Middle East
Israel
Labor Ills
The nationwide doctors’ strike that began in late March led the Israeli press to examine the dispute as a sign of simmering socioeconomic tensions.
Income-based payments into the country’s health funds are designed to ensure equal medical treatment for all citizens. Nevertheless, either through additional private payment by members into the health funds, or directly to doctors via the “Sharap” (private visits at public hospitals) system, a separate stratum of health care for the well-to-do has developed.
During the strike, the wealthy received the best medical care—at public hospitals, from striking doctors. Writing in Tel Aviv’s liberal Ha’aretz (April 9), Haim Shadmi said “private care” comes at a cost. “The state spends millions of dollars on subsidies for medical malpractice insurance, protecting doctors in private practice and in institutions not owned by the state, such as health-fund clinics. These subsidies come on top of full insurance coverage for malpractice claims funded by the state for medical services rendered at hospitals and other state-owned facilities,” he wrote.
The real losers, Shadmi said, are the thousands of people who can afford to pay only health-fund dues. On April 4, Tel Aviv’s centrist Yediot Aharonot reported that hospital support staff have held work stoppages and slowdowns to protest the lack of wage contracts.
Physicians claim that they are paid only 22 Israeli shekels (US$5) an hour for their public-sector work. In an April 4 editorial, Ha’aretz states, “The strikers’ spokespeople are not divulging the doctors’ full pay slips. Were they to do so, it would show that an intern receives supplements to his or her base salary.…Put together, an intern comes away with a gross monthly wage of IS 12,000 (US$3,000). Nor are senior physicians bereft of wage supplements; when these are tallied, they come away with gross monthly wage rates of IS 18,000 (US$4,400).”
Nurses, who have taken part in the job actions by offering minimal services and no outpatient care, are waiting to see how much more money the doctors might obtain. Also, 19 committees representing government ministries struck from March 31 to April 7, demanding substantial wage increases.
The outcome of the strike is likely to have a profound effect on the public-sector wage structure as well as the quality of medical care for Israelis who cannot afford private health services.
