Health Minister Yael German 370.
(photo credit: Courtesy Knesset)
Israel’s health system is among the most unequal in the OECD, ranking alongside
countries such as Turkey and Mexico, according to an internal health ministry
report released yesterday.
According to the report, Israel’s health
system is in the OECD group of the highest level of inequality, at 0.50 (before
National Health Insurance transfers are made to the poor, or 0.38 after such
allocations are received). This puts Israel in the “high group” together with
Turkey and Mexico when measured by the division of expenditure for healthcare
among the national population.
The OECD average is 0.31 to 0.36. The
“middle lower group” includes Western European countries such as Switzerland,
Belgium, France and Germany, as well as Australia, with a rating of 0.27 to
0.30, while the lower groups with ratings of 0.23 to 0.27 have Denmark in first
place, followed by Sweden, Austria, Finland, Luxembourg and Norway.
89-page report on Inequality in the Health System was written by Dr. Tuvia
Horev, a dentist and ministry deputy director-general for economics, and
ministry economist Nir Kedar.
In a press release put out along with the
report, the Health Ministry said the government is working on improvement
through an investment that will reach over NIS 1 billion.
The report was
written and refers to the time before Yael German became health
The report said the ministry took a “strategic decision in
recent years to struggle with inequality in healthcare using the tools it has at
its disposal.... There is no magic solution to reduce the health
It continued that “a longterm struggle that must be joined by all
the factors in the health system, including organizations and service providers.
It’s not realistic to expect immediate improvements. Stubbornness,
professionalism and patience are what are needed from all partners.”
authors noted that “constant monitoring of the gaps, reaching conclusions and
finding solutions are needed to make it possible to reduce inequality in health
over time. Effort must be made to prevent the gaps from widening.”
the major partners in reducing the gap, they concluded, were the four public
“We hope for a united effort and preserving a high level of
determining, a struggle for reducing inequality and ensuring the quality of
health services and advancing the wellbeing of all Israeli residents,” it
Horev commented that the Israeli health system was recently
cited by the OECD for making an effort towards reducing
However, the report did not look forward, set explicit goals
or explain how the severe inequality – despite implementation of the National
Health Insurance Law since 1995 – would be reduced. That law declared that
national health insurance would be “based on the principles of justice, equality
and mutual assistance” – but since 1995, the social gaps have only widened due
to growing privatization; commercial health insurance policies; and gaps among
hospital services in various parts of the country.
The failures of the
ministry’s privatization of the School Health Service, which was responsible for
many gaps in healthcare, was referred to in one paragraph by the authors.