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Israel as a Model for Health Care

Israel as a Model for Health Care

As Congress is working to reconfigure our country's health care system, many are pointing to health systems overseas as examples. Israel has one of the most advanced health care systems in the world, and rivals the United States on everything from quality to cost to coverage.
I recently listened to a podcast by the Israel Project in which Dr. Rafi Cayam (Leumit Director of Medicine for the Jerusalem District) and Professor Shlomo Mor Yosef (Director-General, Hadassah Medical Organization) explained how Israel's health care system works.
According to Dr. Cayam and Prof. Mor Yosef, Israel's health care system has four key components: (1) universal coverage; (2) cradle to grave coverage; (3) coverage of both basic services and catastrophic care; and (4) coverage of all medications. Patients pay just a small co-payment to see specialists and to purchase medication, and primary care is free.
So, Israelis seem to have it pretty good: access to all their medical needs at a nominal fee! 
But they must spend a fortune, right? Not so. All this costs about 8% of Israel's GDP, while the U.S. spends a whopping 17% of its GDP on health care. 
Israelis pay a health care tax of 4.8% of their incomes, and in turn they can join one of the four Israeli HMOs. Costs are contained a number of ways, including covering only procedure that make sense for you (Cayam calls this "rational medicine, not rationing medicine") and electronic medical records in 90% of physicians offices, compared to 15% in the U.S.
Well, they definitely don't have high quality of care then, right? Nope. According to the latest World Health Organization statistics, Israel has a life expectancy of 81, ranking in the top 14 in the world, and ranked higher than average in most categories compared to the U.S. and Europe. 
Israel's first rate doctors attend six years of university, complete a one-year internship, spend five to six years at a residency, and many go on to fellowships in other countries. The Ministry of health issues quality-control measures to the HMOs, testing them at least twice a year.
Now, I'm not going to get into too many details of how Israel's health care system runs - for that, you can listen to the podcast. I think the most important lesson to be learned is by looking at Israel's priorities in health care. They provide universal access to care while maintaining high quality and controlling costs. Sometimes this means you have to wait a little bit to see a specialist, or purchase supplemental insurance from your HMO to cover extra physical therapy sessions or a elected surgery, but the result is an overall healthier population at a lower cost. 
Unfortunately, right now the U.S. health care system looks very little like Israel's. Rising health care costs leave a growing number of people without adequate health care, including the nearly 50 million people who are uninsured. The availability of health care resources is often based on ability to pay rather than need. Finding access to quality health care services is difficult for many. The costs of health care threaten the financial health of millions of individuals and families and the long-term financial stability of our nation.
Congress has the opportunity to change this in the coming months, and I hope that they will look to Israel to understand how universal coverage doesn't have to compromise quality or cost. Senators and Representatives will return to their home states and districts during the month of August, giving you the opportunity to tell them that we need comprehensive health care reform this year. Israel has figured it out, so why can't we?

Published: 7/30/2009

Categories: Social Justice, Uncategorized
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