A wave of indignation erupted on Tuesday in the wake of Deputy Health Minister Ya'acov Litzman's efforts to bypass the public health basket committee and reduce by NIS 65 million the NIS 419m. expansion of the 2010 basket to provide "basic dental care" to children.
Three MKS demanded that Prime Minister (and nominal Health Minister) Binyamin Netanyahu head off the decision made by a telephone vote of ministers on Sunday and Monday nights. A non-profit foundation took the case to the High Court of Justice, while members of the Knesset Labor, Social Affairs and Health Committee were very critical of Litzman's action. In addition, both the Israel Medical Association and Israel Dental Association protested the move.
Knesset Committee chairman MK Haim Katz said that including dental care for children in the basket of health services provided at state expense was welcome in principle, but he said he did not have the data to determine whether providing free dental care could be covered by the NIS 250m. that Litzman claimed, part of which would come from the increment to the basket and the rest to be sought from government ministries. Taking some 15 percent of the basket increment for this purpose would certainly harm the basket, Katz said.
Litzman, who was called to attend the emergency meeting, said child dental care was supposed to have been included in the basket when the National Health Insurance Law was implemented 15 years ago; in fact, the Treasury cancelled it. But now the Treasury is supporting Litzman's effort because it doesn't want all the cost to come at the expense of the national budget and will have a precedent for dipping into the basket to cover the cost of other health services.
Dr. Ziv Ner Yitzhak, head of the state doctors' union, said that it was important for the basket committee to be run by professionals rather than to have tens of millions of shekels "snatched away" by politicians.
MK Orly Levi, however, welcomed Litzman's initiative, saying that a "populistic struggle" had been launched against the deputy minister that "cynically used terminal patients."
Ministry director-general Dr. Eitan Hai-Am came to the defense of his boss and said that if "NIS 1 billion were available for expanding the basket, some patients would argue that it was not enough."
In their letter to Netanyahu, MKs Haim Oron (Meretz), Rachel Adato (Kadima) and Yuli Tamir (Labor) said that it had taken a long struggle to get the Treasury to agree to the NIS 419m. increment for lifesaving and life-improving and -extending drugs. Dental care for children and the elderly, they contended, should be funded directly by the Treasury.
Litzman's critics argue that he took the controversial action because, as a Gur hassid of the Agudat Yisrael Party in United Torah Judaism, he is aware of the popularity he would get among haredim, who produce between a quarter to a third of all Israeli babies and want free dental care for them.
The Israel Medical Association, in a position statement, said there was no reason for Litzman's "secrecy" and the "urgent phone vote in the middle of the night." It empties the basket committee of its content and responsibility, the IMA said, and is a "brutal intervention" in its work, which is due to end before the end of December. The ministers had a right to hear both sides of the argument, the association concluded.
The AMAN voluntary organization sent a letter to basket committee chairman Prof. Rafael Beyar, who is also director-general of Haifa's Rambam Medical Center, calling on him and the other committee members to resign immediately. It reasoned that its work would be impossible with a big chunk of the funds being grabbed for other uses instead of being used for medical technologies to help hundreds of thousands of patients.
The Dolev Fund for Medical Justice filed on Tuesday a plea to the High Court of Justice to cancel the cabinet decision on the basis that it was illegal and reached without authority. It argued that schoolchildren should get free basic dental care with separate funding not taken from the basket.
Among the few proponents of the deputy health minister's initiative was the "Coalition for Public Dental Care," which called it the beginning of an effort to close the serious health and social gap between the well-off and poor segments of the population. The voluntary organization called Litzman's act "bold," and called for support for a bill it helped prepare that will soon be tabled in the Knesset that would raise health taxes by 0.15% to provide dental care for children and the elderly.
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