The Independent Commission for Human Rights (ICHR) organised a hearing session on Sunday 21st of December 2008 with Dr. Fat‘hi Abu Mughalli, Minister of Health, to discuss the Draft Health Insurance Law. Taking place at the ICHR offices in Ramallah, the session brought together representatives of labour unions, syndicates, health insurance stakeholders, as well as relevant governmental departments and civil society organisations. In relation to the Draft Health Insurance Law, several important issues were introduced in the hearing session:

1. Discussants commended efforts made by the Ministry of Health to develop the Draft Law of the National Health Insurance.
2. The Draft Law still needs further financial, economic, and social studies in conformity with the public‘s current circumstances and the status of health care services delivered to citizens.
3. A study on the package of national legislation relating to health insurance, including the Law of Public Retirement and Labour Law, should be compiled.
4. The health insurance system deducts 5 percent of income. Since a taxation law has not yet been in place, it will be difficult to apply such a deduction. Furthermore, the deduction will undermine principles of solidarity and equity between men and women.
5. Clear standards and principles should be developed for selection of members on the management board of the National Health Insurance Institution. Posing a conflict of interests between service suppliers and beneficiaries, participants asked why the Minister of Health will chair the Health Insurance Institution.
6. Financial costs of the Draft Law as well as citizens‘ ability to cover subscriptions to the Health Insurance Fund need be examined. Taking into account that 65 percent of the Palestinian people comprise youths, including students and unemployed women.
7. Illustrating degradation from the rights to health care, free health care services delivered in accordance with the Draft Law are reduced compared to current service delivery.
8. Article (2) under the Draft Law appropriates 20 percent of health insurance revenues to covering a number of free basic services. In reality, these services, such as vaccination, are a primary component of primary health care, for which the state is responsible. World Health Organisation constantly confirms this fact.
9. The Draft Law must provide for expanding the scope of social categories benefiting from the health care service provided by the health insurance system. These will include farmers, workers in family enterprises, unemployed women, female-headed households, housemaids (persons in informal jobs).

In conclusion, participants in the workshops agreed to submit a request to President Mahmoud Abbas and Prime Minister Salam Fayyadh  calling on them to postpone promulgation of the Draft Law to allow for further discussions among stakeholders and a wider participation of the public on issues related to the draft law.  It was also agreed that discussions among all relevant stakeholders will be continued in order to submit specific proposals to Palestinian decision-makers regarding the draft law  within a maximum period of one month.

ICHR and Forum of Health Policies have been assigned to receive proposals from stakeholders. These will be drafted in the form of particular recommendations and presented to the relevant decision makers. Finally, a Draft Law of the National Health Insurance will be developed in line with human rights standards. 22

December 2008