MOLR: Addressing Inequality In Israeli Healthcare

A report released by the Ministry of Health report at the end of last year shows huge differences in the quality of healthcare between the periphery regions of Israel and the center of the country (Jerusalem, Tel Aviv and surrounding areas).

In the sampled period 2013-2015, Israel counted 15,487 hospital beds or 1.8 per 1,000 people. The most beds are available in Jerusalem, where there are 2.41 beds per 1,000 residents. Tel Aviv comes in a close second with 2.02 but there are just 1.57 in the north and only 1.35 in the south of Israel. Similarly, there are worryingly discrepancies between the periphery’s and the center’s doctor to person ratio. In Tel Aviv there were 5.1 doctors per 1,000 residents compared to a low 2.3 in the North. Nursing staff is also falling short: in 2014 Israel had an average of 4.9 nurses per 1,000 residents compared to the OECD average of 9.5.[1]

But the inequality in healthcare does not stop there. In theory, every Israeli citizen is entitled to healthcare services under the National Health Insurance Law but a growing number of people are disqualified or receive only limited healthcare coverage.

New Olim (immigrants), Ktinim Chozrim (returning minors) and Ezrachim Olim (Israeli citizens born abroad) are entitled to up to one year of free health insurance with a very basic level of coverage if they are not working. The basic coverage given to these groups of people is often inadequate as many drugs and treatments fall outside the ‘healthcare basket’: the services, medications, supplies and medical equipment that the insured is entitled to receive according to the National Health Insurance Law.  In other words, people who fall in the aforementioned categories and require medicine and/or services outside of the basic coverage can only get the treatment they need if they have sufficient private funds.

Toshavim Chozrim (returning residents), on the other hand, do not receive free health coverage at all and are required to pay for their own insurance during the first year, even if they do not have an income. Even the most basic coverage plan from one of the 4 national health insurance institutes in Israel can easily cost about 570 NIS per month ($150 USD); a steep price for someone without employment.

For non-permanent residents, the situation is even more difficult. Foreign workers that are legally working in Israel can find themselves uninsured after becoming unemployed for health reasons, as their health insurance is dependent on continued employment and salary deductions. The tens of thousands registered asylum seekers in Israel are deprived of even the most basic healthcare if they live outside Tel Aviv, as the only clinics that provide limited medical treatment to this population are all in the Tel Aviv area. Denying asylum seekers who cannot be deported and who suffer from mental illnesses or chronic illnesses the right to medical treatment is not only unethical but also in violation of the Basic Law on Human Dignity and Freedom, as interpreted by rulings of the Supreme Court.[2]

In response to these issues, we have set up Medicine of Last Resort (MOLR), which helps make private healthcare available to those who cannot afford it. Through crowd funding, we raise funds for the private purchase of medicines and treatment. We also lobby pharmaceutical companies to subsidize and/or donate drugs for those in need and encourage members of the public and pharmaceutical companies to form test groups for particular drugs to establish a case for their inclusion in the healthcare basket. Once a case for subsidy has been established, MOLR lobbies Knesset members.

To date, MOLR has purchased over 100,000 dollars worth of medicine for those who cannot afford it. We have a long waiting list of patients we cannot help yet because of a lack of funding. If you want to help these patients get the treatment they need, you can make a donation to MOLR here.

[1] http://www.timesofisrael.com/health-levels-in-periphery-lagging-behind-center-report/

[2] http://www.haaretz.com/opinion/1.735733