AUGUSTA VICTORIA HOSPITAL TO DENY CARE TO

UNCLAS JERUSALEM 001852 SIPDIS SENSITIVE SIPDIS NEA FOR FRONT OFFICE; NEA/IPA FOR WILLIAMS/GREENE/WAECHTER; NSC FOR ABRAMS/DORAN/LOGERFO; STATE PASS TO USAID/BORODIN; TREASURY FOR ADKINS E.O. 12958: N/A TAGS: PHUM EAID EFIN KWBG IS SUBJECT: AUGUSTA VICTORIA HOSPITAL TO DENY CARE TO PALESTINIANS ABSENT FUNDING REF: JERUSALEM 1697 ¶1. (SBU) Summary: In a May 4 meeting with EconOffs, CEO of Augusta Victoria Hospital (AVH) Tawfiq Nasser warned that AVH would be forced to deny "catastrophic care," such as pediatric dialysis and oncology treatment, to Palestinians due to a lack of funding. AVH, together with St. John Eye Hospital and Al-Makassad Hospital, provide over USD 750,000 in medical services to about 6,000 Palestinians referred by the PA and UNRWA per month. These hospitals have traditionally relied on reimbursements from the PA, but are facing financial pressures because of the PA's inability to make the payments. Nasser added that he had briefed Washington officials on this problem during an April visit. End Summary. Getting down to the numbers -------------- ¶2. (SBU) According to Nasser, AVH is the only hospital in East Jerusalem or the West Bank that is able to provide chemotherapy and pediatric dialysis. The PA had agreed with AVH on a monthly fixed payment of USD 322,000, including oncology treatments in order to cover the costs of PA referrals (reftel). Presently, the PA owes AVH USD 1.5 million and has not made a payment since February. Treatment for Palestinians accounts for 40 percent of AVH's budget: 20 percent is paid by UNRWA and 20 percent is part of the PA's contractual obligation. AVH's underlying institution -- the Lutheran World Federation -- informed Nasser that AVH should start contingency planning should the PA default on its obligations. Nasser said that this meant that AVH would have to begin denying care to patients in one to two months if funding does not materialize. ¶3. (SBU) Nasser said that drugs account for 70 percent of its expenses. The hospital spends USD 200,000 to 250,000 per month for dialysis and oncology treatments, gastrointestinology, and endoscopy procedures. The majority of drug suppliers are Israeli firms that contract out to Palestinian agents. Even though USD 1 million is owed to drug suppliers, Nasser said he was unable to approach the GOI to ask for their assistance given the political sensitivities. UNRWA confined to reimburse AVH only for refugees -------------- -------------- ¶4. (SBU) UNRWA has a contractual agreement to reimburse AVH for tertiary services provided to refugees and, according to Nasser, is unable to expand its mandate (reftel). (Note: While all Palestinians are eligible to purchase insurance from the PA, PA employees are required to enroll in the PA insurance scheme. End Note.) Nasser said AVH had discovered that Palestinians, looking for a lower co-payment, apply for both UNRWA and PA health insurance, complicating AVH's billing system. (Note: Palestinians pay a 30 percent co-payment under the UNRWA insurance and a 10 percent co-payment under the PA insurance. End Note.) He urged that the PA should revamp the system to avoid inconsistencies in the healthcare sector, particularly since there is no common database to track insurance coverage. AVH shuttle service -------------- ¶5. (SBU) Nasser noted that AVH has four daily shuttles to Hebron, Abu Dis, and the north of the West Bank. Nasser said that this busing system, called "Hope and Health Across the Wall," was designed to facilitate the travel of West Bank patients for care at AVH in East Jerusalem. He estimated that it costs AVH USD 290,000 per year to run the shuttle service, although some of the costs are defrayed by payments from the staff. Comment: -------------- ¶6. (SBU) Helping AVH meet its unfunded costs would be an ideal use of donor humanitarian funds, since AVH is one of the few non-PA MOH providers of catastrophic care to West Bank Palestinians. End Comment. WALLES