While the Germans have certainly played their role in building up the Jewish State, particularly through controversial Holocaust reparations and provision of advanced military technologies, the latest to do so is not from the Rhineland at all, in fact she’s from Herzliya.

That individual is Minister of Health Yael German (pronounced GER-man, not JER-man) who came into her position with no background in medicine or healthcare, and who has drawn criticism at various points throughout her tenure for dubious decisions and priorities.

Nonetheless, this week she seems to have (hopefully) saved the public healthcare system as we know it.

The long anticipated Committee to Strengthen the Public Healthcare System in Israel, headed by German, has finally published its recommendations after a year of debate and tension around the question of how to achieve what the committee wants to do (see its name) and what the future of public healthcare in Israel will look like. The committee’s conclusions had been far from predictable with the wildcard German at the helm.

Simply put, the committee generally accepted the stance of outspoken proponents of public healthcare who argued that while increased privatization of the system may be better for the select few who can afford it, it ruins the system for everyone else.

The committee recommends to:

Increase health plan (kupat cholim) funding
This will improve the quality and availability of medical services and decrease the strain on hospitals and other facilities, as well as allow for better long-term planning by the health plans themselves.

Invest a BILLION shekels towards shortening wait times and employing specialty docs in the hospital system during afternoon hours
Major investments will be made in the hospitals to implement a national program to shorten wait times for surgery and improve services in the ER service. As part of the plan, there will be incentives for shortening wait times, the public will be able to check the wait times for various services and be able to make more educated decisions about receiving them. Paying specialists to work in the afternoon will lure them back to the public sector, decrease the attractiveness of private insurance, and improve overall service provided to patients. Preference for professional advancement and other benefits will also be given to “full-timers” (the catchy nickname given to doctors who have committed to working in the public healthcare system full-time rather than working part-time in private clinics or hospitals).

Establish a new model for private health insurance and regulate private healthcare
Policyholders will be able to easily compare the various policies they have so that they can understand if they are paying for the same services twice and can drastically reduce their total insurance expenses. Supplementary insurance policies (sold by the health plans) will also be “unbundled”, with some of their revenues going directly towards covering committee recommendations. The obligations and quality of private healthcare facilities will be regulated to a greater extent than they currently are.

Regulate medical tourism in hospitals
Strict adherence to the rights of Israeli citizens must be ensured, as well as the availability of medical services for them. Medical tourism will be harnessed for the benefit of Israel’s citizens instead of at their expense.

Expand the choice of medical services in the hospital system
Citizens will be able to choose between a few options offered to them, and coordination between the health plans and the hospitals will be improved to provide the best comprehensive treatment options. Patients will be guaranteed a choice of hospitals based on proximity, as well as specialization.

Set up a National Hospital Authority that will manage the national public hospitals and strengthen the Ministry of Health as a regulator.

Prohibit SHARAP (private medical services in hospitals) from being expanded to public hospitals
The public hospital system will be funded from public sources, meaning that just because someone has money to pay for private medical services in a public hospital will not mean they are entitled to better care or services in a tax-payer funded facility.

The committee report naturally includes a score of other recommendations on a variety of topics, and obvious questions remain as to how all of these recommendations will be implemented, if funding for them will be approved and where that funding will come from. One recommendation widely discussed is a universal 0.5% increase in the health tax. This is a seemingly small price to pay for saving the public healthcare system in Israel.

German and her committee do not seem to have dropped the ball, choosing to strengthen the public healthcare system (with an increased budget and some systemic changes) rather than let private interests continue to creep their way into the public system ultimately at the public’s expense.

Thanks for not blowing it, Minister German!