Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

17 Elul 5765 - September 21, 2005 | Mordecai Plaut, director Published Weekly










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Shema Yisrael Torah Network
Shema Yisrael Torah Network











Collective Supplementary Health Insurance Plan for Entire Chareidi Public

By M. Halevy

Due to the heavy financial burdens that have fallen on many chareidi families as a result of extremely expensive medical treatments, a single, collective medical insurance plan for the entire chareidi public is being formulated. The plan, which is nearly complete, will provide coverage for expensive treatments and medications not covered by the various healthcare funds (kupot cholim) such as organ transplants, special treatments abroad and high-priced drugs— all for a monthly premium of just 18 shekels per family.

Behind the initiative, which takes advantage of the chareidi community's massive collective economic power, is a group of professionals headed by businessman R' Yosef Rosenstein, who serves as the Union of Yeshivas and Torah Institution's official representative for health affairs.

The collective insurance plan was encouraged and blessed by gedolei Torah shlita. A letter from HaRav Yitzchok Zilberstein reads, "R' Elimelech Firer contacted me regarding the health insurance R' Yossi Rosenstein is offering for bnei Torah and anshei maaseh families. He says the insurance is good, worthwhile and important. We have learned that the premium is low and provides coverage up to age 60. Therefore, since this is pikuach nefesh mamash, and in light of the many pleas that come before us constantly, in my humble opinion it is worthwhile and desirable to join this and may the verse Ki ani Hashem rof'echo be brought to fruition in us."

The matter was presented to Maran HaRav Eliashiv shlita who inquired how the insurance companies would be able to afford to pay based on such a low monthly premium. The organizers explained that the monthly rate depends on the number of families who join the plan. Maran added, "The matter itself is certainly very important," blessing the organizers for success in their undertaking.

Hundreds of avreichim have already signed up for the Chai Lemishpacha plan, even before it was publicized. The low premium is less than a third of other collective health insurance plans on the market, which typically cost NIS 70- 80. This rate includes children up to age 21 and does not rise even when additional children are born into the family or when the policy holders reach more advanced ages, compared to other plans, which can exceed NIS 100 per person as the individual ages. The insurance coverage continues indefinitely as long as the monthly premiums are paid, as guaranteed by the Insurance Law, which requires insurance companies to continue to provide the policy as long as the insured party pays the premiums.

The contract explicitly states that in case of differences of opinion Rav Firer will serve as arbitrator.

Those unfortunate enough to have gone through the experience of trying to claim insurance benefits for an organ transplant know what it means, when the doctors almost invariably recommend undergoing surgery abroad but the insurance company insists that the operation can be performed just fine in Eretz Yisroel.

Many of us currently pay good money for supplementary coverage for the entire family without really knowing what it provides, but with the hope that in a crisis situation the policy will come through for us. Even if we have been disappointed in minor matters, at least in a critical situation, such as an operation or organ transplant abroad, we'll be covered. That's what the contract says.

But this is all an illusion. The shaky state of the health system, which is on the verge of collapse, is merely the starting point. When a sick person in need of a transplant or expensive medication asks to collect benefits from the supplemental insurance policy, he is told to read the fine print — and then his plight becomes painfully clear to him.

After all of the procedures and bureaucracy, he suddenly discovers that there are various criteria for an organ transplant abroad. The first criteria is that the procedure cannot be performed in Israel. The second criteria stipulates the patient must be in a life-threatening situation.

Most organ transplants can be performed in Israel, but the waiting period can be years and in the meantime a large portion of the patients leave This World, sparing the insurance company from having to pay. The second condition also works to the insurance company's advantage: once the patient is in a life-threatening situation in most cases it is already too late to fly abroad.

The statistics bear this out. In the year 2000, for example, out of over 1,000 patients in need of organ transplants, only 264 underwent the operation.

In the case of high-priced drug treatments, the patient is also in a bind. Approximately 2,400 medications, some of which are classified as "lifesaving drugs," are not included even in the updated health basket. Patients who need these types of medication have to pay thousands and even tens of thousands of shekels per month and soon discover that they were not included in the supplemental health insurance basket either. Even when expensive drugs are included the healthcare funds sometimes place obstacles that force the patient to pay from his own pocket.

It should be noted that one of the reasons that the price is so low is that the initiators and organizers of the plan are working lesheim Shomayim and are not raking off big profits.

For more information call: 15 99 566 555; or write: Kulanu Ke'echod, Besht 7, Bnei Brak.


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