Can Universal Healthcare Work? A Look at Israel's Successful Model
By Sharon Segel
Healthcare is once again a headline issue in the United States. President Barack Obama’s healthcare reforms have met with huge opposition from Republican opponents, insurance companies and many American citizens who do not have the means for enforced medical insurance and recent state intervention. Others believe the proposals, while necessary, do not go far enough to protect those Americans most in need. The majority of opinion leaders and parliamentarians believe that the system does not work, but differ radically on a solution.
Solutions have eluded many presidents and lawmakers, yet a consensus clearly needs to be reached if change is to be effected. Many academics and medical professionals believe that to determine a system that works for one and all America needs to stop looking inwards and learn from models in place in other western countries.
Step forward Israel. A relatively modern healthcare system that has been in existence since – and even predates – independence in May 1948, present-day Israel has 46 hospitals and medical centers, more than 2,000 community-orientated primary care clinics throughout the country, three rehabilitation hospitals, four medical schools, two schools of dentistry, two pharmacology schools and 20 nursing schools.
Today, all Israeli citizens – Jew, Christian and Arab – are entitled to basic health care as a fundamental right. Legislation enacted in the 1990s mandate citizens to join one of four health care funds, which ensures basic protection; citizens can choose to purchase supplementary health care.
Legislation has also played its part in ensuring the needs of all citizens are met. Two laws exist to protect the citizen – Israel National Health Insurance Law (1995) and Israel’s Patient’s Rights Law (1996). Israel’s National Health Insurance Law mandates universal and comprehensive health care and requires every resident of Israel to register with one of Israel’s four health care organizations. The law makes it illegal for health funds to bar applicants on any grounds, including age and state of health and institutionalizes the state’s responsibility to provide residents a broad array of health services, which include medical diagnosis and treatment, preventative medicine and health education, hospitalization, surgery and transplants, first aid and transportation to a hospital, among others.
Israel’s Patient’s Rights Law establishes the ethics for protecting the rights of every person who requests medical care or who is in receipt of medical care with 12 basic principles including the right to medical care, a second opinion, patient dignity and privacy and care under emergency or grave danger.
There are several benefits to the Israeli system. The legislation in place accords citizens real protection and does not leave them vulnerable to socio-economic circumstance or a preexisting medical condition.
What makes the Israeli model so successful? Dr. Rafi Cayam, Director of Medicine for the Jerusalem District, attributes four key elements. The first is universal coverage, second is cradle-to-grave coverage, third is the healthcare basket provided by the Ministry of Health that consists of both basic and catastrophic healthcare and fourth is access to medication that is affordable and in some instances covered entirely.
Dr. Cayam looks to the statistics produced by the Organization for Economic Cooperation and Development (OECD) to substantiate his argument. “According to the latest figures released by the OECD in 2009, life expectancy in Israel is 81, putting Israel in the top 14 countries in the world, with Japan the highest at 83,” said Cayam. “Israel ranked higher than average in most of the most health care categories as compared to Europe or the United States The newborn mortality rate was three for every 1000 births. The mortality rate for children up to five years old was five to every 1000. In all, 121 people for every 100,000.”
Israel also works to bring down the costs of health care. Records are almost entirely computerized with around 95% of doctors using electronic medical records, compared to around 15% in the United States. This provides transparency, drug interactions and prescribing patterns, among others.
Medical innovation and biotechnology is also highly developed in Israel. 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. Hadassah Hospital conducts more than half the hospital research in Israel, while the Hebrew University conducts more than one-third of Israel’s scientific research, including more than 40% of the biotechnology research in Israel. The advances made by Israeli scientists and medical professionals contribute to a sophisticated healthcare system.
The Israeli model isn’t perfect – no system is – but it works. While America is looking around the world at other health systems, it may want to look at Israel.
Sharon Segel is a Legacy Heritage Fellow and Heads the Specialist Stories Project for The Israel Project, a nonprofit, nonpartisan organization impacting world opinion to help achieve security and peace for Israel.