Prof. Jonathan Halevy, the longtime director-general of Jerusalem’s Shaare Zedek
Medical Center, will be chairman of the public committee that recommends to the
government what medical technologies to add to the basket of health services in
The almost completely new committee was appointed by Deputy Health
Minister Ya’acov Litzman on Tuesday.
The previous chairman, for several
years, was Prof. Rafael Beyar, a senior interventional cardiologist and
director-general of the state-owned Rambam Medical Center in Haifa.
committee has to make life-and-death decisions because many patients needing
expensive drugs cannot purchase them if they are not subsidized by health funds.
Committee members will have NIS 300 million worth of Treasury allocations to
expand the 2012 budget, the same as in the past few years but smaller than in
some previous years.
The recommendations are due to be formally approved
by the government before the end of December, and implemented at the beginning
The medical technology expansion budget is the funding with
which the four public health funds provide their members with new mediations,
medical devices and services.
Public health advocates have for years
demanded that the allocation be increased automatically by two percent annually,
thus reducing the power of Finance Ministry budget officials over the health
system and eliminating the Health Ministry’s need to negotiate (or beg) for
higher allocations each year. The Treasury has always thwarted such initiatives,
which also come from Knesset members.
The committee’s coordinator will
again be Dr. Osnat Luxenburg, who heads the Health Ministry’s department for
medical technologies and infrastructure, which prepares background on each
proposed technology and a rating system to be used by committee
So far, importers and manufacturers have presented 600 different
lifesaving, -extending and -improving technologies for inclusion in the basket
whose total cost would require a state allocation of several billion shekels.
Only a few dozen new medications, services and types of equipment are approved
each year within budgetary limitations. Thus, setting priorities and making
decisions is always very difficult.
The committee consists of of Health
and Finance ministry professionals, as well as doctors, public and health fund
representatives, economists and rabbis. Its members also include Prof. Dina
Ben-Yehuda, Prof. Nir Giladi, Eyal Gabai, Shira Greenberg, Prof. Ya’acov
Neparstek, Noam Hoizlich, Rabbi Avraham Menale, Revital Topper, Prof. Haim
Bitterman, Prof. Avi Porath, Dr. David Mossinsohn, Prof. Daniel Vardi, Yair
Assraf, Iris Ginsburg, Prof. Riad Agabaria and Prof.
Meanwhile, Kadima MK Rachel Adatto, a gynecologist by training and
(ironically) Halevy’s deputy at Shaare Zedek years ago, criticized the choice of
“Again we witness the committee representing most
hospitals but not family practitioners – those physicians who serve on the
frontlines of patient care,” Adatto said.
“It would have been preferable
out of concern for patients’ interests that their voices be heard [directly],
and not through hospitals or health funds,” she continued. “An additional
worrisome fact is that the committee is made up of a large number of
administrators and financial people, whose role is to worry about patients
medically, socially and ethically.”
Financial and administrative
representatives naturally want to cut costs.
Adatto also pointed out that
only four are women.
“The fact that women did not get equal
representation on this important committee raises the question of what message
the ministry is sending women in the health system, and Israeli women in
general,” she concluded.
A coalition of health rights groups sent a
letter to Halevy congratulating him on his appointment. But it noted that the
Finance and Health ministries “do not supply you with the full tools needed to
carry out your national mission, and send you to battle over patients lives with
a low budget.”
The coalition, which includes Israel Cancer Association
director-general Miri Ziv and Patients Rights Association head Shmuel Ben
Ya’acov, said this is the third year the Treasury has allocated “only half of
the necessary budget for updating the basket with vital drugs, not only for
economically disadvantaged patients but also in the middle class.”
coalition’s members called on Halevy, who as a physician and hospital director
deals daily with problems resulting from the lack of medical technologies in the
basket, to demand that “the allocations reflect the professional recommendations
of the committee and not the policy of Treasury officials.”
Copies of the
letter to Halevy were sent to Prime Minister Binyamin Netanyahu, who holds the
portfolio for health affairs, and to Finance Minister Yuval Steinitz.