Counter to frequent government claims that the local health system is among the "best in the world," an "objective" comparison conducted for the Israel Medical Association of a large variety of parameters shows it gets only average marks when compared to European Union countries. Israel received a middling 50 on a scale of 100. The National Health Index assessment tool developed by the IMA and conducted by leading doctors, academics and health system experts was revealed on Monday for the first time by Dr. Yoram Blachar, the IMA's outgoing chairman. His successor will be chosen at the IMA's 41st national conference in Jerusalem this week. The team of experts found that the relative position of Israel's health system compared to EU countries is declining; this includes the state of preventive medicine; the amount of available medical manpower and infrastructure; and inequity of healthcare among the various ethnic and socioeconomic groups. Blachar warned that if the pace of decline continues, by 2015, Israel will be among the bottom third compared to developed European countries, when today it is in the middle. He said the IMA intends to publicize the National Health Index every year, and that the ratings will be used by international organizations such as the World Health Organization and the OECD. The IMA will consider the inclusion of additional parameters and invites all relevant groups to join the initiative to develop the index and advance the level of healthcare. The country's faltering educational system is objectively compared every year with those in Western countries, but the IMA maintains that until now, this was not done with the health system. The findings counter positions of the Treasury, which has consistently stated there is no major need for expanding medical infrastructure. Among the factors making up the index were longevity, morbidity, health behaviors, vaccinations, diagnosis of infectious diseases, ratios of doctors in various specialties and nurses per capita, the size of medical infrastructures, satisfaction of residents with their health care and way they are treated in medical institutions, and gaps in care, morbidity and mortality among various population groups. In the periphery, infant mortality is much higher than in the center of the country. Asthma and diabetes are much more common among low socioeconomic groups. There are two few operating rooms and hospital outside the center of the country. Poor people often forgo the purchase of drugs they are prescribed or medical care they need because they can't afford the copayments, the IMA said. There is no trend that shows a reduction in inequity, the IMA's 39-page report concluded.