Health care system in Israel

1. Health care system in Israel An-Najah National University Faculty of Medicine NarmineElian

2. According to the WHO , Israel has the 28th best health care system in the world . • Agencies involved in health :  • The Ministry of health (MOH) -  overall responsibility • National Insurance Institute (NII) - collects the health tax • Health plans: voluntary, non-profit-making organizations - four health plans: Clalit, 53% , Maccabi, 24%; Meuhedet, 13%, Leumit, 10%

3. Hospitals: Government - half of acute beds Clalit - one-third of the acute beds • Magen David Adom (“Red Star of David”): Israel’s equivalent of the Red Cross - emergency services.

4. Health Status • 2006 - life expectancy at birth: 78.5 for males, 82.2 for females • 2006 - infant mortality rate : 3.9 per 1000 live births, it has declined by 38% since 1996 • The crude mortality rate in 2006 was 5.5 per 1000 population, down from 6.1 per 1000 population in 1999

5. Primary care physicians • 80% of Clalit health plan members – primary care from Clalit-owned clinics. • Within their neighbourhood clinic, people are free to choose their PCP and can switch periodically. • 20–25% of Clalit members receive their primary care from independent physicians (IPs) at facilities operated by the IPs themselves. • All of the other health plans also engage some PCPs in facilities owned and operated by the health plan.

6. NHI financing • More than half of the health care system’s activities are financed by NHI, which was established by the NHI Law in 1995. • All permanent residents of Israel have been entitled to a benefits package specified in the NHI Law . • They’re required to enrol in one of four competing health plans, allowed to switch between plans once a year.

7. Out-of-pocket payments 1998- all health plans were authorized to charge their members for visits to specialists & raise payment rates for pharmaceuticals. co-payments: • flat-rate charge for the first visit in any quarter, repeat visits within the quarter to the same specialist . • elderly & children receiving disability payments are exempt from co-payments for all visits . • people with end-stage renal disease, cancer, AIDS, thalassemia or (TB) are exempt from co-payments at hospital outpatient departments and dialysis centres.

8. Non-national health insurance financing • Households pay out of pocket for certain services- ex: visits to private physicians, psychological and psychiatric visits, and dental care. • Households are subject to cost sharing for some services - visits to health plan specialists, institutional long-term care.

9. Services outside the NHI system are financed via VHI, and direct out-of pocket payments for private sector services. • Health plan VHI includes both services of “complementary” nature – those excluded from NHI - dental care “supplementary nature” – faster access or greater choice for services included in NHI - choice of hospital-based physician. • NO “substitutive” insurance for people excluded from the NHI system

10. Web sites system • All the health plans operate extensive web sites • public - learn about types of services they offer • members can access test results, in some cases schedule appointments. • The health plans also operate call centres - members/patients can obtain 24-hour guidance (specially trained nurses) on how to respond to various illnesses and symptoms.

11. References • http://www.who.int/en/ • http://www.health.gov.il/english/ • www.euro.who.int