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xperts and patients
agree that major sur-
gery is needed to revive
Israel's public health
service which is close to
bankruptcy and leaves some
citizens without health in-
surance coverage or with in-
complete service. Health
Minister Haim Ramon has
formulated a national health
insurance bill to remedy the
situation, which he hopes to
push through the Knesset.
But political opposition,
ironically from his own Labor
party, threatens the bill's
passage.
Mr. Ramon is un-
characteristically cir-
cumspect about his col-
leagues' resistance to the bill.
"I have no problem with mak-
ing amendments to the bill
that the party can agree on,"
he says. "But I hope that the
final decision will be for the
good of the patient rather
than the establishment."
Mr. Ramon's bill would
guarantee the right of every
Israeli citizen to streamlined
medical health services
through the health fund of his
or her choice. At present the
onus is on citizens to arrange
their own insurance and some
4 percent of Israelis, mainly
in the Arab sector, remain
without coverage. Instead of
allowing the various health
funds to set and collect their
own fees, the National In-
surance Institute would
automatically levy fees at the
5.3 percent of income, thus
making sure everyone joins.
This clause antagonizes the
powerful Labor-run Histadrut
Trade Union which runs the
country's largest health fund.
Its Kaput Holim Clalit
(General Health Fund) has
3.7 million members
representing 74 percent of the
health fund market. It also
owns six of the country's 26
hospitals.
If Mr. Ramon's bill becomes
law, the Histadrut will be
greatly weakened, not only
because it would no longer
control its own finances but
more significantly because
people who want to join
Kupat Holim Clalit now must
also joint the Histadrut labor
feceration, and monies go for
other than medical activities.
But Histadrut Secretary-
General Haim Haberfeld sees
nothing untoward in this con-
nection. "We are not a
sinister Bolshevik organiza-
tion," he insists. "We're a na-
tional institute that has serv-
ed the interests of the Jewish
State since before in-
dependence. And we have
built up an impressive level of
medical care comparable to
other western nations."
Professor Shmuel Penchas,
director-general of the
Hadassah Medical Organiza-
tion, also stresses the relative
quality of Israel's health care
system. "Remember that one-
third of U.S. citizens have no
health care insurance," he
relates. "That's more than 90
million people."
"It's true that in Israel we
have long queues for medical
service," he continues, "but
this stems from a scarcity of
resources in the past. We
must set our economic
priorities to reduce such in-
conveniences and maximize
fair and equal treatment."
Professor Penchas, an
authority on the organization
and administration of health
Israel has long
queues for
medical service.
services, was also one of the
architects of the proposed
health care legislation. He
sat on the government ap-
pointed Netanyahu Commis-
sion of Enquiry into the
Operation and Efficiency of
the Health Care System sub-
mitted its report in 1990.
This became the basis of
former Likud Health
Minister Ehud Olmert's pro-
posed health care reform bill,
which failed to pass through
the Knesset. The widely held
assumption was that the new
Labor-led government would
amend the bill in order to pro-
tect the Histadrut's power.
But Mr. Ramon, always the
affable political maverick,
surprised everyone by propos-
ing a bill remarkably similar
to Mr. Olmert's. "I have add-
ed clauses about the basket of
services" (which will include
routine and specialist treat-
ment, subsidized medication
and hospitalization coverage),
Mr. Ramon explains, "which
will ensure that the poorest
citizens receive fair treat-
ment."
Mr. Haberfeld, however,
thinks the bill will favor the