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Part Three - The Social Program
Public Health
Background – A Sick System
It is well known that the health system in Israel is a public system. In media discourse, the healthcare system in the country is seen as one of the best public health systems in the world. But, unfortunately, as is known by professionals in the field, this is far from reality, despite the fact that the level of the doctors and medical staff in the country is indeed one of the highest in the world.
Data from the Economic Department of the Health Ministry indicate that in 2011,[30] approximately 40% of the total national health expenditure came from private financing. Taking into account informal private expenses, such as unreported payments to doctors and therapists, and hospital expenses abroad, then at least half of the national expenditure on health comes from the private sector. This means that the market has voted with its feet, and while we're talking about ideals, the reality is that citizens have already privatized half the system.
This privatization is a necessity, both because of the extended waits for carrying out tests, treatments and surgeries, and because of the shortage of hospital beds and the improvised solutions to this shortage. Privatization is also a necessity to fairly compensate excellent and talented doctors, many of whom receive low salaries in relation to their skills, and whose working conditions are very difficult.
However, this privatization is contrary to the traditional policies of Israel's governments, and is carried out while overcoming the obstacles it presents. In practice, the government's health budget stands at less than 30 billion shekels, while private expenditure on health is at least double that.[31]
Our Goal for Healthcare
Zehut will design a better health system, similar to our approach to education and other areas. The starting point is maintaining the current level of health services. Hence, we will be targeting public spending to the patients who need it rather than to the commodity consumed, while allowing transparent, efficient and free purchase of private health care in a variety of qualities and prices.
A health system, like a properly running economic system, is a basic necessity for a prosperous society. A person has the exclusive right to determine his own priorities. There are those who prefer to receive basic medical care at a lower cost, and there are those who would prefer to pay huge sums of money to get treatment at a higher level. We believe in respecting the choices of the people and not dictating their decisions through the government apparatus.
The assumption that the state can provide affordable health services and prevent health disparities proved to be wrong in Israel and around the world. On the one hand, we see that the most advanced health systems were developed in the free world, the United States being the foremost example. The world's wealthiest patients travel to the U.S. to be cured and they are willing to pay the highest medical fees. The best doctors in the world aspire to work in the U.S., and there they receive the highest wages in the world. On the other hand, we see that despite the wonderful system that was built in the U.S., a political outcry has also arisen, due to the condition of a minority that feels deprived by the fact that it cannot purchase premium health products. This situation has led the United States to change the system and damage its private health system.
The Zehut Healthcare Solution
Zehut's solution is based on a commitment to maintain the current level of healthcare services, while allowing those who are interested to invest in healthcare, improve it and optimize it. Opening the healthcare market to competition will attract both developers and investors from the world to Israel, and will create new and lucrative workplaces that will provide an incentive to doctors and Jewish professionals in the healthcare field to immigrate to Israel and settle here.
Zehut's healthcare reform will leave the health funds in their current structure in the current stage and will not change health insurance premium payments. The proposed reform focuses mainly on hospitals.
Under the reform, hospitals will be privatized through an open tender process, and neither health funds nor the government will be permitted any hospital ownership. The developers who purchase the hospitals will commit through a long term contract to maintain the current price level and not reduce the medical services of the hospitals they purchase. Developer possession of hospitals will be limited in a way that will oblige them to compete in the national market with other developers. Health funds will purchase services for their members from private hospitals in the same way and at the same cost that they had purchased them from state-owned hospitals.
All private hospitals will be allowed to engage in medical tourism and private surgeries and will be able to devote to this purpose a fixed percentage of their beds and the work hours of their doctors and medical staff. In this way, hospitals will receive access to a new and profitable source of income that will encourage them to raise their level of care and allow them to offer competitive salaries to doctors. The expected rise in salaries for talented doctors will encourage them to remain and work in the country and even encourage immigration of doctors and medical staff to Israel from abroad.
Each developer will receive the right to establish a hotel and a shopping center close to the hospital, under the same license, which will constitute another source of income alongside their direct income from health funds and private surgeries. At the same time, the state will allow developers to build new private hospitals, with the single restriction being adherence to medical standards.
The reform is expected to bring the state treasury tens of billions of shekels immediately from the sale of government hospitals to developers, contribute to the economy through the development of medical tourism and private medicine and save the state hundreds of millions in deficits each year. Under private ownership, the hospitals will be managed effectively and become profitable and developing service providers. The potential benefits in medical tourism and private medicine and the need to compete in the national and international arena will encourage healthcare developers to invest in improving the level of health services so as to attract high-quality professionals through high salaries and good conditions. The improvement in the quality of health services and medical staff in hospitals will benefit all citizens who use their services.
Removing Restrictions on Medical Cannabis Treatment
Many studies have shown that cannabis may be useful in treating severe symptoms such as pain, depression and loss of appetite. Many patients treated with cannabis indicate improvement in symptom relief and quality of life. Other drugs do not help some patients to the same extent, or cause them serious side effects. However, there are exceptional limitations on the medical use of cannabis in Israel. Unlike other drugs, which can be prescribed at the discretion of the attending physician, the license to use cannabis can only be given by the Medical Cannabis Unit at the Health Ministry – the MCU. The MCU can reduce the dose recommended by the physician or simply deny the request. In addition, there is a very limited list of diseases and health phenomena for which treatment with medical cannabis is authorized. These extraordinary restrictions have nothing to do with medicine – they exist only to prevent leakage of the drug into the private market.
Zehut will eliminate the Medical Cannabis Unit and the list of diseases authorized for treatment with medical cannabis. The license to use medical cannabis will be given by the physician at his sole discretion. The decision regarding medical cannabis therapy shall consider only the medical needs of the patient, and not considerations of enforcement or other extraneous considerations.
Allowing export of medical cannabis
In Israel, there are companies that grow medical cannabis, known worldwide for their unique knowledge and skills. If growing companies are permitted to export their product, they will be able to compete successfully in the international market. The export will create profits for the growing companies that will allow them to invest in research and development, generate tax revenues for the State of Israel, and respond to the medical needs of millions of patients worldwide.
Zehut will enable growers to export cannabis for medical purposes, according to the law in the target countries and the international conventions signed by Israel.
[30] Data released by the Central Bureau of Statistics
[31] In the above document released by CBS, it is clear that in 2011 only 35% of national health expenditure was financed from the state budget, while the remaining 65% percent was divided between health tax, private financing and a small amount from donations from abroad.
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