In the quest to create a healthcare system that provides universal health coverage to all Americans, it is important to evaluate other healthcare systems throughout the world. While conversations typically focus on the European Union’s health insurance programs, I believe that further investigation of the universal healthcare system in Israel is necessary.
Under collaborative supervision by the Israeli Ministry of Health and the Palestinian Authority, all citizens and residents of the state of Israel receive compulsory health insurance and medical services. This means that all people inhabiting the state of Israel, even those who accept Palestinian Authority citizenship and deny Israeli citizenship, receive health insurance regardless of religion, gender, race, or socioeconomic status. Not only do all people residing in Israel receive health insurance, patients have the freedom to choose from one of four competing health plans on the market, allowing them to select the program that best fits their medical needs. Besides giving patients freedom of choice, the competition amongst the health insurance plans drives down costs. Further ensuring the success of the system, all persons are required by law to enroll in a health insurance plan. Because it is illegal to be unenrolled in the health insurance program, high-income low-risk individuals subsidize low-income high-risk individuals. In the United States, many opponents of the Affordable Care Act fear that the lack of competition on the market will cause prices to sky-rocket for patients. More so, they fear that high income low risk individuals will chose to pay the small fee associated with not enrolling in the health insurance, thus threatening the financial stability of the U.S. healthcare system. Israel’s healthcare system addresses these concerns, while still maintaining a system that reflects the fundamental ideals of the Affordable Care Act: providing healthcare for all people.
In addition to the distinctive structure of the Israeli healthcare system, Israel’s Magen David Adom and their method of caring for senior citizens make the healthcare system unique and particularly interesting in its own right. Magen David Adom (MDA) is the Israeli version of the Red Cross and acts as Israel’s emergency medical service providing first aid assistance by ambulance, a blood bank, and first aid and disaster relief courses. While the government mandates that this organization serves as the first responders in a medical emergency, they do not receive any government funding. Thus as Israel’s sole EMS system, they are entirely reliant on donors for funding as well as the 10,000 volunteers who make up their staff. These volunteers are trained through a 60-hour rigorous course and serve as assistant medics and dispatch center employees, among other roles. The donors and volunteers have created a qualified and effective emergency service system in Israel that successfully operates without government funding.
Another identifying aspect of the Israeli healthcare system is the way in which it cares for senior citizens. Since Israel is a developed country, characterized by a less intact community structure in which family members often live far way from the aging, the country’s health system is forced to handle disabled elderly citizens. Further complicating the issue, in Israeli culture, sending elderly persons to retirement homes is considered immoral and disrespectful. Hence, the majority of elderly people are taken cared for at home. Currently, community health organizations provide many necessary services for the elderly, including preserving at home independence, providing financial assistance for in-home caretakers, ensuring safety at home, and providing meals-on-wheels, medical equipment, and transportation.
However, the healthcare system is not without flaws and it presents a number of challenges to the public health status of the country. Many politicians assert that the immense military spending budget has undermined the need for budget allocation to health care (Reeves & Stuckler, 2013). The inadequate funding has led to high copayments and a turn towards privatized medicine, placing low socioeconomic individuals at risk. Many Israelis also complain about the wait times to see specialized physicians and the fact that many life saving medications are not approved because of the cost-benefit ratio (“Overview of Israeli Healthcare System,” 2016).
Overall, however, the Israeli healthcare system is considered efficient because the health status levels of the population are relatively similar to that of other developed countries, even though a lower proportion of GDP is spent on health care. Israel’s healthcare expenditure comprises 7.5% of its Gross Domestic Product (GDP), which ranks 10.4 % lower than the United States’ share of GDP spent on healthcare, and 1.4 % lower than the OECD country average. (Chintz, 2014). While still considered a form of socialized medicine, the competition amongst healthcare insurance plans provides fair market pricing and physician choice for the patient.
This past summer I spent two months living in Tel Aviv and working in Israel’s health sector. I chatted with young professional Israelis who appreciated having the ability to chose their own health insurance plan. I met children who had been waiting over a year to see a specialized physician for their rare condition. I encountered economically disadvantaged patients receiving similar treatment as their economically advantaged counterparts. I worked alongside health care providers who were not only multi-lingual, but were able to provide culturally and religiously competent care to all patients they treated. As Israel is a mecca of religions, cultures, languages, and ethnicities, I personally witnessed a healthcare system which is responsive to the needs of the community. While of course no system is perfect, as American leaders work to create a healthcare system that provides quality, culturally competent, and affordable healthcare to all citizens, I believe that we could learn a thing or two from the Israeli healthcare system.