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.
