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
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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