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Antebi: Health funds cannot sell insurance for life-saving drugs
By Ronny Linder-Ganz
Tags: Israel

On the eve of the decision on which drugs will enter the official state-sponsored health insurance drug basket for 2008, the treasury has made it clear to the local health funds that they can no longer sell their members commercial insurance policies covering life-prolonging or life-saving drugs.

The commissioner of capital markets, insurance and savings in the Finance Ministry, Yadin Antebi, published a clarification last Thursday on the matter. From now on, the public will have access to all life-saving drugs either directly through the basic health services basket, or through a commercial, private insurance policy. HMOs will no longer be allowed to sell additional, commercial insurance to their members to cover these drugs.

HMOs had attempted to get around the new requirement in this year's Economic Arrangements Law, which passed at the end of 2007 and ordered the removal of life-saving drugs from the health services' supplemental insurance policies. To continue making money from these drugs, the HMOs made deals with private insurance companies to sell their policies to the HMO members - with a cut going to the HMOs, of course.
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Antebi explained that such competing insurance policies could lead to conflicts of interest, and might influence the level and quality of services provided by the health funds, since the funds would have monetary interests in the quality and coverage of the basic services they offered. The treasury was worried the competition between the health funds would no longer be over the basic services they offered, but over the services offered as part of the supplemental insurance policies - and their price.

Antebi's declaration is particularly important for the Leumit Health Fund, which is the only fund that already has issued such a policy, called Leumit Maximum, through Harel Insurance. It seems the treasury's announcement means these policies cannot be renewed when they expire.

The treasury said regarding the fate of the Leumit Maximum policies: "The decision concerning Leumit Maximum will be made in light of the principles laid down in the Economic Arrangements Law amendment on the matter."
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