The intention of the Health and Finance Ministries to charge people who come to a psychiatric emergency room NIS 600 to NIS 800 for treatment aroused the ire of the Knesset Health Committee on Monday.
Acting committee chairman (United Torah Judaism) MK Moshe Roth declared: “There is no place for such a fee, and the Health Ministry must force the health funds to establish treatment centers in the community.” He even suggested considering the establishment of unified hotlines for all health fund members and to examine the possibility of adding reasons for granting an exemption from fees when going to the emergency room.
He asked the Health Ministry to submit to the committee within a month a calculation of the estimated amount of income from examination fees at the psychiatric hospitals, the types of referrals for a psychiatric examination, and the percentage of repeat referrals to psychiatric examination.
Move will cause "unprecedented harm"
The MKs present said that this new demand from the ministries “is serious and causes unprecedented harm to the mentally challenged, and it could further worsen their situation and the situation of the system, which are also in bad shape.
According to Religious Zionism MK Michal Woldiger, who was one of the initiators of the debate, the emergency fee at the general hospitals is intended to reduce the number of visits to the emergency rooms so that those in need of medical assistance will use the treatment options in the community, thus easing the burden on the hospitals.
However, while in general medicine, there is an abundance of treatment in the community, the mental health system currently provides a very limited response in the community.
“The initiative of the current fee is to incentivize the health funds to also develop a mental response in the community." According to her, the Health Ministry has many ways to incentivize the funds – "but the cost must not be passed on to the patient’s family,” she said.
Ra’am MK Iman Khatib Yasin warned of the lack of accessibility and adaptation to the various populations of people with mental illness, and the addition of the fee - will create another barrier on the way to treatment,
Dr. Gilad Bodenheimer, head of the Health Ministry’s mental-health division, replied that the national program being promoted these days would expand the community response in the field, such as increasing the number of professionals in the system, alternatives to hospitalization and emergency centers, scholarships for psychologist interns, increasing the salary for psychologists and psychiatrists, establishing new psychiatric clinics – including in the Arab sector – and more. According to him, the lack of manpower in the psychiatric emergency rooms requires payment because today, no one pays for such treatment, not even the health insurance funds. In specific cases, the intention is not to shift the payment to the patient – but to the health funds. Terms for exemption from the fee, he promised, will be set as broadly as possible.
Orly Malka, director of pricing and accounting at the Health Ministry, added that today, no fee exemption is granted for mental health care at a general hospital, but in three months, the procedures for the exemption will be determined.
According to Justice Ministry attorney Daniel Raz, most of the people who apply to psychiatric hospitals today are weak populations. Orna Yirimi, a representative of Clalit Healthcare Service (the country’s largest public health fund), warned that opening centers according to geographical distribution would be inefficient and proposed a test of support for the pricing of emergency rooms.