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00:00:00they are also doctors. of Israeli forces and the army.
00:00:03This also happens in other Therefore, the case and the report are studied in accordance with
00:00:07the insurance policy and medical protocols. The medical protocols in force.
00:00:10So why, doctor,
00:00:12medical network, this name, does the person also have an insurance card
00:00:16will be in my network. when they go to the hospital? Or other simple matters
00:00:19news spread, are treated, but for some examinations, the doctor has to
00:00:22talk to the company to obtain approval.
00:00:26This means that he already has approval,
00:00:30but it is not an exception, but he must
00:00:33communicate with the company that manages
00:00:37this matter and get approval.
00:00:40Why do some procedures require
00:00:45it could be in several clarification in the first place? Clarification as to why
00:00:49to urge citizens this procedure is requested at this time. We are talking about non-emergency procedures.
00:00:54during the coming Of course, we are not talking about emergencies. Emergencies are dealt with
00:00:56quickly, and so on, and approvals are obtained.
00:01:00For example, we can talk about
00:01:02occupation began directly MRI scans, CT scans.
00:01:05and other organizations For example, scheduled surgeries
00:01:07that are not
00:01:11to play their role in emergencies require some documents and supporting evidence
00:01:13from the medical entity
00:01:16to study them. Do they comply with
00:01:20the policy or not? Does this policy cover
00:01:24the lawyers' syndicate, for example. these procedures or not? Has the medical protocol been followed? For example, I don't know
00:01:28what to give from the first visit.
00:01:30An MRI scan. There must be a medical
00:01:35towards their homes. history for the patient, the residents, and what an attempt at certain
00:01:37treatments through medication, through natural treatments,
00:01:41through such. In the event
00:01:43villages and towns to
00:01:44since there are also more that this protocol or these procedures are exhausted, some images
00:01:48are resorted to, and for this
00:01:50and village councils reason, there are grounds for clarification from the treating physician to the insurance
00:01:54which the Israeli occupation company. Honestly, doctor, several
00:01:59especially since this questions came to my mind.
00:02:00incident occurred Well, what if the coverage is rejected? I mean, the patient
00:02:04is surprised that he wants treatment for chronic diseases or
00:02:08other things, or a scan, and it was rejected,
00:02:10and it is not in the policy. What happens?
00:02:13I mean, it was rejected. Or, for example, he might say to you,
00:02:18the cost. But today, "Okay, I can pay, for example,
00:02:19we must think about to cover a larger policy. I will pay you the difference, and it will be
00:02:22dealt with." I mean, what happens? What are the options for the person
00:02:26who is really in need
00:02:30assaulting citizens, and it is rejected? The examinations are rejected because the policy does not cover this matter.
00:02:33Unfortunately, here
00:02:35You told us about we are talking about something rejected
00:02:38outside the scope of the policy. I mean, the insured's policy does not cover.
00:02:42The insurer apologizes for covering this procedure
00:02:46or this scan. Now, naturally,
00:02:49we are not talking
00:02:52network of correspondents here about the absence of a medical need for the procedure.
00:02:55We are talking about the absence of approval from
00:02:58the policy or from
00:03:01the insurance document. So, we try
00:03:05to help the patient by, for example, amending the policy
00:03:08at that moment. Certainly not, because
00:03:12this is not possible. It has procedures and so on.
00:03:16However, we can go in other directions, for example,
00:03:20providing another
00:03:22you, colleague Marah, and all medical opinion. We can help him
00:03:24obtain, by virtue of the relationship between him and
00:03:28the provider, a certain discount rate, and so on,
00:03:33and until this day, so that we can help ensure that he does not bear
00:03:36occupation army camp, the costs, and we reduce the costs of the procedure that we did not cover.
00:03:40with complete impartiality. And it happened to us many times that we helped with matters.
00:03:43Sometimes there are many insured with private insurance and government insurance.
00:03:47Sometimes they go to the government sector, so it is much
00:03:50cheaper for them. Doctor, what came to my mind, honestly,
00:03:54is the question, is there an idea
00:03:57to merge government sector insurance
00:04:01with private insurance? Has this idea been raised?
00:04:05Honestly, private insurance, I mean, the situation in
00:04:08the government is known. There is a shortage of capabilities,
00:04:12a lack of services.
00:04:13as the occupation There is a major
00:04:15shot him in the upper financial crisis in the sector.
00:04:17extremities of the body, And whoever has tried private insurance
00:04:18and also in the lower knows how fast things are.
00:04:20One criterion is for the doctor And it is treated quickly, and so on. And if the policy
00:04:23is good, he does not find problems, and he goes to good
00:04:26hospitals as well. So, can we merge
00:04:30the government sector and the private sector? Have you discussed
00:04:35spread of the medical network these matters? Honestly, there were
00:04:37many proposals for this matter in the previous
00:04:40periods and in the previous and even current ministries.
00:04:43First, to expand
00:04:45the medical network so that the insured the reach of medical insurance to all members of society.
00:04:48This is one. Second, to improve the service
00:04:52provided in the... Because I feel that private
00:04:56insurance is closer to people because it is faster.
00:05:00First, I don't have to wait in line for a long time.
00:05:04Clinics, even at the clinic level. I mean, I want to see a specialist.
00:05:07They might give me an appointment after three or four months.
00:05:10Okay. And this is not limited to our country, to Palestine.
00:05:15countries, or in the side. At the end, or so on.
00:05:19There are waiting periods that can take a long time in the government
00:05:23sector. Now, in cases where waiting is not a problem,
00:05:26but in simple or urgent cases,
00:05:30it is necessary. So, there was a high-level discussion about
00:05:34merging the two sectors
00:05:37to improve the service. For example, it was suggested
00:05:41that TPA companies take over government
00:05:44insurance, and also issue
00:05:47policies for government insured.
00:05:50It could be with lower coverage, it could be
00:05:54with higher co-payments,
00:05:57ways, but at least we would improve the service.
00:06:01Yes, we could raise the price for those who want it.
00:06:05This is one, or increase the co-payments.
00:06:08There was a proposal, and civil society
00:06:11organizations worked on this,
00:06:13and conducted research,
00:06:17worked on this. And several meetings were held
00:06:21in this regard. But you know, sometimes there are many
00:06:24obstacles. But the existence of this idea is
00:06:27there, it is there, true. Because as I speak with you,
00:06:31I feel that, as you mentioned, private insurance,
00:06:34despite being more expensive compared to government insurance,
00:06:38which costs about 700 or 650 shekels per year,
00:06:42private insurance is higher. But people are closer to this
00:06:46topic because the services are faster. The access
00:06:50to the service is the basis and the criterion, let's say,
00:06:53for private insurance, especially
00:06:57options in private insurance. Government insurance is limited
00:07:00to government institutions, government hospitals.
00:07:04For example, if we talk about someone with private insurance
00:07:06in Ramallah, we have eight private hospitals
00:07:09and an uncountable number of them.
00:07:20So, he can go at any time, 24/7, to medical
00:07:24institutions. Doctor, since we mentioned government
00:07:28and private, I just want you to explain
00:07:32to us the TPA you mentioned earlier, the service
00:07:35management. What is the difference between TPA and the traditional
00:07:39model? So that I can move on to other topics, because
00:07:42talking with you has taken us to an important and vital
00:07:46topic, but this is an important point. What is the difference
00:07:49between the traditional system and the TPA system
00:07:52that insurance companies follow?
00:07:55First, TPA is a third-party
00:07:59administrator, or it is the third party that manages
00:08:03health insurance, and it is a company
00:08:06independent of other or traditional insurance companies.
00:08:09It manages the insurance and acts as an intermediary
00:08:12between the insurance company and the insured, and the other
00:08:16party is the service provider, whether
00:08:19it is a doctor, hospital, or other.
00:08:22The difference between them and the traditional system was that
00:08:26before the existence of TPA, the insurance company itself
00:08:29was the one that set the policy
00:08:33and wrote it, and it was also the one that managed
00:08:36the coverage and claims, and so on. The existence
00:08:40of the other party
00:08:42isolates it from managing
00:08:44expenses
00:08:47and managing coverage. Therefore, the coverage is done
00:08:52Of course, as a TPA company, I am not concerned
00:08:55with the loss or profit of a specific
00:08:58policy. I am concerned with the coverage according
00:09:01to the agreement and medical protocols.
00:09:04Doctor, I will also go to a very important topic.
00:09:08How is the medical network or service providers
00:09:12selected? Some doctors are in insurance companies,
00:09:15and some are not. Is there a criterion
00:09:17based on, for example, the price of the examination,
00:09:21or is there a specific experience?
00:09:23How is it done? There is a difference, honestly,
00:09:27between one doctor and another in price. There are two criteria.
00:09:32or medical institution in their desire to join
00:09:36the medical network. This is one side. The other
00:09:40thing is a criterion for
00:09:42insurance companies or TPA companies. I mean, the geographical
00:09:47is important. So, I go and look at the medical network
00:09:50I have in a certain place, in a certain city,
00:09:53in a certain village. So, I seek to expand
00:09:58is... Because the institutions
00:10:01might be from several areas in the country.
00:10:04So, I might be forced to provide a medical
00:10:08network geographically and also specialized.
00:10:10I mean, I must have an orthopedic
00:10:12doctor, a gynecologist, a pediatrician,
00:10:16an ophthalmologist in general. And I also have hospitals, centers, and laboratories.
00:10:20So, the criterion is primarily a geographical
00:10:23and specialized criterion, so that we provide
00:10:26all specialties, especially the names. You know that
00:10:29there are some doctors that everyone agrees on.
00:10:32So, as a company, and I like to have a strong
00:10:37or this doctor, or this center, or this hospital
00:10:41On the other hand,
00:10:44the price criterion
00:10:46also plays a role. But in general,
00:10:50there is a contract between the company
00:10:53and the provider. And sometimes it is through associations,
00:10:57for example, or through syndicates. So, some insurance
00:11:00companies have signed agreements with the pharmacists' syndicate,
00:11:04with the doctors' syndicate,
00:11:06with the radiology syndicate, or individually.
00:11:09It also depends on the company and how, let's say,
00:11:13smart the company is in attracting offers
00:11:16to it. Who determines the prices of the service
00:11:19in the end? I mean, who determines the doctor's price,
00:11:23the examination price, and all these matters?
00:11:27I mean, some prices are determined by the syndicates.
00:11:30I mean, the doctors' syndicate has a pricing
00:11:33for examinations. I mean, I might have a policy,
00:11:37and you have a policy. You might be with the lawyers'
00:11:40syndicate, so the price might be different from mine as
00:11:44an ordinary person, because I am not with
00:11:49It's not like that. If you have Smart Health
00:11:53company, all Smart Health
00:12:03company insured have the same insurance card
00:12:07from Smart Health company. So, whether it is a lawyer,
00:12:11an engineer, or other, as long as they have the card,
00:12:14all prices are unified. But I, as a specific company, might have better
00:12:18prices than...
00:12:27Welcome, dear viewers, to this special coverage
00:12:30on Palestine TV, to keep up with the latest
00:12:34developments and field developments in various
00:12:37governorates of the homeland, in light of the escalating
00:12:40violations and attacks by settlers and the occupation
00:12:42army against various governorates through
00:12:46the campaign of incursions and raids it launches
00:12:49against various villages and towns, and what accompanies
00:12:52it of raiding homes,
00:12:55and also we are talking about tightening military
00:12:58procedures at the entrances and exits of all
00:13:02towns and villages of the governorates,
00:13:06within the policy of collective punishment pursued by the
00:13:09occupation against our people in various governorates
00:13:12of the homeland. More details with our
00:13:17in the field. And we start with Jenin
00:13:21and our correspondent Amina Bilal.
00:13:25Amina, welcome. So, the occupation forces
00:13:29opened live fire towards a vehicle near
00:13:32Haddad Tourist Village, east of Jenin city.
00:13:36And there is news of
00:13:41a martyr and an injured person. More details with you.
00:13:44Yes, after greeting
00:13:47dear viewers. Indeed, this event
00:13:50and this news are still ongoing at this
00:13:54moment near Haddad Tourist Village, where Haddad Tourist
00:13:57Camp or the Israeli
00:14:01which is still continuing its construction in
00:14:05the eastern region of Jenin Governorate. Half an hour
00:14:08ago, we received news of a martyr, who was
00:14:11shot by the Israeli occupation army while
00:14:15he was inside his vehicle with one
00:14:19of his friends. And thus, the Israeli
00:14:23occupation army officially announced the martyrdom of this young man,
00:14:26whose identity has not yet been confirmed. But a few
00:14:30moments ago, we confirmed with the Palestinian Liaison
00:14:34that the young man is critically injured,
00:14:43extremities of the body. And the injured person
00:14:47was arrested and transferred to a vehicle belonging
00:14:50to the Israeli occupation army towards the Jalamah
00:14:54military checkpoint located north of the governorate.
00:14:56So, he is injured and not a martyr
00:15:00until this moment. He is seriously injured,
00:15:04in addition to the fact that the young man who
00:15:07was with the injured person was arrested and was
00:15:10not injured, but he was severely beaten and abused
00:15:14and transferred to the Jalamah military checkpoint located
00:15:17north of the governorate. Until this moment,
00:15:20the injury is still serious.
00:15:23We also confirmed that
00:15:25the young man is from Jenin refugee camp.
00:15:29But the name of the young man
00:15:32is with us, but we cannot say
00:15:36the name until we confirm the name of the injured
00:15:39young man. Until this moment.
00:15:42So, the Israeli occupation army
00:15:45opened fire randomly towards a vehicle
00:15:49carrying two young men towards Haddad
00:15:53Tourist Village. And after this
00:15:57ambulance vehicles tried
00:16:00to reach the injured person inside the vehicle,
00:16:03but until this moment, the Israeli occupation
00:16:06army is still detaining the Palestinian Red Crescent
00:16:10crews who were heading towards the vehicle
00:16:13that the Israeli occupation opened fire on very
00:16:17heavily. And they are still detained until this
00:16:21moment. The Israeli occupation army began detaining
00:16:25citizens' vehicles and assaulting all citizens,
00:16:28especially those coming from the eastern villages.
00:16:31We are talking about Deir Abu Da'if village,
00:16:34Aba al-Sharqiya village, Jilbon village. The Israeli
00:16:39after this incident
00:16:42by deploying military checkpoints, assaulting
00:16:46citizens, and arresting citizens and severely
00:16:49beating them. A wide-ranging arrest campaign is being
00:16:52carried out at this moment by the Israeli
00:16:55occupation army against all citizens in that
00:16:58area, and detaining dozens of Palestinian
00:17:02vehicles coming from the eastern areas
00:17:06or returning from the city
00:17:08center of Jenin governorate
00:17:12The Israeli occupation is also setting up military checkpoints
00:17:16at this moment on the bypass road connecting the northern
00:17:21the city center, with calls
00:17:23for all settlers to leave the settlements,
00:17:26especially the settlements of Ganem and Kadim,
00:17:31returned to recently. To leave these settlements,
00:17:38half an hour ago near the Ganem and
00:17:41Kadim settlements. Therefore, at this
00:17:44moment, there is a massive deployment of settler
00:17:47gangs in that area, especially around
00:17:51Haddad Tourist Village, where the Israeli
00:17:54occupation army camp, which is still continuing
00:17:57its construction and establishment to secure
00:18:01protection for all settlers in Ganem and
00:18:04Kadim settlements. There is also a deployment
00:18:07of occupation forces that came out of Jenin
00:18:10camp in the city center. And a state of panic
00:18:14and terror that spread among citizens and residents,
00:18:17especially with citizens leaving their workplaces,
00:18:21as this area where we are located at this
00:18:25moment is the area of government departments
00:18:28and official institutions. Therefore, behind me,
00:18:32Jenin camp appears through the lens of Palestine
00:18:35TV, which is still closed for almost two and a half
00:18:39years with earth mounds and iron gates,
00:18:43and entry to the camp is prohibited. There are
00:18:46real movements of foot patrols around Jenin
00:18:49camp, especially behind the earth mounds.
00:18:53The Israeli occupation ambushes with foot
00:18:55patrols all citizens who try to approach
00:18:59these mounds. They open fire
00:19:02randomly at any citizen who tries
00:19:05to approach the entrances of the camp.
00:19:09Continuing the process of changing the demographic
00:19:12and geographical character of Jenin camp
00:19:16by opening new roads and creating new
00:19:18roads at the expense of the lands and properties
00:19:22of the displaced inside the camp, especially
00:19:25we are talking about 22,000 displaced
00:19:29persons who are still prevented from entering
00:19:33the camp for almost two and a half years. Returning to the incident
00:19:41where the Israeli occupation opened fire heavily
00:19:45and extensively on a vehicle carrying two young
00:19:49men. These young men reached the area
00:19:53of Haddad Tourist Village in the eastern
00:19:56side and the eastern part of Jenin
00:19:59Governorate. They were surprised that the Israeli army
00:20:03had set up military checkpoints and started
00:20:06firing heavily. The Israeli occupation
00:20:10army announced the assassination of one of the young men.
00:20:13But after confirmation from the Palestinian Liaison,
00:20:16it was confirmed that the young man is critically
00:20:19injured and is from Jenin refugee camp. Thank you,
00:20:23Amen Bilal, our correspondent from Jenin, for all these
00:20:27clarifications and details so far. And we will
00:20:30certainly stay with you during this coverage.
00:20:34But we move to Nablus, and the Governor of Nablus,
00:20:37Ghassan Daghlas, joins us via phone. Your Excellency,
00:20:41welcome. So, the occupation is tightening its military
00:20:45measures in various villages and towns of Nablus
00:20:48governorate, coinciding with daily incursions
00:20:52and raids, and also widespread arrests.
00:20:55What are the implications of the continued incursions
00:20:59into the governorate, its towns, and its camps? Yes, Nablus
00:21:02is experiencing,
00:21:05like the rest of the governorates, a very severe siege.
00:21:08All the checkpoints surrounding Nablus
00:21:12are tightening more and more, even
00:21:16the earthen mounds are working to close
00:21:20them in all areas. A tight siege. We in Nablus,
00:21:23with the Minister of Education, opened five schools today.
00:21:26But, I mean, after hearing the news that there are
00:21:30complete closures of the provincial association,
00:21:34we are now on the air on Voice of Palestine Radio
00:21:39to take more caution and vigilance
00:21:44hours, especially in the southern areas of the governorate
00:21:46and the northwestern areas of the governorate.
00:21:50Things are escalating greatly. There are clear
00:21:53calls from settlers. But we urge all popular and village protection
00:21:57committees
00:22:01protecting families and families, God forbid, from
00:22:05home invasions.
00:22:15Your Excellency, how do these
00:22:18incursions and arrests affect
00:22:23is the situation
00:22:26in the governorate? Continued,
00:22:29but there is concern that there will be much
00:22:33more severe reactions from the settlers every
00:22:36day. We have called upon all municipal
00:22:40to reflect on their role in the governorate,
00:22:44and the protection committees are very important
00:22:47in these difficult circumstances. The Nablus road is closed.
00:22:51Nablus is closed. All these roads are closed. This means
00:22:55transforming the entire governorate into a large
00:22:58prison. Our role as Palestinians is to stand together
00:23:01in these difficult circumstances and break the siege,
00:23:04God willing, no matter
00:23:09protecting our homes,
00:23:13especially in the areas close to the settlements.
00:23:17Thank you, Governor
00:23:19of Nablus, Ghassan Daghlas, for all these
00:23:22clarifications and details.
00:23:25the situation in the governorate in light
00:23:29of the occupation's attacks and repeated violations
00:23:31against Nablus governorate, as well as the rest
00:23:35of the governorates of the homeland. So, dear viewers,
00:23:38it is a new aggression carried out by the occupation
00:23:41forces and settler gangs against the governorates
00:23:45of the West Bank, taking advantage of
00:23:48the Jewish holidays. How these attacks
00:23:51and violations in various governorates, from
00:23:54north to south, and also the tightening
00:23:58of military measures at all entrances
00:24:00and exits of towns, villages, and cities
00:24:04of the governorates in the West Bank, within the policy
00:24:07of collective punishment pursued by the occupation
00:24:11against our people in all governorates.
00:24:14It is a retaliatory policy
00:24:17that continues to this day, pursued by the occupation
00:24:21for a long time
00:24:23retaliation against our people.
00:24:27Also, all these attacks
00:24:31and violations coincide with the continuous occupation
00:24:34aggression against our people in the Gaza
00:24:37Strip, where the occupation continues its violations
00:24:41of the ceasefire agreement on a daily basis.
00:24:44Martyrs and wounded in various areas
00:24:47of the Strip. Also, dear viewers,
00:24:50we would like to mention that a short while ago,
00:24:54the Israeli occupation prime minister, Benjamin Netanyahu,
00:24:58ordered the reinforcement