How Israel Turned Its Back on a Refugee From Ukraine When She Was Diagnosed With Cancer

16.08.23, Liza Rozovsky and Bar Peleg, Haaretz

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Svitlana Haiova, 47, fled the war in Ukraine and has since been living in Israel. In March, she was diagnosed with breast cancer. A cruel and Kafkaesque coincidence has led to her having no medical insurance, preventing her from getting an appointment for surgery or chemotherapy for almost half a year.

It all began with her insurance company and health fund revoking her insurance coverage. Following that, her employer, through whom she was insured, terminated her contract. For the subsequent two months, her efforts to obtain state-approved treatment were met with failure. Ultimately, medical treatment for Ukrainian refugees was suspended due to the Israeli government’s failure to approve a budget. As a result, she endured nearly half a year with a diagnosed cancer without receiving the necessary medical care, all while the clock continued to tick.

With insurance coverage no longer in place, a single doctor who examined her recommended that she return to her place of origin to seek medical treatment. In a summary from a follow-up report received by Haaretz in May, the oncologist from Bnei Zion Hospital in Haifa wrote: “Molecular testing is not feasible, and it seems that surgery and chemotherapy options are also unavailable. If an insurance-based solution isn’t found, I advise returning to Ukraine for treatment.”

However, for Haiova, going back is not an option: the village she hails from in the Kharkiv region remains under Russian control, and intense battles are raging nearby. “They’re suggesting I return to Ukraine. But I cannot go back there. My village is under occupation,” she says.

Haiova arrived in Israel in June 2022, following her husband, who worked here legally even before the war. Almost immediately upon arrival she began working in cleaning, and was enrolled as is customary in health insurance through her employer – the Vered Hatzafon company – which insured Haiova through another subcontractor.

At the end of the year she discovered a lump in her breast and saw her family physician. In early 2023, before she had an opportunity to be examined, the manpower company employing her transferred her to another insurance company – Menora Mivtachim, which works with the Kupat Holim Leumit HMO. She underwent the necessary tests through Leumit, and in March was diagnosed with cancer.

At this critical moment, when she needed urgent medical care, the HMO informed her that Menora Mivtachim had stopped insuring her. Haiova’s employer tried to transfer her to another insurance company, but was denied. Shortly thereafter, Haiova’s employer fired her, and she remained uninsured.

Haaretz has learned that the reason Haiova’s insurance was terminated following her diagnosis is that Menora Mivtachim and Kupat Holim Leumit believed she had hidden the suspicion of cancer from them when she was enrolled in the policy. Haiova, however, told Haaretz that she was never asked about her medical condition when she was transferred to a new insurance company. She says her employer informed her of the transfer by text message and without asking her anything.

Haiova’s story illustrates just how dire the situation is for war refugees and asylum seekers in Israel. The socio-economic system in the country is constructed in a way that facilitates the exploitation of these individuals as cheap labor. The safety net that is supposed to be provided by the system, in cases where a worker loses their ability to work due to medical reasons, is entirely dismantled. As a result, a woman trapped in a bureaucratic tangle between health funds, insurance companies, employers, and the welfare system – has been diagnosed with breast cancer for half a year without receiving the necessary treatment.

Haaretz reached out to the Union Pro Ltd company, listed as Haiova’s employer in the insurance documents. Following this contact it turned out that the HR company had never employed her or known of her existence, but only served as a “broker” for purposes of the insurance for another HR company – Vered Hatzafon. Union Pro told Haaretz that Vered Hatzafon was supposed to sign Haiova to a new health statement form before transferring her to a new insurance company. Vered Hatzafon says that they did sign her to such a form, but have not provided Haaretz with any proof of its existence. Vered Hatzafon confirmed to Haaretz that the reason for Haiova’s termination was the company’s inability to employ her without insurance.

Lacking medical insurance and a job, the nearly last safety net Haiova had been the welfare authorities, but they have disowned her as well, as the funding for healthcare for Ukrainian refugees has been stopped. Haiova turned to the Terem network, which provides urgent medical care for Ukrainian refugees. She was tested at the network’s Carmiel branch on June 2, and since then awaited word on whether she would receive approval for surgery and other treatments. Last week she received notice that healthcare for Ukrainians has been terminated.

The Welfare and Social Affairs Ministry said in response that they had approved her request on July 27 – almost two months after it was filed. Terem, on the other hand, say they didn’t receive approval from the Welfare Ministry until July 30, when the ministry notified them that funding for healthcare for Ukrainians has been stopped anyway. After another examination, the Welfare Ministry informed Haaretz that in fact the official request from Terem was only received on July 27, and was approved on August 1.

‘We’re replacing the State of Israel, plain and simple’

After it seemed that the HMOs and the welfare system had slammed the door in her face once and for all, refugee aid organization HIAS sent Haiova to the Veahavta clinic in Haifa. At this clinic, physicians, nurses, and pharmacists aid the undocumented voluntarily. Haiova went to the clinic last week, where she was given medication supposed to retard the development of the tumor, gave her an appointment for an oncologist, and also managed to schedule surgery to remove the tumor, to be performed voluntarily at Elisha Hospital.

Following the surgery she will receive radiation therapy, also free of charge, to be performed at the Italian Hospital in Haifa. “We’re replacing the State of Israel, plain and simple,” says Dr. Margalit Lurber, the clinic’s director. “The resources we have are mostly connections we employ. We can’t help everyone, so we are forced to choose the patients with the best chance. This patient has a chance because she’s young.”

Following Haaretz’s queries to insurance company Menora Mivtachim and the Kupat Holim Leumit HMO, it turns out that the cancellation of Haiova’s insurance was the result of a “misunderstanding.” Now, half a year after its cancellation, the company and HMO announced that they are willing to re-enroll her. Menora Mivtachim said to Haaretz: “Based on medical information received from the HMO that did not exist at the time of joining the policy, the policy was revoked on the grounds of non-disclosure of medical information at the time of joining. Following your query, another verification was made with the HMO, and we will act to renew the insurance in accordance with the terms of the policy.”

Leumit HMO said: “Due to a misunderstanding, the policy was revoked rather than have it stand and add an exception clause to it. Following the query and discovery of the error, the policy has been renewed, effective immediately. We wish her health and full recovery.”
It is unclear how Menora and Leumit can insure Haiova now, considering that she was insured through her employer, and since then has been fired and has not been employed for months. To Haaretz’s question, Leumit responded that “Menora will solve it technically.” Since then, no one has contacted Haiova.

On Monday, Ukraine’s Foreign Minister, Dmytro Kuleba, spoke with his Israeli counterpart, Eli Cohen. Following their conversation, Kuleba conveyed that Cohen had assured him that Ukrainian nationals residing in Israel would continue to receive health insurance coverage from the state and that “the issue would be resolved soon.”

Responding to a report in Haaretz about the reduction of assistance to Ukrainian refugees, including in areas of food, housing, and psychological care, Ukraine’s Ambassador to Israel, Yevgen Korniychuk, stated, “I call on the Israeli government to act compassionately towards individuals who sought refuge from war in Israel,” and he expressed hope that “health insurance and other humanitarian programs would be reinstated this week.”
Terem said that regarding Haiova’s case, “Terem was in constant contact with the Welfare Ministry and by July 30 approval for the treatment had not yet been received. Unfortunately, at that time Terem was also informed of the termination of all funding for healthcare for Ukrainian refugees.”
The Welfare and Social Affairs Ministry said the query into Haiova’s predicament “was officially transferred by Terem with the documents to the Tzav Hasha’a administration on July 27, 2023.” The ministry added that the appeal was “approved on August 1, 2023,” and that “Notice of cessation of funding for medical aid was only delivered on August 8, 2023.”
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