarrassment to the State of Israel," he said.

(Elli Wohlgelernter contributed to this report.)
By JUDY SIEGEL, Jerusalem Post.

Thursday, February 20, 1997

Moving House

It isn't often that a hospital moves from one location to another; Maccabi's Ramat Marpeh Hospital has, however - from Ramat Gan to a new building in Petah Tikva. Some NIS 50 million were invested in the old/new hospital, where some 13,000 operations will be carried out this year. Located on the top floors of the Kikar Ha'ir building near the municipality, it covers 4,200 square meters. Its patients are, of course, Maccabi health-fund members, but it also accepts members of the other insurers when referred.
by JUDY SIEGEL, Jerusalem Post.

Sunday, November 3, 1996

Your Health!

(November 3) - This government, like many of its predecessors, treats health like a middle-aged man who chain-smokes, eats steak for breakfast and "exercises" by pointing his remote control at the TV - an attitude that implies "Things will work out, so let's not worry about tomorrow; let's think positive and not bother trying to change the situation."

There was thus little surprise that the health portfolio was the last to be filled. It was finally handed over to a young man with no proven interest or experience in the subject, and apparently equally little desire to fix it.

Then as soon as recent law graduate Tzahi Hanegbi was offered the job of acting justice minister, he grabbed it, spending less and less time learning the ropes at Health and more and more in the more genteel, suit-and-tie atmosphere of Justice.

Now it seems that the career-minded Hanegbi, who had barely warmed his seat at ministry headquarters in Jerusalem's San Simon quarter, is off full-time to the Justice Ministry enclave in eastern Jerusalem.

 
Taking over from Dr. Ephraim Sneh (a physician who himself showed more enthusiasm for security affairs and running for the premiership than for health matters) Hanegbi said he had really wanted to be transport minister and reduce road accidents. But if that wasn't to be, he said, he was "happy" to tackle the Health Ministry.

He went on the requisite tours of hospitals and clinics, appointed a number of committees to investigate medical "scandals" disclosed by the Hebrew papers, persuaded the Treasury to increase nurses' job slots - and that was it.

He spoke several times about amending the National Health Insurance Law to make it more workable and financially stable, but nothing came of it.

The national health insurance system, already over NIS 1b. in deficit, teeters on the edge of a major crisis, and there is scant evidence that the ministry will be ready to include psychiatric services in the health care basket on the (already postponed) scheduled date, January 1.

Given the fact that he was also the government's liaison to the Knesset and head of the Ministerial Justice Committee, Hanegbi had precious little time for the ministry.

This was illustrated by his surprising absence from a recent two-day Jerusalem conference on the national health insurance system attended by nearly every major figure concerned; Hanegbi's spokesman explained that the minister was absent owing to "previous commitments."

 

Now Likud sources say that one man who was studiously paying attention at that conference, MK Yehoshua Matza, will become health minister this week, leaving Hanegbi to be "promoted" to full-time justice minister.

The 65-year-old Matza, best known to the public as a lackluster candidate who unsuccessfully ran several times against Teddy Kollek for the Jerusalem mayoralty, wants to get into the government, even through the "basement" of the Health Ministry. Matza has waited quietly to be rewarded with a portfolio for his loyalty to Binyamin Netanyahu.

This is probably his last big career move, so Matza will want to make good. The question is whether he has the capability, dedication and political acumen to push the right reforms through.

A nation's health must not be regarded as a luxury, or as an unproductive expense. The ministry's budget is one of the largest, and its life-and-death decisions affect us all. Nothing promotes a decent society more than a health system which ensures every citizen can function physically and emotionally at his or her highest potential.
By JUDY SIEGEL-ITZKOVICH, Jerusalem Post.

Wednesday, July 10, 1996

Israeli Medicines Cheaper Than in Europe,
US - Survey.

JERUSALEM (July 10) - An "average basket" of pharmaceuticals is cheaper in Israel than in Europe and in the US, according to a survey conducted by the Manufacturers Association pharmaceutical branch. Moshe Manor, branch chairman, said yesterday that the average basket of drugs in England is 19 percent higher than here, while in Belgium and in Holland, the cost is 69% and 92% higher respectively.

Contrary to myths about pill-popping Israelis, Manor said that annual per capita use of medications here is among the lowest in the world. The survey compared local usage with 18 western European countries and the US.

EachIsraeli uses an average of $94 worth of medications per year compared with $284 in the US, $245 in France, $231 in Germany, $226 in Italy, $205 in Switzerland, $154 in Canada, $123 in Holland, and $112 in Britain. Only in Ireland ($76) and in Greece ($89) are the figures lower.

The pharmaceutical industry here is very competitive, with a large number of suppliers and only a handful of institutional buyers (the health funds), Manor said. During the past six years, the price of drugs has eroded by an average of 33% compared with the cost of living index, he added.
by JUDY SIEGEL, Jerusalem Post.

Thursday, December 19, 1996

Ministry: Health fund deficit to hit 
NIS 2.2b. in '97

JERUSALEM (December 19) - Two years after the National Health Insurance system went into effect, there is a cumulative deficit of over NIS 1 billion, and next year it will grow to NIS 2.2b., Health Ministry director-general Gabi Barabash said yesterday.

Barabash addressed the Knesset Labor and Social Affairs Committee on the proposed Arrangements Bill, which would cancel the "parallel tax" and bring in government accountants to supervise the functioning of the four health funds.

"One can't reach a balance without symmetry between income and expenses," said Barabash.

Without such balance, he said, the system will speed towards economic chaos, and the first victims will be the waiting lists for medical procedures. The solution lies in increased efficiency, supervision of health-fund expenses, and funding arrangements for the insurers, he said.

The ministry will not cooperate with efficiency efforts that do not deal with the fundamental financing problems of the health system, Barabash said. The problem with the health system is not the Arrangements Bill, he said, but the fundamental under-funding of health services.

Representatives of the health funds were unanimously against the Arrangements Bill, arguing it would reduce the amount of funds available for health services, beyond those brought in as health taxes through the National Insurance Institute.

Economists note the parallel tax is, effectively, a fiction and that the government really pays a share of the worker's healthcare costs, instead.

Due to this criticism, the Treasury now wants to cancel the so-called tax and increase employers' NII payments on behalf of workers. But it will mean less money to cover health services, even if the health system will be partially compensated.

Committee Chairman MK Maxim Levy said, "we hope the government will sober up and cancel the Arrangements Bill immediately. A correct distribution of the burden can bring about the saving of NIS 9b. without hurting the middle class and turning them into the disadvantaged. The finance minister has begun to realize that he'll have trouble within his party getting the law through."

The Israel Medical Association, representing over 12,000 physicians, has come out strongly against the bill, arguing it would intensify the deficits, while nationalizing the health funds. The Health Ministry would receive major powers under the law, including the appointment of health-fund staffers and setting their constitutions, the IMA said.

Monday, September 16, 1996

Dassy Rabinowitz,Subject of Cancer-Treatment Scandal, Dies

JERUSALEM (September 16) - Dassy Rabinowitz, 19, the cancer patient from Efrat who made headlines this summer after she and her family complained that Jerusalem's Hadassah-University Hospital hematology department chairman Prof. Eliezer Rachmilevich refused to treat her, died Friday night at her home.

Rabinowitz, who died after a two-year battle with non-Hodgkin's lymphoma, was buried last night at the Kfar Etzion cemetery.

The incident occurred in May, when Rabinowitz was refused an emergency blood transfusion by Hadassah, where Rachmilevich had been treating her. Hospital staffers told the family they had been ordered by Rachmilevich to refuse her further treatment, after the family had gone to Rambam Hospital in Haifa for a second opinion. The transfusion was done by Shaare Zedek Hospital instead.

After the incident was reported in Ma'ariv Rachmilevich denied Dassy had been refused treatment out of spite, saying it was because the hospital lacked information on the type of treatment she had undergone at Rambam Hospital. But a Health Ministry investigating team concluded in July that the Rabinowitzs' complaint "was correct in all its details."

Following the receipt of that report, Health Minister Tzahi Hanegbi appointed an official committee to examine wheth