Controversial bill passed to regulate medical tourism

 

In Israel, medical tourism has become a profitable export industry that brings in foreign currency and supplies taxes, employment and a financial boost to medical institutions.

The new bill regulating medical tourism was passed after more than a year of heated discussion and the result has been criticised by all sides as not being as detailed or stringent as the original wording.

The final version includes some but not all of the long list of items in the original wording that would have required compliance from hospitals and medical tourism agents. The bill also seems tougher on medical tourism agents than on hospitals.

Hospital requirements now in place

The regulations on medical tourism for hospitals include:

  • Medical tourism must not harm the quality of medical treatment given to the Israeli patient
  • Hospitals must provide the health ministry with a comprehensive report on medical tourists treated at the hospital and the income received
  • There is a ban on higher payments to doctors or hospitals for treating medical tourists than for treating Israelis
  • Medical tourists will only be treated in the afternoon and not during regular hospital hours, aside from emergencies or other exceptions. The sanction for treating a medical tourist during public morning hours is a 50,000 shekel (US$13,680) fine
  • All medical tourists must wear an identifying tag when in hospital

Excluded from the final bill

One rule excluded from the final bill was that hospitals would be restricted on how many medical tourists they could host, based on data regarding the waiting time for carrying out various procedures in the hospitals and infrastructure availability.

Instead, the Health Ministry is given the option of allowing individual hospitals and doctors to charge more for overseas patients. It is also given powers to restrict the number of medical tourists to specific hospital treatments, if there are concerns about the impact on the availability of treatment for Israeli patients.

Another part of the original bill that didn’t make it was the plan that sought to redistribute the profits from medical tourism from the big city hospitals to smaller provincial ones. The health ministry is now tasked with working out the profits that should go to the periphery and report on this without committing on time or a specific sum or percentage of the income. There are strong suspicions that this will quietly disappear.

Medical tourism agent regulations still uncertain

To regulate the business of medical tourism agents, a register will be compiled of medical tourism agents, with set preconditions for those wishing to register.

The full details on rules on agents are not yet available but it is reported that the original plan that anyone operating as a medical tourism agent would have to possess certain minimum qualifications, has been dropped. What is known so far is that medical tourism agents must be over 21 and have no criminal record.

Agencies cannot make one service contingent upon another, so obtaining medical services contingent upon reserving a hotel room via the agent is not legal. Agents can only contact doctors via the hospital or clinic, not direct.

A disciplinary committee for medical tourism agents, headed by a judge, will be established, and can fine agents who break the rules.

It is not yet known if other original rules on agents are in the bill or not. These were that agents had to:

  • operate fairly towards both the patient and the medical institution where they are to be treated
  • maintain medical confidentiality and privacy
  • ensure reservations are made in writing. The patient must sign the original price quote from the medical institution, to ensure that the medical tourist is given the complete information for informed consent before leaving home
  • reveal any personal interest that the agent has in a medical institution

It is also not yet known whether the new law will keep the original bill text requiring all medical tourism agencies to divulge the volume of business and number of foreign patients they attract to Israeli hospitals.

No authority in Israel has full data on medical tourism.  The Health Ministry has only partial data that includes the state hospitals’ revenue. Private hospitals refuse to divulge, even to government enquiries, how much they earn from medical tourism, but estimates range from US$100 to $300 million for procedures performed for non-Israelis.  View the IMTJ country profile for further 2018 analysis of the medical tourism industry in Israel.

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