Global Insight Perspective | |
Significance | Over the next three years, the drug basket will be allocated an additional 370 million shekels (US$96 million), with the allocation for 2008 increased by 150 million shekels. In return, health funds in Israel will no longer offer drugs not included in the basket as part of the supplemental health insurance funds. |
Implications | The deal is essentially a compromise after the health minister's attempts to allow Maccabi Health Services to offer extra medications in its supplementary insurance programme was criticised by private health operators. |
Outlook | The additional allocations to the drug basket provide a short-term boost, despite the fact that in the larger context the provisions are still short of the 1.8-billion-shekel expenditure suggested by health experts. |
The Knesset Finance Committee in Israel has approved new budget allocations for the country's basket of health services. The provisions primarily include two elements, affecting the health services and the health funds. The Jerusalem Post reports that the Ministry of Finance extended a three-year budget to 1.44 billion shekels in total. This includes a provision of 150 million shekels for 2008 drug basket—a state subsidiary from health insurers thereby expanding the total basket allocated by 425 million shekels; there are also extra provisions for vaccines and other health programmes to be spread over the next three years. Although the Knesset was able to push through for more cash from the Ministry of Finance, as the source notes, the deal ended in compromise with the removal of "lifesaving drugs" from the health funds' supplemental insurance policies. The source noted that the agreement will not affect Clalit and Maccabi Health Services members who have already started paying for the drug coverage in supplemental insurance.
Earlier this year, the Ministry of Health enabled Maccabi and Clalit to offer extra treatments in is supplementary insurance programme, which was met by severe criticism from private insurance players. This prompted the government to withdraw the initiative through the Arrangements Bill.
Israel's National Health Insurance Law stipulates that the public health basket must encompass state-funded medications, treatments, and technologies given to all citizens through the four health maintenance organisations (HMOs). The annual cost of the basket is estimated at approximately 25 billion shekels, with annual reviews of potential upgrades that could include new medications and technologies or new uses for existing ones.
Outlook and Implications
The provisions approved by the Committee are not automatically increased by 2% of overall budget as demanded by stakeholders in the health sector, and hence marks something of a disappointment. Health experts had lobbied for a policy measure to include an automatic rise, arguing that it would support the inclusion of new drugs into the drug basket. Additionally, the amount does fall short of the 1.8-billion-shekel fund infusion that the sector was hoping to receive. Still, the allocations do provide a fillip to the sector, particularly the drug basket; the allocations provide a short-term benefit. The government's attempt here is to provide a wider range of health services, with an emphasis on accessibility. Israeli health minister Yacov Ben Yizri has lobbied for the increase, asserting that supplemental insurance could lead to privatisation of the drugs basket, increasing public burden. Costs of new treatments for 2008 in the drug basket were estimated to be at 600 million shekels, with 78 drugs presented as essential or life-prolonging in a recent Ministry of Health document. Of these, 30 drugs were classed as priority. It is believed the additional allocation will pave the way for the inclusion of some of these drugs.