What should be given a priority - costly medications for relatively few people or inexpensive ones for many? The Health Parliament public consultation initiative in Israel.
BACKGROUND
In the past two decades, government and civic organizations have been implementing a wide range of deliberative public consultations on health care-related policy. Drawing on these experiences, a public consultation initiative in Israel called the Health Parliament was established.


OBJECTIVE
To implement a public consultation initiative that will engage members of the public in the discussion of four healthcare policy questions associated with equity in health services and on priorities for determining which medications and treatments should be included in the basket of national health services.


METHODS
One hundred thirty-two participants from the general population recruited through a random sample were provided with background materials and met over several months in six regional sites. Dilemma activities were used and consultants were available for questions and clarifications. Participants presented their recommendations in a national assembly to the Minister of Health.


RESULTS
Across the regional groups the recommendations were mostly compatible, in particular regarding considering the healthcare system's monetary state, even at the expense of equity, but for each policy question minority views were also expressed. A strong emphasis in the recommendations was pragmatism.


CONCLUSIONS
Participants felt the experience was worthwhile; though the actual impact of their recommendations on policy making was indirect, they were willing to participate in future consultations. However, despite enthusiasm the initiative was not continued. Issues raised are whether consultation initiatives must have a direct impact on healthcare policy decisions or can be mainly a venue to involve citizens in the deliberation of healthcare policy issues.
Guttman
Nurit
N
Department of Communication, Tel-Aviv University, Tel Aviv, Israel. guttman@post.tau.ac.il
Shalev
Carmel
C
Kaplan
Giora
G
Abulafia
Ahuva
A
Bin-Nun
Gabi
G
Goffer
Ronen
R
Ben-Moshe
Roei
R
Tal
Orna
O
Shani
Mordechai
M
Lev
Boaz
B
D026683:Advisory Committees; D003256:Community Participation; D003253:Consultants; D003299:Cooperative Behavior; D011307:Drug Prescriptions / Q000191:economics*; D015276:Health Care Rationing / Q000191:economics*; D006291:Health Policy; D006292:Health Priorities / Q000191:economics; D006297:Health Services Accessibility; D006801:Humans; D007557:Israel; D009313:National Health Programs / Q000191:economics*; D012923:Social Class