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The Health Ministry is bartering with patients' rights, thereby compromising their situation severely and unjustly, a senior Health Ministry official recently wrote to Health Minister Yacov Ben Yizri.

The senior official, Yoel Lipshiz, head supervisor over the health maintenance organizations and complementary insurance schemes, complained to Ben Yizri about an agreement which the ministry had signed with the treasury earlier this week. In the agreement, the two parties concluded that the national health package, to which all citizens are entitled, will grow by NIS 1 billion by 2010.

In exchange for the addition in funds, the treasury insisted the Health Ministry agree on the removal of several expensive drugs from HMO complementary insurance schemes. The Health Ministry gave the HMOs permission to include the drugs in their complementary insurance schemes earlier this year. Currently, some 1.7 million Israelis are covered by the insurance.

In his notice, Lipshiz wrote that the treasury's condition for bolstering the health budget was "illegal, immoral, and a condition to which the Health Ministry must not agree." He concluded by warning that it will "cost patients' lives, which are in our hands and on our conscience." Lipshiz sent the notice on Sunday, 24 hours before the agreement was signed.

"The agreement is flawed from the onset. Patients' rights for complementary insurance are secured through legal precedents. The assumption that these rights can be negotiated in the framework of budgetary discussions is wrong," Lipshiz argues.

"It could lead to a problem down the road. The Health Ministry might stand to gain something in short term, but in the long run, we are missing out on an opportunity to provide financial security for patients. They are now able to afford expensive medications through convenient premium rates. If we take that option way from them, they will be left stranded in their hour of need."

Minister Ben Yizri said earlier this week that his initial decision to include the expensive drugs in HMO complementary insurance schemes was a mistake because it resulted in a hike in premium rates.

Deputy Director General for Health Economics, Gabi Ben-Nun, replied to Lipshiz' letter yesterday by saying that "an ordered mechanism for updating the drug package is the recipe for maintaining the quality, efficiency and public nature of the Israel Medical system." Ben Nun added that the agreement and the cancellation of life-saving drugs from complementary insurance schemes would make for a more egalitarian health system, as not everyone can afford them.

"The new complementary insurance plans might have directed the Israeli health system to follow the bad example of its American counterpart, which is more or less based on complementary insurance," Ben Nun countered in his letter to Lipshiz. "The American health system is one of the most expensive to maintain, producing below average results."