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The public committee that recommended NIS 415 million worth of new drugs and indications for the 2009 health basket has urged that basic dental care be supplied by the four health funds at Treasury expense and that the basket be expanded automatically by 2 percent annually instead of being dependent on Treasury dictates.
At a two-hour session of the National Health Council in Jerusalem on Wednesday, committee chairman Prof. Menachem Fainaru also said a statutory body, led by a retired Supreme Court justice, should be established to hear appeals by individuals who need vital drugs but do not qualify for them.
Fainaru, introduced by Health Ministry director-general Prof. Avi Yisrael, said the Treasury should provide the extra funding for this as well as for preventive health care services that are not in the basket of health services. Ways must be found to minimize out-of-pocket drug copayments and make it possible for low-income patients to get the care they deserve, the former dean of Tel Aviv University's medical school said.
The National Health Council voted unanimously to accept the basket committee's recommendations of adding some 70 new drugs or indications to the basket. The list is due to be publicized officially on the Health Ministry's Web site (www.health.gov.il) after it is officially approved at the cabinet meeting on Sunday.
The council's discussion of the recommended list of medical technologies was calm - and for the first time in years, members were not met by demonstrators at the building's entrance. This was presumably due not only to the cold temperatures and winds, but to the fact that the budgetary addition for 2009 was reasonable - even though an automatic 2% increase would have meant some NIS 560m. more.
The basket has grown by a total of NIS 1 billion in the last three years, compared to NIS 450m. for 2001 to 2005, Health Minister Ya'acov Ben-Yizri said, noting that media criticism had been muted this year.
Two years ago, the Treasury committed itself to setting an annual basket-expansion budget of over NIS 400m. through 2010 - which some argued was a way to weaken demands for a 2% automatic annual increase. Nevertheless, private members' bills for automatic updating are likely to be discussed in the next Knesset plenum in 2009, as such a proposal had wide support among MKs of the current Knesset.
The process of deciding on expanding the 2008 basket was delayed by two months, with the drugs added only in March and the Treasury withholding one-sixth of the money.
However, this time the committee was appointed last June and met intensively for hundreds of hours. Fainaru said he had received over 600 e-mails and documents from individuals and lobbyists and consulted with specialists and doctors in sub-specialties.
Over 300 medical technologies worth NIS 2b. were proposed. A shorter list of 120, worth NIS 1b., was narrowed down, and then an even shorter list was finalized after balancing the rights of the elderly and the young, the call for life-extending drugs and those that improve the quality of life, and the issue of expensive drugs for the few vs. cheap drugs for the many. An estimated 340,110 additional patients will benefit from the expanded basket.
Fainaru said that the basket committee should get the right to remove obsolete technologies so that better ones can be subsidized instead. He also advocated formal hearings of patients, drug companies and other vested interests, as well as adding basic dental care and a body to hear requests for exceptional cases.
Significant amounts of money should be spent on preventive medicine and rehabilitation, he said, but drugs that help smokers kick the habit, for example, were not on the list "because smokers spend more than the drugs' cost on their cigarettes."