Health basket panel ready to make 'Solomonic decisions'

Parkinson's patients demonstrate outside for more drugs to be included in the 2008 basket of health services.

pills 88 (photo credit: )
pills 88
(photo credit: )
As a small group of Parkinson's patients demonstrated outside for more drugs to be included in the 2008 basket of health services, and Israel Medical Association chairman Dr. Yoram Blachar didn't appear at the 16-member basket committee meeting following his resignation Saturday night, Health Minister Ya'acov Ben-Yizri defended himself on Sunday regarding the committee's composition and the amount allocated by the Treasury to update the basket. The new committee chairman, Prof. Menahem Fainaru said he would like to open the committee's deliberations to the media. He offered veiled criticism by saying he had been appointed without knowing who the members were. "Some people tell me this is not a good idea and will interfere [with the deliberations]," Fainaru, a former dean of Tel Aviv University's Sackler School of Medicine and a veteran internal medicine specialist, said. "If they persuade me this is true, at least we will issue summaries of discussions for the public." Fainaru said the committee had received proposals of more than 500 new lifesaving, life-extending and life-improving drugs and medical technologies for inclusion of the basket that would cost some NIS 1.5 billion. But the Treasury has allocated only NIS 275 million for 2008, plus NIS 75m. for the Health Ministry to expand vaccinations and other direct services, he said. Fainaru said the committee, aware that its Solomonic decisions meant life or death for some people, would work hard to be objective and fair. The committee, which will deliberate over the next few months and recommend drugs and technologies that the health funds will provide at Treasury expense to members who need them, consists of seven state employees, including Treasury and Health Ministry economists, but no representatives of patient groups or hospital doctors. Blachar, who had been a member of the basket committees since they were first appointed in 1998, attacked the choice of nominees and called the committee an "impotent" body chosen according to the Treasury's directives. He said in his resignation letter to Ben-Yizri that the amount allocated by the Treasury was "less than half the amount needed" to offer important new lifesaving medical technologies to patients and that it must automatically be updated annually by 2 percent a year, rather than debated anew by Treasury officials each year. Ben-Yizri said he would be happy if Blachar reconsidered and joined the committee deliberations, which are due to conclude around the end of 2007. He said the members included 10 physicians and prominent public representatives, such as Dalia Rabin-Pelosof and Rabbi Yuval Cherlow. Ben-Yizri said the Treasury had at first insisted the committee would be more efficient with just 12 members. But, he said, "I got up on my hind legs and insisted," so it was set at 16 - even though the previous committees had 21. Ben-Yizri said the average budget for expanding the basket in previous years had been NIS 170m. The latest figure of NIS 350m. will be applied in 2009 and 2010 as well, he said, adding, "It can be more, but it can't be less." The Dolev Foundation for Medical Justice sent a letter to Ben-Yizri, claiming he did not have the authority to appoint committee members. This was the "exclusive authority" of the Israel Health Council, which acts according to the National Health Insurance Law of 1994, and not of the minister, the group said. But Health Ministry associate director-general Dr. Boaz Lev told The Jerusalem Post this was "not true," as the health basket committee was not part of the National Health Insurance Law, and the health and finance ministers therefore had the authority to appoint its members.