In a previous post I translated a letter from a current Hadassah hospital doctor explaining his point of view as to the source of the current crisis and the justification for bailing the hospital out with public money. Here I would like to bring an unsolicited rough translation of part of a letter of support sent by the chair of the Israeli organization of state employed physicians:
What is the cause of the Hadassah crisis?
Most of the blame for the monetary crisis should be put on the ministry of finance and not on the Hadassah management, its doctors and its other workers. Here is how the system works:
- Israeli citizens pay a health tax that is then transferred to HMO’s through social security
- HMO’s must use this money to finance medical care as outlined by law. If the HMO’s lack sufficient funds, the ministry of finance bridges the gap (this is called “support”)
- The Ministry of Health sets the prices for healthcare administered in hospitals, but the Ministry of Finance forces hospitals to offer HMO’s discounts and work at a loss to minimize the “support” it will later need to offer them
- For this reason all hospitals in Israel operate at a deficit, however the Ministry of Health covers the deficit in state owned hospitals while private hospitals such as Hadassah remain “orphan”.
A hospital’s deficit varies according to the level of discount it offers HMO’s. For instance, the Nahariya hospital, offered a 7% discount and has a 90 million shekel deficit this year. The Ichilov Hospital in Tel Aviv offered a 25% discount and has a 190 million shekel deficit. Finally, the Hadassah Medical Center offered 30-40% discounts and respectively has a 300 million shekel deficit.
Was there a salary spending “party” at Hadassah?
The physicians at Hadassah make the same salaries that the rest of the country’s (Israel) physicians make as per the agreement with the government. The vast majority of the doctors at Hadassah make the same salary we do. They earn it through hard work, loyalty and dedication. They have been pulled into this crisis against their will as part of a power play by the Ministry of Finance.
What about private medical care in Hadassah? Is it to blame?
Millions of shekels that have been paid to a small number of physicians as part of private medical care at Hadassah has generated income for the hospital. In other hospitals across the country there are doctors that make similar amounts of money, but that earn it outside of the hospital, in private practices, and thus their employers do not see part of this revenue. Therefore, private medical care at Hadassah cannot cause a deficit, only profit.
Dr. Rachamimov continues to explain why his organization is supporting Hadassah at this time. He specifically says:
Our organization sees the hospitals in Jerusalem as an example for excellent healthcare delivery, dedication and professionalism that combine private and public medical care under one roof. Supporting them and their success is important in the dispute between us and the Ministry of Finance and may affect each and every one of us.
He also outlines what he feels the solution should be:
We support the doctors at Hadassah in their struggle. We feel that the Ministry of Finance is using this crisis to stop private medical care in Hadassah, to limit the amount of students and residents being taught and to cut research funds. We see this as blackmail and we oppose it. We therefore strongly urge that:
- The Ministry of Finance must immediately release the discount funds that have been offered to the HMO’s and use it to pay workers their salaries and to return the hospital to its normal function.
- We fully support a serious negotiation to find a lasting long-term agreement.
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