Life-saving drugs

Cancer sufferers were right to reject demeaning charity - they were courageously upright.

cancer protest 1 (photo credit: Ariel Jerozolimski [file])
cancer protest 1
(photo credit: Ariel Jerozolimski [file])
Colon cancer sufferers on a hunger strike outside the Knesset yesterday rejected billionaire Sami Ofer's largesse and Prime Minister Ehud Olmert's proposal to reconvene the committee that decided not to include in the state's "health basket" medications prescribed to the protesters. Ofer's beneficence would have covered the estimated NIS 3.5 million needed to supply the patients with Avastin and Erbitux for one month. Meanwhile the recalled committee would presumably busy itself reviewing the situation.
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Though Health Minister Ya'acov Ben-Yizri said that he "just doesn't understand the strikers," it is he and the rest of the government who don't get it. The cancer sufferers were right to reject demeaning charity and proposals for more bureaucratic rounds -- they were courageously upright. It must have been tempting, given their compromised condition, to make do with an eight-day fast, grasp the temporary humanitarian lifeline and hope that it would facilitate some effective arrangement to enable them to afford medications vital to extending their life expectancy. But they rejected the easy way out, the path that would have taken the government off the hook of its most basic obligations to its citizens. Most of Israel's 120,000 cancer sufferers or recovering patients, and the 23,500 new cancer patients diagnosed each year, paid their health taxes during the entire course of their working lives. The presupposed contract between them and the state was that in the event of illness, their needs would be attended to. Though no insurance system covers all drugs on the market, coverage of critical life-sustaining drugs is the essence of the insurance concept. Yet many have been forced to sell off all they possess to finance a few more months' prescriptions. From their vantage point, this is unconscionable. Moreover, this is not their misfortune exclusively. But for the grace of God, any of us can end up in similar hardship. To essentially reduce those who fulfilled their obligations under all health insurance regulations to the role of beggars pleading for handouts from compassionate moneyed donors is insensitive, to say the least. The immediate answer to the anguish demonstrated outside our parliament daily is to reorder our scale of priorities. In all, the Health Ministry itself claims the annual outlay would be NIS 200 million, while colon cancer patients claim the cost would be just NIS 78m. a year. Whatever the true cost is, it is in itself certainly not an extraordinary sum, particular in comparison to the sums wasted on excess ministries, bureaucratic inefficiencies, and new spending promised during the coalition negotiations for purposes hardly more urgent than the life-and-death plight of cancer patients. The problem, the Health Ministry argues, is that there are many drugs that were also not funded that are higher on the priority list than those relating to colon cancer. Accordingly, if the government acceded to the colon cancer patients' demands it would immediately face multiple new demands, including legal challenges, that would cost much more to fulfill. This argument raises an obvious concern: If a colon cancer drug that undisputedly extends the lives of cancer patients is far down the priority list, then our system is plainly not only failing to fund this drug, but many other drugs that the Health Ministry has determined are even more critical to the lives, health, and well-being of our citizens. There is, it seems, something fundamentally wrong with the financing of a health system that, even in times of relative budgetary plenty, cannot afford to fund effective, high-priority drugs that thousands of people need to live normal lives, or simply to live. In other countries, the budget for such drugs is a fixed percentage of the health basket, so that health ministers do not have to go begging every year to the Finance Ministry for this sort of funding. The treasury, moreover, cannot argue in recessionary years that cuts must be made in the health budget, while refusing in high-growth years to spend increased revenue from the 4.8 percent "health tax" on health. The colon cancer patients may be the most vocal, but they represent thousands of people quietly suffering from the lack of a panoply of critical drugs that our health insurance system, if it is to be worthy of the name, should pay for. The system should be changed so that life-giving drugs and treatments receive greater priority as a matter of course.