Because of the high cost of living, about a third of Israelis said in the past month that they had been forced to reduce or forego medical services for themselves, their children and their parents; Due to the amount of the deductible, about a quarter forwent visiting a specialist at the health plan, and 17% had to forgo purchasing medications prescribed by the health plan doctor, even though they are included in the basket of drugs.
These worrying and unprecedented data emerge from a survey revealed here for the first time, in which the Israel Medical Association examined in June of this year the economic burden of health service consumption in Israel, through Geocartography, headed by Prof. Avi Degani and Dr. Rina Degani.
The survey, the most comprehensive conducted in Israel on the subject in many years, was conducted using an online questionnaire among about 1,000 Israelis, including in the Arab sector, who constitute a nationally representative sample of the population that went to see a doctor in the public service in the past year.
The cost of living and its impact on our health: the numbers,
According to the survey, the impact of the cost of living is already evident not only in the avoidance of essential medical services, but in real harm to health – in the increase and prolongation of diseases: between 40% and 61% of the respondents reported that they had been forced to forgo medical treatment, including medications and visits to specialist professional doctors, and noted that as a result their medical condition deteriorated. That is, their illness has become more severe or more prolonged, as well as among their children or elderly parents.
Moreover, 37% reported that they already pay more for health services – 40% had to pay for private medicine out of pocket and without any reimbursement, 21% noted that they were refused medication by the health funds even though it is included in the basket of medicines, and 27% of the health plans refused to fund drugs that are not included in the basket and supplementary insurance of the health plans.
As a result, 47% of the survey participants said that they do not currently feel confident that they will be able to fund medical treatments outside the basket, 48% expressed concern that the financial burden on new drugs and treatments will fall on them, and 42% believe that the state is not doing enough to include new drugs in the public health basket.
Health Basket Committee Summary, 2023 | Moshe Ben Simhon
Growing distress
These harsh figures join the exposure of Israel Hayom last May, according to which thousands of patients a year are forced to forgo purchasing essential drugs, some of which save lives, even though they are included in the basket of medicines and are budgeted by the state. The reason: patients are struggling financially, or are already living in poverty, and therefore cannot afford the deductible that the health funds charge them for the drugs in the basket.
The May publication was based on data from patients' associations, headed by Friends of Medicine from Bnei Brak, which helps finance medicines for about 7,000 welfare recipients each month. According to the association's figures, dozens of patients turn to it every day who are unable to pay the health funds every month for the tens or hundreds of shekels for the drugs in the basket.
Following the survey's findings, Baruch Lieberman, CEO of Friends of Medicine, now tells Israel Hayom that "as the main organization for assistance in obtaining drugs, we handle tens of thousands of inquiries a year and experience the growing distress of patients who do not have the ability to pay even for the co-payments for the drugs to which they are entitled as part of the health basket."
"We are assisting but our capacity is limited." Lieberman, Photo: Coco
"We are doing our best to help, and we are succeeding, but our capacity is limited and there are patients who remain unanswered. We recently met with Health Minister Moshe Arbel, Ministry Director General Moshe Bar Siman Tov and Health Committee Chairman MK Uriel Bosso, and they all agree that we need to promote and find the fastest way to significantly reduce the deductible for chronically ill patients who have difficulty paying it.
"Every day that people don't take essential, life-saving medications leads to a significant deterioration in their medical condition and can lead to real danger to life."
"The public must get what it deserves"
The chairman of the Israel Medical Association, Prof. Zion Hagai, attributes the findings of the survey to the fact that "the government is not investing enough in the health system" and therefore "the public is forced to pay a heavy price for this. For most of us, the price is an increase in payments for medicines and medical services, and for some of us this means forgoing medical treatment that cannot afford it. Woe to a country that is at peace with such a difficult phenomenon, which is only expanding."
"Values are eroding." Prof. Haggai, Photo: Oren Cohen
Prof. Hagai recalls, "Israel was one of the pioneering countries in the world that introduced a National Health Insurance Law, but the main values that underpinned it are eroding day by day. The Israeli government flagrantly violated its budgetary commitments to the health system on the eve of the establishment of the government, and we intend to remind it of this until the Israeli public receives what it deserves."
The Director General of the Israel Medical Association, Adv. Leah Wepner, believes that the survey data "require decision makers to do some soul-searching and recalculate their route. The Israel Medical Association has been warning for years about the huge gap between public expenditure on health in Israel and average expenditure in developed countries, and the findings in the survey are a derivative of this."
"An accessible and equitable system". Adv. Wepner, Photo: Yossi Zeliger
Wepner emphasizes that "with all due respect to the rising prices of sweet drinks or cornflakes, you can't talk about the cost of living without dealing with the cost of health. 17% of Israelis say they have had to give up a medication prescribed by their doctor, and we don't see press conferences or dramatic announcements from the government. This is a statistic that must bounce us all. The state must enable the Israeli public to receive a proper, accessible and equitable health system."
Change your priorities
Prof. Nadav Davidovitch, Chair of Health Policy at the Taub Center and Director of the School of Public Health at Ben-Gurion University, points to "a very serious phenomenon of the connection between economic status and access to health services," according to the survey data.
"The National Health Insurance Law is based on principles of justice, equality and mutual aid, and is one of the most important social laws enacted in Israel, but due to poor priorities, a gap of billions of shekels has been created over the years that has led to processes of widening gaps."
"The state's duty to the residents." Prof. Davidovitch, Photo: Danny Machles, Ben Gurion University
Prof. Davidovitch notes that "with all the goodwill of the Ministry of Health and important programs to reduce gaps, until the state changes its priorities, we will continue to see the gaps, which are already reflected in exposure to risk factors such as obesity and smoking, and later also in access to health services. Health is an essential part of the state's duty to residents, and tools must be given to the starving system in order to allow fair access to all, with an emphasis on the social and geographic periphery."
The Ministry of Health said in response to the survey's findings: "The Minister of Health and the Ministry of Health are working to realize and promote health for all citizens of Israel. Just this week, the ministry acted to freeze the increase in deductible rates in drug prices.
"Working to promote health for all citizens." Minister Arbel, Photo: Oren Ben Hakon
"Over the past year, many actions have been taken to reduce costs to citizens, including an addition of NIS 100 million to the basket of medicines, which enabled the introduction of dozens of drugs and various technologies into the basket, as well as lowering the age of eligibility for free dental care to 72, and providing free eyeglasses to children up to age 7. In addition, the Ministry worked to promote legislation for the prevention of double insurance. The Ministry of Health will continue to work to reduce health gaps."
Wrong? We'll fix it! If you find a mistake in the article, please share with us