ISRAEL | Summary

In Israel, the Ministry of Health is responsible for the development of health policy, operation of the nation’s public health services, and management of the governmental health care budget. The government also owns and operates many of the country’s larger hospitals.⁴ The National Health Insurance (NHI)  Law secured universal health coverage for citizens and permanent residents. The law states, “Health insurance shall be based on principles of justice, equality and mutual assistance.” Israel was the penultimate developed country to achieve universal health coverage, leaving the U.S. to be the only one left. There are four health plans that Israeli citizens and residents can choose and they all offer identical benefits. The health plans are financed by an earmarked, income-related tax and general government revenue. There is no cost-sharing with primary care or hospital inpatient care. However, copays range from 6.5-9 US dollars for specialty care and a minimum coinsurance of 4.5 US dollars for each prescription drug.⁵

 

Most citizens in Israel purchase voluntary health insurance which serves as complementary coverage for benefits excluded from the National Health Plans; for example, certain medications, adult dental care, and more services. Individuals with this coverage also have faster access to quality care and a greater provider choice such as private providers. The options for voluntary health insurance are either from National Health Insurance-sponsored plans, which are nonprofit or through for-for profit plans. Some obtain both forms of supplementary coverage. In 2016, 84 percent of adults were enrolled in NHI private insurance plan and 57 percent were enrolled in a commercial private insurance plan.⁵ 

 

Israel has been experiencing increases in health spending, mostly due to higher out-of-pocket expenditures. The private health sector is growing which requires a higher share of out-of-pocket payments.⁶ In 2016, out-of-pocket spending accounted for 22 percent of total health expenditures. The majority of these payments come from voluntary health insurance (38%), adult dental care (38%), and pharmaceuticals (15%).⁵ Another challenge in the health care system is issues with quality due to high occupancy rates of beds. Israel has very few hospitals beds compared with the OECD average as well as a 94% hospital bed occupancy. However, the government intends to add more beds.⁶ Nevertheless, the health system still provides quality care and is considered to be one of the most efficient systems.⁷

 

The Ministry of Health is leading multiple courses of action to reduce health disparities in the country. In Israel, Arabs constitute the largest minority and have been shown to have poorer healthcare utilization patterns and worse health outcomes. Life expectancy is lower among Israeli Arabs than Israeli Jews. Furthermore, Arabs in Israel generally have lower socioeconomic status and more than 50 percent live under the national poverty line. The disparities faced by the vulnerable populations can be attributed to lower education levels, and language and cultural barriers. The government recognizes these advantages and plans to reduce financial barriers to access, influence of cultural differences, and improve physical and technological infrastructures, among others.⁹ 

HEALTH INDICATORS & DEMOGRAPHICS

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