Israeli Sick Fund Members Warned

Israel's largest hospital, the government-owned Sheba Medical Center, says it may have to curtail the provision of regular non-emergency services to members of most if not all of the sick funds for the rest of the financial year.

The root of the crisis is the "capping" fixed by the Treasury and the Ministry of Health as part of the General Sick Fund's recovery program, which applies a budget ceiling to hospital revenues derived from services to fund members, calculated on historical utilization by each fund. This is proving detrimental to the public hospitals, as the funds continue to refer patients, even after they have exceeded their budget ceilings, but the hospitals cannot charge the funds. The combined budget ceiling of the four funds to the Sheba alone is around NIS550 million ($174.8 million). Other major hospitals, such as the Jerusalem-based Hadassah group, face the same problem, and have requested a solution from the MoH and the Treasury.

According to the MoH's director general, Meir Oren, the policy of capping, whose objective is the containment of hospital expenditures, is superficial. The ceiling level is no longer realistic as regards the medical needs of the population, and the MoH and the Treasury are looking at new ways of reimbursement between the funds and the hospitals. He doubted whether most of the funds have done enough to reduce the hospital services received by their members, or to remain within the budgetary framework allocated to them.