The management of the health system in the State of Israel is characterized by a lack of long-term strategy and vision.
This situation leads to the system not producing orderly programs.
It is driven primarily by interests, local and contemporary considerations, political pressures and populist pulls from the waist.
The Arrangements Law proposes to impose a first payment obligation on private insurance companies, so that in any case where a person claims insurance coverage in the field of surgeries or consultations, and he is insured with both private health insurance and public health insurance (SHBN), Is obligated to activate the private policy before the HMO's additional health services program.
This is a proposal that indicates a lack of macro vision of the health system, a lack of understanding of how the system developed, and most importantly - a lack of planning ahead.
Except for the fact that such a plan will not be able to exist at the operational level, it should be understood that not every doctor and / or every hospital in the ISA has an agreement with every insurance company, and in addition - there are different rates, different times, etc. Such a plan will probably not work. In a legal test, it is inconceivable that the state would dictate to a citizen how to use a product that he purchased with his own money, money that he honestly earned and for which he paid income tax according to law.
On the face of it, although the basis for the proposal makes sense, the proposed solution is wrong.
There is no reason for Israeli citizens to pay twice for an almost identical product - private insurance and supplementary insurance, but the solution is wrong, since in the first place the supplementary insurance is insurance born of sin.
When the National Health Insurance Law was enacted, under heavy pressure from the Maccabi Health Insurance Fund, which already had a kind of supplementary insurance for its members, the then Minister of Health, Haim Ramon, surrendered and agreed to leave it under the wings of the law.
The State Health Insurance Law is one of the most social laws enacted in Israel.
This is a law that aims to enable every citizen of the State of Israel to receive health services without any conditions.
Every citizen is entitled to medical service whether he is required to, whether he has paid health tax or not.
The scope of coverage is determined by the government and is defined in the health basket.
The health basket changes according to economic and budgetary considerations, equally and uniformly for everyone, and suddenly - within this egalitarian product a purulent wound opens in the form of supplementary insurance.
The same coverage that provides more services, more availability, more health, to those who have money to pay.
This purulent wound should be drained.
It takes political courage, understanding and daring, but it is the way to prevent double insurance from the citizens of the country without violating the basic principles of democracy.
The proper and just solution is for the Knesset and the government to do everything in their power to expand the medical coverage provided under the health basket, while the insurance companies will sell private insurance to those who want it and to those whose penny is covered.
This is the way to ensure good medicine for all citizens.
Dr. Udi Frishman is a health policy expert
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