Israel's Health System: Structure and Content Issues

Abstract

SRAEL'S health services have developed on the basis of a strong social conunitment to universal health covJ T 4 erage, the roots of which began during the growth of j 1 > the Jewish settlement decades before the founding of the State in 1948. Both government and non-governmental agencies have been very active in providing largely prepaid health care which covers nearly the total population. They operate through separate but parallel systems of service at the village, town and neighborhood levels (1,2). These services have contributed to rapid improvement in the health status of both the Arab and Jewish populations, reflected in patterns of morbidity, mortality and longevity which reach levels comparable to those of western countries. The conquest of childhood and other communicable diseases has been achieved largely through the national program of maternal and child health centers located close to the population throughout the country, coupled with improved sanitation and higher socioeconomic and education levels. Prepaid medical care is provided in primary care medical clinics backed up by insured specialty and hospital services under a nongovernmental health insurance system, covering over 95% of the total population, which contributes to improved health status and the sense of well being of the population (3). In spite of the progress made, there are many unresolved issues in the Israeli health care system. Most attention has focused on structural reform, but social and regional disparities in health status as well as heavy demands for medical, hospital and institutional services require a renewed attention to preventive health strategies. The build-up of separate national health care programs for preventive