Health summit debates healthy living, moots 'fat tax'
By Ronny Linder-Ganz
Two things caused vigorous arguments among participants at the annual health system summit, the Dead Sea Conference.
One was a lecture by Omri Padan, CEO of McDonald's Israel, who presented the company's "health revolution" and prompted opposition from many of the conference attendees. The other was a proposal to impose a "fat tax" on foodstuffs as a way to tackle the obesity problem in Israel. This idea sounded extreme even to many of those whose job it is to promote healthy living.
Promotion of a healthy lifestyle is a somewhat neglected field, as some of the conference speakers testified. For example, the yearly budget for combating road accidents, which kill around 500 people a year, is NIS 160 million, while the budget for preventative medicine is NIS 5 to 6 million, even though some 10,000 people die every year of obesity and smoking. Obesity costs the economy NIS 6 billion per year - 15 percent of the annual health expenditure.
Of the many reasons for this neglect, the main ones are as follows:
The health maintenance organizations do not receive a separate budget for promoting healthy living; the system naturally concentrates on curing patients rather than preserving healthy people's health.
Thus, for instance, the drug basket selection committee has a clear preference in favor of non-preventative drugs.
The participants in the conference dealt with a number of difficult issues on the way to drawing up a five-year plan for the promotion of a healthy lifestyle in Israel. Among these were how money could be allocated from the limited budget when patients need life-saving drugs immediately; who is responsible for the subject, the state or the HMOs; and whether it is reasonable to take a paternalistic attitude as in imposing taxes or punishing bad habits.
At the end of their deliberations, the participants presented some recommendations to the health minister.
These included updating the health basket to include preventive services such as funding for support groups for people quitting smoking or visits to dieticians; setting up an interministerial committee to draw up a policy, determine authority and coordinate activity in the field; and the evaluation and remuneration of HMOs for performance on this matter.
Other recommendations included increasing taxes on cigarettes, and encouraging lawsuits by the health system against tobacco manufacturers, encouraging physical activities such as bicycle riding, by building cycle paths, and other sports, subsidizing sports equipment, and restricting advertising of unhealthful products.
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