Compromise wins more money for health basket

Health funds no longer to offer health-prolonging drugs not included in basket, and in return they will receive NIS 150 million.

nurse patient 298.88 ap (photo credit: AP)
nurse patient 298.88 ap
(photo credit: AP)
The Knesset Finance Committee, eager to push through the 2008 budget and get more Treasury money for the basket of health services, approved a compromise on Monday in which the health funds would no longer be permitted to offer health-prolonging drugs not included in the basket as part of the funds supplementary health insurance policies held by some 80 percent of the population. In exchange, the Finance Ministry will allocate NIS 150 million more for the basket provided at state subsidy by the insurers; it will thus be expanded by NIS 425m. for next year. The ministry also agreed to increase the planned expansion by NIS 110m. for 2009 and 2010, bringing the total tally of expansion over the next three years, together with an extra Health Ministry budget for vaccines, to NIS 1.44b. That still falls short of the increase demanded by some in the health community, which was two percent of the current budget, or some NIS 1.8b. over three years. Health Minister Ya'acov Ben-Yizri earlier this year allowed Maccabi Health Services to offer extra medications in its supplementary insurance program and Clalit Health Services to offer fewer of these in their policy. However, he reportedly came under pressure from private health insurance companies, who feared they would lose clients and money, and the minister tried to cancel these supplementary insurance benefits retroactively, with support from the Treasury, who opposed the subsidies granted to these policy-holders. The effort to cancel them permanently was initiated by the Treasury as part of the Arrangements Bill attached to the Budget Bill. Outgoing Health Ministry deputy director-general Gabi Bin-Nun came out against the supplementary policies on the grounds that it was wrong to offer them when some 20% of Israel's residents were too poor to afford tens of shekels apiece per month. Opponents of the Treasury view demanded that the basket of health services be expanded automatically by 2% every year, eliminating the Treasury's power in deciding the final sum. They also said that the Treasury's view was anti-social, as it would push the rich and middle-class to buy private insurance policies to get the extra medications, while the poor would be left out. Ben-Yizri responded to the committee decision by congratulating it for the deal. "I am happy that the social approach won over. The MKs understood that supplementary health insurance policies mean walking a fine line because they were liable in the end to bring about privatization of the health basket and placing the burden on the public. Increasing the basket by NIS 1.44b. over the next three years will reduce social gaps and make it possible for the disadvantaged to get better state health services," the minister claimed. However, Yoel Lifschitz, Health Ministry deputy director-general in charge of supervising the health funds, voiced a different view, saying: "I see it as a sad day for Israeli patients, although in the short-term, there will be more money in the basket. But in the long-term, there will be no supplementary health insurance that can cover drugs that the state will never agree to finance." An outside expert who preferred to remain anonymous said the health funds didn't fight hard for the supplementary policies and were fearful of a Treasury that threatened to limit their executive salaries and autonomy. In the end, he said, all the health funds will purchase group policies for important drugs from commercial health insurance companies to offer their members at high cost and refuse to insure people over 65. The Israel Medical Association thanked the committee MKs for trying to increase the basket, but said that the sums achieved were too small, and that without the option of getting more medications through supplementary policies, many patients with serious conditions would be helpless. He said automatic updating of the basket by two percent was essential. IMA chairman Dr. Yoram Blachar claimed the association's establishment of a public forum of impressive personalities to influence the government on the basket was responsible for bringing out its expansion, although the increase was inadequate. The Physicians for Human Rights-Israel and ADVA said they were pleased by the decision, as it opposed the inclusion of extra drugs in supplementary health policies that only some could afford.