Israel’s health system has earned a quite respectable report card from the Organization of Economic Cooperation and Development, but on some indicators it is failing badly.
The report, issued as a comparison with the 33 other members of OECD that Israel joined almost four years ago, showed that its health system is efficient, its citizens’ life expectancy is admirable and infant mortality is low. However, there are chronic shortages of nurses, hospital beds and scanning devices, like MRIs and CTs, working adults have to support large numbers of children and pensioners, and numerous physicians who are expected to retire soon will create a serious shortage of practitioners in the foreseeable future.
Ministry Director-General Prof.
Arnon Afek said that the OECD report “shows the urgent need to implement recommendations of the German Committee to Strengthen the Public Health System – which were released last week. The public health infrastructure was shown in both reports to be wanting, but at the same time, numerous indicators were complimentary to Israel’s healthcare system.
--- the end of quote? “We are bound to do all we can to protect it and even improve on it,” Afek said.
The data prepared by the ministry covered 37 pages of text and graphs. Among the positive findings: • Israel’s population is much younger and more fertile (in terms of births) compared to the other OECD countries, with the ratio of people over the age of 65 only 10.3 percent compared to the OECD average of 15.7%. The ratio of children under the age of 14 is 28.8% of the population – the second highest after Mexico’s 28.8%. The lowest ratio of children is in Japan, with only 13%. Japan also has the highest ratio of pensioners at 24.1%.
When the ratio of children under 14 is combined with that of pensioners, Israel has the highest “dependency rate” – 62.5% compared to the OECD average of 49.7% and 36.8% (the lowest) in South Korea.
• The life expectancy of Israeli males is 79.9 years, two years higher than the OECD average and the third highest on the OECD scale; the equivalent for females is 83.6 years, 14th on the list. Japan has the longest-lived females, with an average age of 86.4%.
The infant mortality rate here is lower than average, with 3.6 per 1,000 live births compared to the OECD average of four. But some sectors in Israel have a much lower rate. Israel has a much higher ratio of babies produced by in-vitro fertilization and, as a result, lower average birth weights.
• Israeli females aged 15 to 49 give birth to an average of 3.1 babies, the highest rate in the OECD, compared to the average of 1.7 babies and the lowest rate of 1.3 in Greece, which does not approach a replaceable rate. The rate of births by cesarean section is also low here, just 88.7 per 1,000 live births, compared to the OECD average of 261.7 and 479.8 in Turkey, the highest rate.
The deficiencies outlined in the OECD report showed where Israel’s health system needs urgent improvements: • The ratio of Israel’s hospital beds per 1,000 residents is a mere 3.1, compared to the OECD average of 4.9 and Japan’s 13.4. The ratio of beds in general hospitals is 1.9 per 1,000, compared to the 3.3 average and 7.9 in Japan. The ratio of psychiatric hospital beds is only 0.4 per 1,000 in Israel, lower than the 0.7 average and 2.7 in Japan.
• While the ratio of physicians per 1,000 residents in Israel is 3.3., compared to 4.9 in Austria and the OECD average of 3.1, Israel’s relatively high rate is quickly disappearing, as doctors who immigrated from the former Soviet Union in the 1990s retire.
• As for nurses, Israel is in trouble with the second lowest ratio of 4.8 per 1,000 (only Mexico is lower) compared to the average OECD rate of 9.1 and 16.6 in Switzerland.
Israel has an efficient health system, despite these low figures.
Its national health expenditure (as a percentage of the GDP) is just 7.3%, compared to 9.3% on average and 16.9% in the US.
In addition, 80.3 % of Israelis hold supplementary health insurance (beyond the regular health fund basket of services) compared to an OECD average of 34.3% and 0.2% in Iceland, where residents pay almost nothing extra for health. Israelis spend only 4.3 days annually in general hospitals, compared to the OECD average of 6.5 and 17.5 days in Japan.
Private (out of pocket) expenditures for healthcare is high in Israel, at 38.6%, compared to the 27.9% average and 52.4% in the US.
Israeli hospitals have many “warm beds,” as the occupancy rate here is 96.6% – the highest in the OECD – compared to the average of 75.1% and 64.4% in the US.
The mortality rate from breast cancer is high here, with 31.9 per 100,000 women, compared to the OECD average of 23.9 and 12.5 in Turkey.
But deaths due to prostate cancer are low, with only 18.9 per 100,000 men compared to the 31.9 average and 53 figure in Estonia.