In remarks that have sparked intense discussion throughout Israel’s medical community, Rav Yitzchok Zilberstein sharply criticized the country’s health funds for spending vast sums on advertising and public relations campaigns while, he argued, making it difficult for elderly patients to obtain subsidized life-saving treatments.

The comments were delivered during the Rav’s weekly shiur for physicians and rabbanim at the shul of Mayanei Hayeshua Medical Center. For nearly five decades, the gathering has served as a forum where complex questions at the intersection of halachah and medicine are discussed and analyzed.

Doctors who regularly travel from across the country to attend the lectures were taken aback by the unusually forceful criticism directed at the health funds. Rav Zilberstein argued that instead of expanding access to life-saving medications, the organizations are spending excessive amounts on large-scale advertising campaigns and public relations efforts.

The discussion arose from a complicated question involving an expensive medical treatment that a health fund subsidizes only under highly specific circumstances. A patient sought guidance regarding whether he could take certain steps to obtain coverage for a treatment that doctors deemed medically necessary, even though he did not technically meet the required eligibility criteria.

While Rav Zilberstein devoted much of the shiur to analyzing the halachic dimensions of the case, he used the opportunity to address what he described as a broader and troubling reality affecting many patients.

“In my opinion, the doctor is correct,” Rav Zilberstein said. “A health fund may be jointly owned by its members, but that would apply only if the members were consulted regarding all expenditures. Yet these health funds are pouring out money—yes, pouring it out. You ask why I used that expression? Because when an institution spends money on enormous newspaper advertisements, that is called wasting money.”

“Have you seen these advertisements?” he continued. “Entire pages. What is that? A full page costs a fortune. So I wrote that they are ‘pouring out’ money. They are spending it without justification on things that the public clearly would not approve of, such as massive advertising campaigns, public relations efforts, and other activities unrelated to actual medical care.”

Rav Zilberstein also criticized what he described as the approval of numerous prenatal tests that are often unnecessary and extremely costly.

“They act with excessive generosity and without proportion when it comes to these tests,” he said. “Therefore, there is no justification for the claims they make, and one cannot simply accept their position as binding when they themselves are spending money in this manner.”

Turning to the issue of medication coverage, Rav Zilberstein expressed frustration with what he characterized as inflexible eligibility requirements.

“But when it comes to elderly people who need life-saving medications, suddenly they become inexplicably stingy,” he said. “What do they say? ‘You’re missing this requirement. You’re missing a few points.’ That is stinginess. They have rigid rules. If someone’s protein level is 195, is he not in danger? Why must it be exactly 200 before he qualifies for assistance? These numbers can change within a month. They are constantly changing. Therefore, I say that fairness dictates that one should not automatically accept their position.”

Rav Zilberstein argued that the public would overwhelmingly prefer that health fund resources be directed first and foremost toward life-saving treatments.

“In my opinion, the public would rather see this money spent on life-saving medications,” he said. “As long as the health funds never ask the public how these funds should be used, it cannot simply be claimed that every expenditure reflects the will of the public. If they consulted their members, who would approve these advertisements? A single full-page ad costs an enormous amount of money. And there are many more advertisements—in newspapers, institutions, and elsewhere. The advertising is excessive and unjustified. It is money that should not be spent this way.”

One participant asked what purpose such advertising serves.

“Why are they advertising?” he asked. “Is it to build their reputation or to attract more clients?”

Rav Zilberstein replied, “To bring in more money and attract clients. But it is not justified. You cannot collect money from poor people who need that money to live and then spend it this way. It is not justified. Much of what we do today is not justified. It is not according to the Torah.”

{Matzav.com}