THE SPINE MAY 20, 2010
Not a single person is excluded from the system. The non-citizen Arabs of Jerusalem are included in it. The ultra-orthodox Jews, who barely recognize Israeli sovereignty (after all, God did not grant it), use it, probably to excess.
As the United States embarks on its new medical venture, it might be interesting to read an article in the Jerusalem Report of May 2 on the universal health coverage which Israel provides.
Here are seven salient paragraphs:
From the perspective of the bottom line, the figures are impressive: Israel’s per capita health costs are half those of the United States, and the country expends a much smaller proportion of its GDP on health care, yet it provides universal health coverage, and top-notch, technologically up-to-date care. Its outcomes in many areas are superior.
Compared to the US, Israel has more physicians per capita, a lower infant mortality rate, higher life expectancy, and lower rates of cardiovascular disease. The country has the highest number of IVF units in the world per population, and is near the top of the lists of transplant units per population and overall physicians per population.
Although not without its flaws, and always with room for improvement, surveys indicate remarkable general satisfaction with the health care system; a survey conducted every two years by the Myers-JDC-Brookdale Institute consistently shows 88 percent of Israelis report a high level of satisfaction with their health plans.
Notably, that figure is even higher among minorities: The percentage of respondents who were satisfied or very satisfied was highest among Arabic speakers, at 94 percent. “The health system in this country is in good shape, by any measured parameter, in both accomplishments and containing expenses,” says Kobi Glazer, a professor in the Tel Aviv University School of Management, specializing in Health Economics.
In fact, a study that the Pittsburgh Regional Health Initiative (PRHI), a consortium of medical, business and civic leaders in Pennsylvania, commissioned in the autumn of 2009, concluded that the US and other countries might do well to learn from the Israeli health system. “Israel’s healthcare system has significant relevance and important lessons to lend to healthcare reform efforts in the United States,” says Bruce Rosen, director of the Smokler Center for Health Policy Research at the Myers-JDC-Brookdale Institute, who participated in the PRHI study.
“US health reform debates have been about the best ways to move toward a more integrated model, through which payment is aligned with care delivery and that targets safety, efficiency, access, and quality. Therefore, as the US moves to strengthen primary care, contain costs, and require multi-provider accountability for coordinated high-quality care, there is much to learn from Israel, where these concepts are already at work.”
Despite widespread misconceptions, the country’s health care system is not a socialized, single-payer system. Israelis generally accept as almost axiomatic that there should be universal health coverage, with a significant acceptance of government involvement in regulating health care for the sake of redistribution, accountability, and preventing competition from leading to uncontrollable cost overruns. At the same time, there is also recognition of the benefits of keeping a strong measure of competition in the system. This has led to what Glazer describes as “regulated competition”: universal state-financed insurance coverage is provided through four competing health-maintenance organizations.
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