Government bill · 20th Knesset · published as law 11 August 2016
חוק ביטוח בריאות ממלכתי (תיקון מס' 58), התשע"ו-2016National Health Insurance Law (Amendment No. 58), 2016 · automatic translation · suggest a correction
Status: התקבלה בקריאה שלישית
Topics: Health* · * from the Knesset's official law classification
Official summary of the law (Knesset)
The allocation of health service funding sources among the health funds continues according to the main distribution principle of the weighted number of insured persons. This amendment authorizes the Minister of Health to establish Regulations that will set allocation rules in accordance with an estimate of the expected expenses of each health fund. This estimate may be based on actual expenses but also on other factors or characteristics that may affect or reflect the expenses. The new allocation rules will apply only to areas for which the weighted number of insured persons is not a sufficient criterion, which will be detailed in the Eighth Schedule to the Law. Reporting obligations of the Minister of Health to the Knesset's Labor, Welfare and Health Committee were also established.
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Hebrew original
חלוקתם של מקורות המימון של שירותי הבריאות בין קופות החולים, נמשכת לפי עיקרון חלוקה מרכזי של מספר המבוטחים המשוקלל. תיקון זה מסמיך את שר הבריאות לקבוע תקנות שייקבעו כללי הקצאה בהתאם להערכת ההוצאות הצפויות של כל קופת חולים. הערכה זו יכולה להתבסס על הוצאות בפועל אך גם על גורמים או מאפיינים אחרים שיכולים להשפיע על ההוצאות או לשקף אותן. כללי ההקצאה החדשים יחולו רק לגבי תחומים שלגביהם מספר המבוטחים המשוקלל אינו קריטריון מספק, שיפורטו בתוספת השמינית לחוק. כן נקבעו חובות דיווח של שר הבריאות לוועדת העבודה, הרווחה והבריאות של הכנסת.
Readings
- 14 December 2015 · First reading · להעביר את הצעת החוק לוועדההצעת חוק ביטוח בריאות ממלכתי (תיקון מס' 56), התשע"ו-2015Bill National Health Insurance (Amendment No. 56), 2015autoBill passed first reading25 for · 13 against
- 3 August 2016 · Third reading · אישור החוקהצעת חוק ביטוח בריאות ממלכתי (תיקון מס' 58), התשע"ו-2016Bill on National Health Insurance Law (Amendment No. 58), 2016autoLaw passed47 for · 27 against · 1 abst.
What was said in the plenum
The bill authorizes the Ministers of Health and Finance, with the approval of the Knesset Labor, Welfare and Health Committee, to set out in Regulations new allocation rules for the health funds (initially regarding mental health and work injury victims) that would not be based solely on the existing capitation formula but also on an assessment of expected expenses and additional factors. The discussion focused on whether granting broader discretion to the ministers would better reflect the actual expenses of the health funds, or whether it might erode the principle of a uniform and transparent formula and open the door to pressures and political considerations in the allocation of the budget.
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Hebrew original
הצעת החוק מסמיכה את שרי הבריאות והאוצר, באישור ועדת העבודה, הרווחה והבריאות של הכנסת, לקבוע בתקנות כללי הקצאה חדשים לקופות-החולים (בתחילה לגבי בריאות הנפש ונפגעי עבודה) שלא יתבססו רק על נוסחת הקפיטציה הקיימת אלא גם על הערכת ההוצאות הצפויות ועל גורמים נוספים. הדיון נסב על השאלה אם מתן שיקול דעת רחב יותר לשרים ישקף נכון יותר את ההוצאות בפועל של קופות-החולים, או שהוא עשוי לשחוק את עקרון הנוסחה האחידה והשקופה ולפתוח פתח ללחצים וליחסים פוליטיים בחלוקת התקציב.
Arguments for
- The existing capitation formula does not correctly reflect the burden and expenses in areas such as mental health and workplace accidents, and therefore a more flexible mechanism is needed, one that is also based on expected expenses and not only on the number of insured persons.Yakov Litzman (United Torah Judaism), Elie Elalouf (Kulanu)
- The law allows compensating health funds for deficits accumulated as a result of previous reforms that were transferred to them hastily and without appropriate budgeting.Elie Elalouf (Kulanu)
- The law does not change the capitation formula itself but only adds authority to include additional variables in justified cases, subject to oversight and annual reporting to the Knesset Committee.Yakov Litzman (United Torah Judaism), Elie Elalouf (Kulanu)
- All health funds, including the largest fund which was most harmed, supported the amendment during the committee discussions.Elie Elalouf (Kulanu)
- The bill may somewhat ease the pressure placed on patients to turn to private medicine.Aida Touma Sliman (Joint List)
Arguments against
- The law opens the door to a gradual erosion of the clear and transparent capitation formula, by allowing more and more areas to bypass it in the future at the minister's discretion, instead of allocation according to a uniform formula.Michal Biran (Zionist Union)
- It would have been correct to address the existing problems (mental health and work accidents) through a temporary provision, while simultaneously amending the capitation formula itself to include the relevant morbidity factors, rather than breaking the principle of the formula.Michal Biran (Zionist Union)
- The shift from a fixed formula method to a system of "gestures" and individual requests to the minister could force health funds to approach and persuade the minister in a non-transparent manner, which would be flawed over time.Michal Biran (Zionist Union)
Who spoke (9)
| Member | Faction | Readings | Speeches | In the final vote |
|---|---|---|---|---|
| Yakov Litzman | United Torah Judaism coalition | First reading | 9 | no record |
| Israel Eichler | United Torah Judaism coalition | First reading | 2 | for |
| Aida Touma Sliman | Joint List opposition | First reading | 2 | no record |
| Abd Al Hakeem Haj Yahya | Joint List opposition | First reading | 5 | against |
| Yoel Hasson | Zionist Union opposition | First reading | 2 | no record |
| Dov Khenin | Joint List opposition | First reading | 3 | against |
| Yael German | Yesh Atid opposition | First reading | 2 | against |
| Elie Elalouf | Kulanu coalition | Third reading | 2 | for |
| Michal Biran | Zionist Union opposition | Third reading | 2 | against |
An automatic summary of the plenum transcripts: the debate on the bill at every reading it was voted on. Arguments are given as the speakers made them; this is not an assessment. The list of speakers comes from the transcript, without a model. Transcripts of the sittings: 1, 2 · write to the author
Reservations to the second reading
5 reservations were filed: proposed changes to the text the committee brought to the second and third reading.
The reservations are intended to change the mechanism of the budgetary supplement relating to the area specified in the Eighth Addendum and to delete parts of the bill on this matter, as well as to set a commencement date conditional on the enactment of regulations, to postpone the determining date for the regulations' applicability, and to limit the law's validity to two years.
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Hebrew original
ההסתייגויות נועדו לשנות את מנגנון התוספת התקציבית הנוגע לתחום הקבוע בתוספת השמינית ולמחוק חלקים מהצעת החוק בנושא זה, וכן לקבוע מועד תחילה מותנה בהתקנת תקנות, לדחות את המועד הקובע לתחולת התקנות ולהגביל את תוקף החוק לשנתיים.
By faction
- Meretz opposition · 4 reservations · 5 members
- Zionist Union opposition · 3 reservations · 1 member
A joint reservation counts for every faction whose members filed it.
Who proposed what
- קבוצת מרצ · 4The Meretz group proposes changing the terms of the budget supplement according to the weighted number of insured persons, deleting the proposed clauses on this matter, changing the margin heading and the effective date of the Law, and postponing the determining date for the validity of the Regulations.Sections: לסעיף 1, לסעיף 4
- מיכל בירן · 3Knesset Member Michal Biran proposes establishing a commencement arrangement for the Law regarding the enactment of Regulations, and adding a section stipulating that the Law will be valid for two years from its commencement date.Sections: לסעיף 1, לסעיף 4, לאחרי סעיף 4
Proposers and reservation numbers are extracted automatically from the committee version, and the count is checked against the numbers printed in it. The descriptions are an automatic summary. Committee version for the second and third reading (PDF) · write to the author
Reservations, sections and other votes (2)
In order. Votes on reservations and individual sections are shown separately from the vote on the bill as a whole.
- 3 August 2016 · Second reading · קריאה שנייההצעת חוק ביטוח בריאות ממלכתי (תיקון מס' 58), התשע"ו-2016Bill on National Health Insurance Law (Amendment No. 58), 2016auto45 for · 26 againstVote on sections of the bill
- 3 August 2016 · Second reading · הסתייגותהצעת חוק ביטוח בריאות ממלכתי (תיקון מס' 58), התשע"ו-2016Bill on National Health Insurance Law (Amendment No. 58), 2016auto34 for · 39 againstVote on a reservation (amendment)