Hagaon Harav Yitzchak Zilberstein, renowned posek and Rav of the Mayanei Hayeshua Hospital community in Bnei Brak, delivered a sharp condemnation of Israel’s health funds at his weekly shiur for doctors and rabbanim, ruling that their massive advertising expenditures are halachically unjustified – and that patients denied coverage for necessary medications may be permitted to work around the funds’ strict eligibility criteria, according to a Sunday report by Bechadrei Charedim.

The shiur, which Harav Zilberstein has delivered at the shul adjacent to Mayanei Hayeshua for nearly fifty years, drew dozens of physicians from across Eretz Yisrael.

The shaila that prompted the discussion came from a patient who requires an expensive medical treatment but does not meet the health fund’s narrow eligibility criteria for subsidization – despite a clear medical need – and who asked under what circumstances he might be permitted to act in a way that would allow him to receive coverage.

After ruling on that specific case, Harav Zilberstein used the occasion to raise a broader grievance on behalf of the public.

“In my opinion the doctor is correct,” he said. “A health fund is the money of partners – but that is only true if those partners were consulted about all the expenditures. Because the health funds pour out money… they pour it out. You ask why I wrote ‘pour’? Because an institution that spends money on large advertisements in newspapers – that is called wasting money. Have you seen these advertisements? Full pages – what is this? A full page costs a fortune. So I wrote ‘pour’ – they pour the money out, without justification, on things the public would clearly never agree to: massive advertising, public relations that have nothing to do with medicine.”

He also criticized excessive and unnecessary testing approved for pregnant women, which he said adds significant costs without proportionate medical benefit.

“But when it comes to elderly people who need life-saving medications,” Harav Zilberstein continued, “that is where they become inexplicably stingy. What do they say? You don’t have this number, you don’t have that number – you’re missing a few points. That is miserliness. They have rigid rules. Is someone with a protein level of 195 not in danger? Why must it be exactly 200 to receive a subsidy? And it can change within a month – it changes all the time. So I say it is right not to listen to them.”

Addressing the halachic question directly, Harav Zilberstein said that because the health funds spend public money on expenditures the public would not sanction if asked, their claim to that money as sacrosanct communal funds is weakened. “In my opinion the public would prefer that the money of the health funds go first to life-saving medications,” he said. “And as long as they do not ask the public what to do with the money, one cannot say this constitutes theft of public funds” – meaning, in his ruling, that circumventing their criteria in such cases is permitted.

When a participant asked what purpose the advertising serves – whether it is to raise the fund’s profile or attract more members – Harav Zilberstein replied: “To bring in more money, and also to bring in clients. But it is not justified. On that basis you cannot collect money from a public of poor people who need that money to live. It is not justified. The things we do today are not justified. This is not according to the Torah.”

Harav Zilberstein’s remarks sparked significant discussion in Israeli medical circles in the days following the shiur, with doctors and patients alike expressing strong identification with his critique. Many expressed hope that the ruling would influence decision-makers at the health funds to reconsider their spending priorities.