Maccabit Health Services has submitted a confidential document to the Knesset committee discussing the key for allocations to the health funds. The document rebuts the assertions by Clalit Health Services regarding the change in the original allocation formula for the funds (the capitation formula). NIS 21 billion is allocated to the four health funds under the formula.
Maccabi asserts that Clalit’s demands in its High Court of Justice petition are based on outdated and inaccurate information. According to Maccabi, Clalit’s goal is “to increase its capitation share in order to cover its deficit, instead of covering its deficit by streamlining its operations.”
Many months ago, Clalit asked the Ministries of Health and Finance to change the capitation formula, claiming that the current formula discriminated against the fund. After its request was rejected, Clalit petitioned the High Court of Justice six months ago to decide the issue and issue a temporary injunction. The court dismissed the petition.
The Ministries of Health and Finance notified the court that they would establish a committee to examine the matter. The committee is scheduled to submit its recommendations by March 31, 2004.
Based on the number and ages of the health fund members, the current capitation formula determines the allocation of government funds to the funds. Under this formula, the allocation increases with the age of the fund members, under the assumption that older members need more medical services.
Clalit’s court petition asks that the formula be changed to give greater weight to the age of the members, which would increase its allocation at the expense of the other health funds: Maccabi, Leumit Health Fund, and Kupat Holim Meuhedet.
In its document, Maccabi give a great many quantitative data, which it claims include the real cost of the medical services provided to the members.
Maccabi is proposing that the committee change the existing capitation formula to include coefficients not present in the current formula.
Published by Globes [online] - www.globes.co.il - on December 31, 2003