Fight Shaping Up over Compulsory National Health Insurance Bill

A compulsory national health insurance bill that will not take effect before April 1978 has already stirred a bitter battle between proponents and opponents of the measure. The opposition is not against the principle of national health insurance but to the contents of the draft measure approved last week by the Knesset’s Public Services Committee.

The bill would introduce compulsory health insurance through any one of the existing health funds, most of which are affiliated with political parties and the largest of all, run by Histadrut. It is expected to pass its final reading before the Knesset adjourns for summer recess at the end of July.

The bill in its present form is supported by the Labor Alignment and the Rakah Communist Party. Most other parties oppose it for a variety of reasons and their opposition has been strengthened by the Israel Medical Association, the Pharmacists Association and other groups in the medical and health fields. Large advertisements critical of the measure appear daily in the press.

A MAIN POINT OF CONTROVERSY

One of the main points of controversy is the establishment of compulsory insurance through existing funds rather than a State-financed independent health service. Critics say that the existing funds are inefficient and that the State-run Institute of Social Insurance can provide the same services at a fraction of the cost.

The proposed bill would have the Minister of Health determine the premiums. Opponents want a public council to make that decision. But the greatest opposition has been engendered by the bill’s failure to guarantee that a subscriber who wishes to leave one fund for another will not be subject to reprisals from the health fund he is quitting.

Under the present system, a worker cannot benefit from the Histadrut medical services unless he is a member of Histadrut and if he is a member he is required to subscribe to the Histadrut sick fund. Under the proposed measure, a worker may transfer to another fund at six-month intervals but has no guarantee that if he does so, he will not suffer sanctions at the hands of the giant trade union federation.

The Independent Liberal Party, a coalition partner, has threatened to vote against the bill unless guarantees are written into it. Most observers expect the draft to be revised several times before it is implemented nearly two years from now.

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