Sunteți pe pagina 1din 18

Heath Care System in

Israel
Presented by: Kamilah Fernandez,
Kareem Austin, Tenille
Ramkissoon, Coryse Cazoe and
Juilen Marshall.
Israel- Introduction Country Profile
The State of Israel was established in
1948. Israel is a small country at the
eastern end of the Mediterranean.
In 2000 Israel had a population of 6.3
million, 78% were Jews and 22% non-
Jews ( mainly Muslim Arabs) and
currently it stands at 7.8 million.
It is densely populated with 288/km
2

and 60% of the population live along
the Mediterranean Sea..
Israels three largest cities are Tel
Aviv , Jerusalem and Haifa.
It has two official languages Hebrew
and Arabic.
Israel- Introduction Population Demographics
Israel is a young society; 27.1% of the population are under age 15
and only 10.5% are over age 64.





0-14 years: 27.1%
(male 1,084,748/female
1,035,525)
15-24 years: 15.7%
(male 628,205/female
599,871)
25-54 years: 37.8%
(male 1,508,860/female
1,443,898)
55-64 years: 10.7%
(male 333,453/female
352,302)
65 years and
over: 10.5% (male
368,318/female
466,670) (2014 est.)
Israel- Introduction Population Demographics
Its total fertility rate (2.95 per woman) has been accompanied by
phenomenal growth in the absolute number of elderly people.
Immigration plays an important role in the demographics of Israel since
it was declared a state in 1948 and it account for it population growth in
the 1950s, 1970s and 2000. The current population growth is 1.46%
and the net rate is 1.68 migrant(s)/1,000 population.

Israel- Introduction Population Demographics
GOVERNMENT & ECONOMY
Israel is a democratic state and, there is also a Local
government operate as independent authorities providing local
services. Israel is a developed, industrialized country .The 1999
GDP per capita income was US $PPP 18 600, $36,200 (2013)
Israel- Health Status
In 1999 life expectancy at birth was 76.6 for males and 80.4 for
females
In 2000 the infant mortality rate was 5.4 per thousand live births ; it
has declined by 50% over the past decade
The crude mortality rate in 1999 was 6.1 per 1000 population, down
from 6.6 per 1000 population in 1985. The leading causes of death
were heart disease, malignant neoplasms, cerebrovascular diseases,
diabetes and accidents, accounting for two thirds of all deaths from
1995 to 1997.
Lifestyle factors: a low level of alcohol consumption and lower levels
of cigarette smoking.
Israel- Historical Background
Health care services in Israel have been developed by voluntary
health plans (sick funds), non-profit institutions, the government and
the British Mandatory regime (before 1948).

Workers associations established the first health plan in 1911 to
provide care to workers and their families and to employ immigrant
doctors.

Hadassah Medical Organization began its medical activities in Israel in
1913 by establishing the Tipat Halav system (well-baby clinic).

Government hospitals, over 50% of all acute beds in the country and
most psychiatric facilities, consist primarily of hospital established by
the State of Israel in British Mandate hospitals and in buildings
abandoned by British Army camps.

Israel- Historical Background of Health Care
By 1980s, 95% of the population were insured in one of the four
competing health plans; Clalit, Maccabi, Meuhedet and Leumit.
The 1980s due to increasing consumer dissatisfaction the government
developed a State Commission of Inquiry into the functioning and
efficiency of the health care system,
The Netanyahu Commission was a major turning point in history of Israeli
health policy. The commission emphasized the following problems in
the Israeli health care system:
1. inadequacies in the services provided to the public
2. the Ministry of Healths dual role as service provider and regulator
3. vague financing and budgeting procedures
4. sub-optimal organization of the system and lack of managerial tools
low levels of employee satisfaction and motivation.

Israel- Historical Background of Health Care
The majority report of the Commission presented the following
recommendations .
1. legislation to introduce NHI
2. reorganization of the Ministry of Health
3. regionalization, decentralization and enhanced competition
4. a centralized financing system and capitation payment
5. introduction of private medical practice in public hospitals
6. financial incentives for increased productivity, along with enforcement of
the principle of equal pay for equal work.
The Minister of Health, then established a task forces to deal with the
reconstitution of government hospitals as freestanding for-profit entities,
the reorganization of the Ministry of Health, preparation of the NHI law
and health care system economics
Israel- Organizational Structure and Management
In Israel the parliament (Knesset) determines laws and budgets and
has passed important health care laws such as the NHI Law1995
and the Patients Rights Law 1996.
The key parliament committees related to health are the Finance
Committee, the Labour, Social Affairs and Health Committee.
The Ministry of Finance and its powerful budget Division play a
critical role in drafting the budget
The Ministry of Health
The Ministry of Health has overall responsibility for the health of the
population and the effective functioning of the health care system.
It is headed by the Minister of Health, who is a member of the
Government and appoints a physician as Director-General, the
Ministrys senior health care professional


Israel- Organizational Structure and Management
Israels Ministry of Health also plays a major role in the direct
provision of care.
1. It owns and operates 50% of the nations acute hospital beds,
approximately two thirds of the psychiatric hospital beds and 10% of
the chronic disease beds.
2. It operates the majority of the nations mother and child preventive
health centres.
The Ministry of Health receives important input from various advisory
bodies. These include;
1. the National Health Council ( advise the ministry on NHI law)
2. a series of standing national councils appointed to advise the
Director-General on both long-term goals and pressing issues
requiring an immediate policy response
Israel- Organizational Structure and Management
Other key government bodies involved in health
1. The Ministry of Finance
2. The National Insurance Institute
3. The Israel Defence Force

Key nongovernmental actors
1. Heath Plans (Clatit -55%, Maccabi- 24%, Meuhedet-11%, Leumit-
10%)
2. Hospitals
3. Health Care Unions
4. Magen David Adom (Red Star of David)
5. Voluntary Organization

Israel- Organizational Structure and Management
The health care system since 1990
The major organizational problems identified by the 1990 Netanyahu
Commission report were that:
1. the health care system was overly politicized due to the political
affiliations of some of the health plans;
2. there was no comprehensive legal framework for the activities of the
health plans;
3. the Ministry of Healths dual role as regulator and provider led to
conflicts of interest and inefficiencies.
Israels NHI law (1995), addressed the first two of these problems to
a significant extent but was unsuccessful in addressing the third
problem.
Israel- Organizational Structure and Management
The primary organizational changes since 1990;
Prior to 1995 individuals paid their health insurance premiums
directly to the health plans on a voluntary basis. Since the
introduction of NHI these payments are collected by the NII on a
compulsory basis as a health tax then the NII redistributes it to the
health plans.

Employers tax was abolished in 1997 and replaced by an increase in
general tax revenue.
Israel- Organizational Structure and Management
Planning
In 1990 the Ministry of Health sponsored a planning process
involving key health care system actors in order to develop a Health
for All 2000 document ( achievements was not evaluated).
External commissions (e.g. Netanyahu Commission) have as strong
impact on planning and policy development as the Ministry of Health
or any permanent planning entities because they are more objective,
professional and less political.
Regulation
Since the introduction of NHI and the Patients Rights Act in the mid-
1990s, the Ministry of Health has developed new capabilities in the
regulatory area.
There is also consideration of regulating the number of health care
personnel

Israel- Organizational Structure and Management
Decentralization
Despite the fact that the Ministry of Healths Public Health Division
operates through regional and district offices, they have little power.
The regional and district offices serve primarily to implement the
policies and strategies both in the public health area and in the
regulation of long-term and psychiatric care.
The health plans have regional administrations, but authority rests
with their national headquarters.
The NHI law called for reducing the role of government in service
provision in three key areas of activity: personal preventive care, long-
term care and mental health care.

Israel- Organizational Structure and Management
In the past decade the Israeli health care system has undergone:
1. Some deconcentration of central government authority to lower
administrative levels of central government, particularly in the case of
the government hospitals;
2. No significant devolution of authority to regional or local
governments;
3. No significant delegation of responsibilities to quasi-public
organizations(on the contrary, NHI constitutes a process of transfer
of authority from the health plans to the government);
4. Various attempts at privatization (transferring responsibilities for
service provision from the government to the voluntary sector) have
been successfully implemented to date.
References
Websites
http://www.goisrael.com/Tourism_Eng/Tourist%20Information/Discov
er%20Israel/Pages/Population.aspx
https://www.cia.gov/library/publications/the-world-
factbook/geos/is.html

S-ar putea să vă placă și