OECD: Israelis younger with high life expectancy

OECD cites Israel for positive demographic data and criticizes inadequate medical infrastructure and manpower.

By JUDY SIEGEL-ITZKOVICH
israeli girl with star of david painted on face 370 (photo credit: REUTERS)
israeli girl with star of david painted on face 370
(photo credit: REUTERS)
The good news is that Israelis are younger, have a higher life expectancy and lower infant mortality than most other member nations in the Organization of Economic Cooperation and Development. The bad news is that Israel has fewer hospital beds and nurses per capita and lower national public expenditures on health than almost any other member state.
The OECD disclosed this on Thursday, as part of its annual comparative report of healthcare data. Israel has been a member of the organization of advanced nations since 2010.
Most of the negative data on Israel involved its medical infrastructure, while most of its positive statistics involved demographics.
From the former, it became clear that only two of the 34 OECD states have fewer hospital beds per capita than Israel.
The ratio is 1.9 beds per 1,000 residents compared to the OECD average of 3.4. The lack of beds forces medical staffers to discharge patients early and to follow a “warm-bed policy” of admitting patients as soon as the existing ones can be sent home – even if they haven’t totally recovered.
There are 3.3 physicians per 1,00 residents in Israel, compared to the OECD average of 3.2, but the local ratio has declined significantly in recent years and will drop even more in the coming years because of mass retirement by doctors from the former Soviet Union who arrived in the 1990s. In most other OECD countries, doctor-to-resident ratios are increasing.
There are only 4.8 nurses per 1,000 Israelis, compared to the OECD average of 8.8 – a very serious lack. In addition, national healthcare expenditure as a proportion of the gross domestic product is low – 7.7 percent compared to the OECD average of 9.3%. The share of state expenditures continues to decline as residents have to pay more out-of-pocket expenses for healthcare, the report found. It is 60.8% compared to the OECD average of 72.7%.
Israel is third among the OECD in the rate of citizens who have supplementary and private health insurance policies, which is an indication that the residents don’t trust their basic health insurance to provide the care they need (as has been shown in recent opinion polls).
At the same time, Israel is a young country, with only 10% of the population aged 65 and older – although the percentage is constantly growing – compared to 15.4% in the average OECD country. It also has a lot of children – 28% under the age of 14 – the second highest rate in the OECD. Thus the dependence ratio, showing the burden of the working public from those too young or too old to work, is the highest in the organization of states.
The mortality rate in Israel is lower than in the US and the UK, but higher than in Spain, Greece and Scandinavia; however, there are significant differences in mortality rates among ethnic, religious and racial groups in Israel.
A large number of organizations issued comments on the report. The Israel Medical Association said that “unfortunately, a sad and difficult picture of the hospitalization system has been presented. These reports repeat themselves and stress the failure of the health system in supplying needed infrastructures and relieving the difficult working conditions of medical staffers.”
The IMA added that medical technologies, including the number of MRI machines in hospitals, are inadequate and lower than OECD averages.
The doctors’ association said the OECD uses irrelevant criteria – the number of licensed MDs – and not the number of working physicians, which skews the figures and makes the situation look better than it is. A significant chunk of physicians work in research or the pharmaceutical industry or have left the country or are working only in part-time jobs, with the rest of their time spent in private medical institutions, the IMA said.
Meretz MK Ilan Gilon, head of the Knesset Lobby for Equality in Health, commented that “healthcare “is not really a high priority of the government.
[Ministers] prefer to get filmed when they speak about the Iran nuclear bomb than to demand addition medical manpower and infrastructures.”
Gilon also complained that accessibility to healthcare in the periphery is very limited, causing inequity and gaps.
The voluntary organization Yad Sarah called for the expansion of home healthcare to ease the shortage of hospital beds.
Last year, the organization lent 2,100 hospital beds to families so patients could be treated at home – more than the number of beds in the general hospitals.
The beds are purchased by the organization with donations.
As hospital occupancy averages 98% and the population continues to grow, overcrowding promotes hospital-acquired infections. Thus it’s better if patients who can be treated at home have hospital beds to sleep in. Yad Sarah also lends thousands of oxygen-producing machines and even more oxygen cylinders for home use.
The One in Nine organization that helps women suffering from breast cancer said it was happy to note that the rate of mammographies undergone by women over 50 (and younger for women with a family history) is relatively high in Israel.
But the rate is too low among Arab and haredi women, the organization added.
Doctors for Human Rights/Israel commented that the OECD data “hide the large gaps in healthcare and accessibility between the well-off and poor and among various groups. For example, mortality rates among Arab babies are higher than among Jewish babies, and the shortage of nurses and medical equipment is more serious in the south compared to the center of the country.
All the voluntary organizations agreed that the government must immediately raise state expenditure to improve the healthcare system.