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In Palestine, no job means no health insurance

The Palestinian government recently decided to halt health insurance for Palestinian unemployed citizens, sparking angry reactions among civil society organizations in light of the deteriorating economic conditions for hundreds of thousands of Palestinian unemployed citizens.
A Palestinian doctor examines the eyes of a patient at Shams medical centre in Deheishe refugee camp in the West Bank town of Bethlehem May 7, 2012. The new hospital, a stark contrast to Deheishe's general dilapidation, aims to provide services to sufferers of diabetes and hypertension to the handful of refugee camps spread around the Southern West Bank. Three generations of Palestinians displaced by the founding of Israel in 1948 know only life in United Nations refugee camps, going to schools beneath the

GAZA, Gaza Strip — According to official figures published by the Palestinian Bureau of Statistics on Feb. 16, the unemployment rate in Palestine climbed to 26.9%, with 360,500 unemployed out of a total workforce of 1.3 million in Palestine, while the poverty rate in the Gaza Strip exceeded 80%, according to the Zakat Department affiliated with the Palestinian Ministry of Religious Endowments.

Despite these staggering figures, the Palestinian Cabinet announced Feb. 15 the cancellation of all health insurance benefits granted to unemployed citizens starting March 1.

The Cabinet decision irked and outraged civil society organizations. On Feb. 15, the coalition of economic and social rights (a coalition of more than 55 Palestinian civil society organizations and trade unions) called on the Council of Ministers to renounce its halt of health insurance benefits for the unemployed, saying the government's decision is a violation of the Palestinian Basic Law.

Suheil al-Hindi, the Field Research Department coordinator at Al Mezan Center for Human Rights in Gaza, told Al-Monitor, “The government's decision is unjust to hundreds of thousands of Palestinian families who cannot afford health service costs, which would put their lives at risk. The government should have held prior discussions with civil society organizations on this unjust decision instead of making up false justifications.”

The head of the Palestinian General Federation of Trade Unions, Sami al-Amsi, told Al-Monitor, “The Palestinian government's decision to cancel free health insurance for Palestinian unemployed citizens crossed all red lines and we will resort to all means and tools to prevent its execution. We will stage protests and sit-ins until the Cabinet renounces its unjust decision. Palestinian citizens expected the government of national consensus to establish programs that would lead to their employment or ensure their children’s employment to allow them to have a stable life. Instead they saw the level of the services provided to them downgraded.”

The Palestinian Authority (PA) had granted unemployed citizens free health insurance by virtue of a decision by Palestinian President Yasser Arafat in 2000 in light of the deterioration of the economic and social situation in the Palestinian territories with the outbreak of the Al-Aqsa Intifada in the same year.

In 2000, 39,000 unemployed citizens benefited from free health insurance. According to estimates of the Palestinian Health Ministry, the number of beneficiaries of this free insurance reached around 250,000 in 2016.

In turn, Youssef Abu al-Rish, the director general of the Hospitals Department at the Health Ministry in Gaza, told Al-Monitor, “Until the end of 2016, 235,000 families benefited from free health insurance granted by the Health Ministry in Gaza, including 95,000 beneficiaries who have access to free health insurance from among the category of unemployed, families of martyrs and wounded, prisoners and beneficiaries of Social Affairs Ministry programs.”

He added, “The Ministry of Health in Gaza will not abide by the Palestinian Cabinet’s recent decision and vows to maintain the free health insurance benefits for those who meet the conditions,” noting that the ministry will add a new category of beneficiaries from the free health insurance consisting of citizens earning less than the minimum wage, which currently stands at 1,450 shekels (around $396) a month.

Health insurance in Palestine is divided into two schemes. The first is mandatory health insurance, where individual participants pay a monthly contribution ranging between 50-75 shekels ($14-$21) while public or retired employees have 5% deducted from their basic salary or pension.

The Social Security Law guarantees this to any person. Until the end of 2014, 150,464 families benefited from this insurance scheme in the West Bank.

The second insurance scheme is free health insurance granted to unemployed citizens, families of martyrs and wounded, prisoners, and beneficiaries of the Ministry of Social Affairs programs.

It should be noted that after the Palestinian division and Hamas’ takeover of the Gaza Strip, Palestinian President Mahmoud Abbas issued on June 14, 2007, Decree No. 18 of 2007 that exempts Gaza Strip citizens from paying any fees or taxes on all services provided by PA departments, including health insurance; the decision includes all citizens, including employees and retirees.

Atef Adwan, a Hamas parliamentarian and the head of the Economic Committee of the Palestinian Legislative Council, told Al-Monitor, “The Ramallah government shall bear the consequences of the decision to halt free health insurance for the unemployed since it is exploiting the state of political vacuum and the disruption of the Legislative Council since the Fatah-Hamas division in 2007 to pass decisions aimed at fragmenting the social fabric and that serve Israel.”

He added, “The free health insurance granted to unemployed citizens costs the Health Ministry in Gaza up to 81 million shekels [$22.1 million] every year, in the absence of any financial assistance from the PA in the last 10 years.”

The Palestinian Legislative Council has been holding extraordinary sessions since the outbreak of the Palestinian division in 2007, and the last session in Gaza was held on Jan. 26.

Youssef Mahmoud, the spokesman for the consensus government, told Al-Monitor, “Many have misunderstood the Council of Ministers' decision, which provides for the suspension of the free health insurance scheme as of the beginning of March to allow workforce-related data to be updated. The decision does not provide for the definitive halt of this insurance as some have alleged.”

The dean of the Faculty of Law at Umma University, Abbas Noureddine, is not convinced by Mahmoud’s argument. He told Al-Monitor, “According to the applicable legislative regulations in force in Palestine, the Cabinet decisions shall be published in the Palestinian Official Gazette (al-Waqa'eh) to enter into force and become legally binding.

He noted that any governmental explanation about any legislation in force should be published in the Palestinian official gazette and not made public through press statements. “Did the government take back its decision to halt free health insurance benefits?” he asked.

One cannot predict what will happen if the government of consensus decides to execute its decision to stop free health insurance for the unemployed as of the beginning of March. However, it is likely that this step would lead to protests and sit-ins against the government by unemployed citizens in the West Bank and the Gaza Strip, demanding back their right to free health insurance.

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