Today, the report of the Public Admissibility Commission of the Ministry of Health was published, which is valid for 2020. The report details tens of thousands of complaints and admissions filed against the Ministry of Health and against the insuring health funds.
Ahead of the report, Health Minister Nitzan Horowitz said that “the Public Admissibility Commission has an important role to play in this task. The Commission is a unique body in the Ministry of Health that provides an address for each resident. And treated in all his disputes with the HMO. “The door of the commission is open to everyone, and attention is drawn to the individual patient to help him and bring about a solution to the difficulty he is facing.”
One of the most prominent sections of the report relates to the number of admissions filed. About 20,000 complaints were received by the Ministry of Health in 2020, an unusually low figure for previous years.
And the explanation? The corona. The virus caused Israelis to consume less elective, non-urgent medical services, and as a result we had fewer complaints.
A particularly worrying statistic concerns the percentage of admissibility that turned out to be justified. This figure has been steadily rising in recent years. In 2017, 27.6% of complaints were found to be true. The number climbed to 35% of them, as of last year.
The Director General of the Ministry of Health, Prof. Nachman Ash, explained this figure, saying “this finding indicates a gap in the implementation of the basket of services as defined in the National Health Insurance Law. “I believe that the HMO’s position reduces the medical right, and that the HMO had to approve the treatment or examination requested. I call on the HMOs to be more careful in implementing the actual basket of services and to pay extra attention to patients’ rights.”
The complaints filed by Israelis are particularly diverse, ranging from complaints about funding for dental care, refusals to apply for home oxygen generators, rejection of non-urgent treatments for no good reason – and complaints regarding the transition between health funds.
And which HMO against which the most complaints were filed? The answer is unequivocal. 5.23 insured persons out of ten thousand filed against the National Health Insurance Fund, acceptable to the Ministry of Health on any matter. More than 1.5 times second place. And how many of these complaints were justified? 30.4%.
In second place is the Maccabi HMO, against which 3.9 admissions were filed, for which 10,000 insured. The rate of justified complaints at the checkout is the highest of all – 37.2%.
In third place – the HMO is united with 3.73 complaints, with 31.7% of them being justified. And in last place, the largest HMO in Israel – Clalit. Against it, the insured filed 3.57 complaints out of every ten thousand – 35.5% turned out to be justified.