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9 t h A n n u a l C o n g r e s s o n
Nursing & Healthcare
December 03-04 , 2018
Amsterdam, Nether l ands
Journal of Nursing and Health Studies
ISSN: 2574-2825 Nursing & Healthcare 2018
Miriam I Siebzehner, J Nurs Health Stud 2018, Volume: 3
DOI: 10.21767/2574-2825-C5-014
Background & Context: The Israel National Health Insurance Law, enacted in
1995, determines a National List of Health Services (NLHS) to which all citizens
are entitled. In order to maintain the high standard of medical care provided by
the Israel healthcare system, the NLHS should be updated periodically. The
NLHS can be updated only by allocation of funds from the Government. The
rapid development of medical technologies together with the limited resources
available in the healthcare system makes priority setting inevitable. In 1998, a
systematic process to adopt new medical technologies within the NLHS was
initiated. The decision making process for inclusion of health technologies
into the NLHS is based on the recommendations of a National Public Advisory
Committee which integrates not only the clinical and economical aspects, but
social and ethical values. Members of the committee include representatives
of government officials, health professional, economists, and of the public
amongst others and ethicist and a rabbi.
Content & Findings: Decisionmakers strive to improve quality of life andwelfare
of the population, but at the same time they confront the dilemma of balancing
health benefits with a shortage of resources, therefore, rationing is required.
The prioritization of health technologies provoke many ethical dilemmas that
the decision makers and the society in Israel are facing throughout the years,
such as: what should be given priority? Is it costly medications for relatively
few people or inexpensive ones for many?
Conclusion: Israel offers a unique example of implementing a methodology of
health technology assessment (HTA), combined with a priority setting process
debated within a National Public Advisory Committee forum which takes into
account cultural and moral values. After years of experience, this process
is considered by many health policy analysts in Israel and abroad, to be a
breakthrough on an international scale.
Biography
Miriam I Siebzehner is a Deputy Director and Senior Researcher
Israeli Center for Technology Assessment in Health Care
(ICTAHC ). She holds two MA's in Nursing from Tel Aviv
University and in Public Administration from Harvard’s John F
Kennedy School of Government. She received her PhD in Health
Management from Ben-Gurion University. She is the Chief
Nurse Officer of the Central Health District, Ministry of Health.
She has published more than 30 articles in professional Israeli
and international journals. She has lectured in professional
educational programs in Tel-Aviv University. During 20 years,
she is a Consultant to the Israeli Foreign Ministry, Division for
International Cooperation on Health Issues for Latin America
and selected African countries. She has received professional
awards: The International Council of Nurses and 3M, Israel
Award for outstanding professional achievements, the Ministry
of HealthOutstanding Employee Award in recognition of highest
level of excellence, The Prime Minister Office Civil Service
Commission Outstanding Governmental Employee Award.
Ethical dilemmas in selecting health care technologies
Miriam I Siebzehner
Ministry of Health, Israel