On 9 February 2009, Adalah sent a letter to the Minister of Health and the Attorney General demanding that they include MRI scans for breast cancer in the basket of health services provided by health funds in Israel. In the letter, Adalah Attorney Sawsan Zaher argued that there are many cases in which health funds refuse to perform an MRI test on women because of the relatively high cost of the procedure relative to other tests designed to detect breast cancer, such as mammograms. Adalah further contended that there are no clear written criteria to govern in which cases health funds should refer patients to undergo an MRI test as opposed to an alternative test. This lack of clarity renders the National Insurance Law – 1994 vague and its application arbitrary.
In the letter, Adalah demanded that clear, written criteria be defined for MRI scan referrals based on a range of considerations, including the condition of an individual patient’s health and her financial situation, in order to achieve equality in access to health services and to realize the right to health in an equitable manner.
Attorney Zaher emphasized the importance of early detection of breast cancer for the successful treatment of the disease, and the fact that MRI scans are the most effective means available of identifying breast cancer, with detection rates exceeding those of mammograms and ultrasounds. The MOH itself has stated the importance of MRI scans in detecting breast cancer in a ministerial order released on 31 May 2005 entitled, “Early detection of cancer”.
Adalah argued in the letter that preventing MRI scans from being performed on patients violates women’s right to health, bodily integrity and dignity. In addition, providing funding for MRI scans some women while denying it to others, as is currently the case, is illegitimate.
Adalah further contended that the harm being caused to Arab women in particular is greater, given that rates of breast cancer are higher among Arab than Jewish women in Israel. Medical research in this field has demonstrated that Arab women are affected by breast cancer to a higher degree and at a younger age than their Jewish counterparts, Adalah stated. Moreover, the greater harm caused to Arab women is exacerbated by the relatively low socio-economic status of Arabic citizens relative to Jewish citizens of the state.