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Israel’s Health Efficiency With Limited Resources
Health status levels are comparable to those of other developed countries, even though Israel spends on average a relatively low proportion of its gross domestic product on healthcare (less than 8%) and nearly 40% of that is privately financed.
Israel is a small country, with just over 8.7 million citizens and a modern market-based economy with a comparable level of gross domestic product per capita to the average in the European Union and a substantial high technology sector.
It has a compulsory national health insurance (NHI) system that provides for universal coverage. Every citizen or permanent resident of Israel is free to choose from among four competing, non-profit-making sickness funds, called health plans “Kupot Holim”, which are charged with providing a broad package of benefits stipulated by the government. The system is financed primarily via a combination of a health-specific payroll tax and general taxation. The four Health plans (HPs), Clalit, Maccabi, Meuhedet and Leumit are both insurers and providers of services.
Overall, the Israeli healthcare system is quite efficient. Health status levels are comparable to those of other developed countries, even though Israel spends on average a relatively low proportion of its gross domestic product on healthcare (less than 8%) and nearly 40% of that is privately financed. Factors contributing to system efficiency include regulated competition among the health plans, tight regulatory controls on the supply of hospital beds, accessible and professional primary care and a well-developed system of electronic health records (95% of doctors). Israeli healthcare has also demonstrated a remarkable capacity to innovate, improve, establish goals, be tenacious and prioritize – all of which has enabled it to achieve good health outcomes with limited resources.
Israel’s capacity to improve has been highlighted by its documented and rapid improvements in quality of care in the community. Crucial has been the commitment of the HPs to improve the health of their members, the HPs’ capacity to translate strategy into action and their close working relationships with their professionals.
Medical innovation and biotechnology are highly developed. In 2008, Israel opened its first Bio Park – a medical research orientated Technology Park at Hadassah Medical Organization’s Ein Kerem campus comprising Hadassah Hospital and the Hebrew University’s schools of medicine, dentistry, pharmacy, nursing and public health.
Israel is undergoing numerous health reform efforts. The health insurance benefits package has been extended to include mental healthcare and dental care for children and a multipronged effort is underway to reduce health inequalities.
One of the major challenges currently facing Israeli healthcare is the growing reliance on private financing. The increasing growth of private expenditure has raised serious concerns about a shortage of resources in the public system and rising inequalities. Efforts are currently underway to expand public financing, improve the efficiency of the public system and constrain the growth of the private sector.
Supplementary Insurance - Even though the Israeli NHI benefits package is broad compared to most OECD countries, the voluntary health insurance (VHI) market is one of the biggest, with about 87% of Israel’s adult population covered with health plan VHI (supplementary insurance offered by the HPs to all of their own beneficiaries) and 53% covered with commercial insurance (offered by commercial insurance companies to individuals or groups). Household spending on VHI has increased markedly over the past decade. Out-of-pocket (OOP) expenditures are also high relative to many other countries (26% of total health expenditure, compared to an EU average of 21%) and have increased somewhat over time. There are large differences in households’ expenditures on health by income quintile, which indicate the existence of inequalities.
Among main Sources: -Rosen B, Waitzberg R, Merkur S. Israel: health system review. Health Systems in Transition, 2015; 17(6): 1212.. https://lawoffice.org.il/en/exemption-from-licensing-examination-to-practice-dentistry-in-israel/ https://www.timesofisrael.com/spotlight/4-things-youneed-to-know-about-dentistry-in-israel/