Sperling Daniel, Cohen Nissim
Department of Master Degree Studies in Health Systems Management, Yezreel Valley Academic College and Faculty of Law, University of Haifa, Haifa, Israel.
Department of Health Systems Management, Yezreel Valley Academic College, 19300, Yezrael Valley, Israel.
Isr J Health Policy Res. 2018 Nov 27;7(1):71. doi: 10.1186/s13584-018-0261-9.
Under structural conditions of non-governability, most players in the policy arena in Israel turn to two main channels that have proven effective in promoting the policies they seek: the submission of petitions to the High Court of Justice and making legislative amendments through the Economic Arrangements Law initiated by the Ministry of Finance. Nevertheless, an analysis of the principal trends emerging from the High Court of Justice rulings and legislative amendments through the Economic Arrangements Law indicates that these channels are open to influence, primarily by forces that are essentially neo-liberal. Little is known about the effects of these trends on the right to healthcare services, which in Israel has not been legislated as an independent constitutional law in Basic Laws.
We use four major legal cases decided by the Supreme Court of Israel in the past 10 years where the Court reviewed new legislative initiatives proposed by the Economic Arrangements Law in the area of healthcare. We utilize an institutional approach in our analysis.
A neo-institutional analysis of the legal cases demonstrates that petitions against the Economic Arrangements Law in the area of healthcare services have been denied, even though the Court uses strong rhetoric against that law and the government more generally in addressing issues that concern access to healthcare services and reforms in the healthcare system. This move strengthens the trend toward a neo-liberal public policy and significantly weakens the legal protection of the right to healthcare services.
In deciding petitions against the Economic Arrangements Law in the area of healthcare, the Supreme Court allows the Ministry of Finance to be a dominant player in the formation of public policy. In doing so, it may be promoting a goal of strengthening its position as a political institution that aspires to increase the public's trust in the judiciary and especially in the Supreme Court itself, in addition to exercising judicial restraint and allowing more leeway to the executive and legislative branches more generally.
在治理不善的结构条件下,以色列政策领域的大多数参与者转向两个已被证明在推动其寻求的政策方面有效的主要渠道:向高等法院提交请愿书,以及通过财政部发起的《经济安排法》进行立法修正。然而,对高等法院裁决和通过《经济安排法》进行的立法修正中出现的主要趋势的分析表明,这些渠道容易受到影响,主要是受到本质上是新自由主义力量的影响。对于这些趋势对医疗服务权的影响知之甚少,在以色列,医疗服务权尚未在基本法中作为一项独立的宪法法律进行立法。
我们使用了以色列最高法院在过去10年中裁决的四个主要法律案件,在这些案件中,法院审查了《经济安排法》在医疗领域提出的新立法倡议。我们在分析中采用了制度方法。
对这些法律案件的新制度分析表明,针对医疗服务领域《经济安排法》的请愿被驳回,尽管法院在处理与获得医疗服务和医疗系统改革相关的问题时,对该法律以及更广泛的政府使用了强烈的言辞。这一举措强化了新自由主义公共政策的趋势,并显著削弱了对医疗服务权的法律保护。
在裁决针对医疗领域《经济安排法》的请愿时,最高法院允许财政部在公共政策的形成中成为主导参与者。这样做,除了行使司法克制并更广泛地给予行政和立法部门更多回旋余地之外,它可能还在推动一个目标,即加强其作为一个政治机构的地位,该机构渴望提高公众对司法机构,特别是对最高法院本身的信任。