What health care services does the public want and who should decide? Ask them!

Abstract

Most of the parties involved in healthcare decisions - governments, politicians, healthcare professionals, pharmaceutical companies, special interest groups - actively work to make their desires known. In Israel the public is part of the decision committee; in Germany health care decision are made more or less without the public being involved. In a recently published IJHPR article, Giora Kaplan and Orna Baron-Epel raise the question of how well acquainted senior decision makers in the Israeli health system are with the public's priorities regarding the services being considered for inclusion in the public funding list. This commentary speculates about the reasons for the discrepancies found in that article between the decision makers' and the public's view. Furthermore, it reports on survey results from Germany about who should be part of the decision making committee and briefly touches upon the situation in other OECD countries. While public opinion may not be the determining factor, all authors advocate a strengthening of the public's contribution to the health care decision making process, including steps to make decision makers aware of public priorities on an ongoing basis.