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Israel Healthcare


Israel's extensive medical network and high doctor-patient ratio are reflected in the low infant mortality rate (5.4 per 1,000 live births) and high life expectancy (80.9 years for women, 76.7 for men). Western-level training for medical professions is offered at the country's schools of medicine, dentistry, pharmacology, nursing and physical rehabilitation.

The National Health Insurance Law (in effect since January 1995) provides a standardised basket of medical services, including hospitalisation, for all residents of Israel. Health insurance premiums are collected by the National Insurance Institute which transfers the funds to the four healthcare organisations providing the medical services.

Responsibility for all health services is vested in the Ministry of Health, which prepares legislation and oversees its implementation; controls medical standards throughout the country; licenses medical personnel; and supervises the planning and construction of hospitals. The ministry also acts as a public health agency with regard to environmental and preventive medicine.

Health services are offered at 354 general and specialised hospitals (with some 39,600 beds), as well as through a network of outpatient clinics, mother-and-child healthcare centres, convalescent homes, rehabilitation institutes and school health programs, which include dental care. Medical facilities and services are provided by the Ministry of Health, the large municipalities, private and non profit institutions and health insurance funds.

Emergency care is available through Magen David Adom (Red Shield of David), which corresponds to the Red Cross, or the Red Crescent, in other countries. It provides a public ambulance service, mobile intensive care units and emergency treatment at first aid stations all over the country, and maintains a network of blood banks.

Israeli researchers have made impressive contributions in the fields of cancer immunology and cardiology, as well as in brain, orthopedic and plastic surgery and in the treatment of burns. Israel is also playing an important role in the development of medical technology, including computerised diagnostic and monitoring systems, pacemakers, lasers and other life-saving and pain-relieving devices.

Social Security

Israel's social security system is a wide-ranging but not over-generous safety net for the population. The general principle of the system appears to be quite liberal in outlook. For example, paternity leave is permitted. As the benefits payable are not adequate for all, the state encourages private provision in many areas.

The system is administered by the National Insurance Institute of Israel, which comes under the Ministry of Labour and Social Affairs. Contribution levels are significant, but for employees are subject to maximum amounts based on salary and are tax deductible.

The total cost of social security in 1998 was NIS 87.8bn (USD 23.1bn), a substantial 23% of GDP. Rising costs are due to both increases in population as a result of mass immigration in recent years and increases in scope and amount of benefits.

Between 1989 and 1997 government transfer payments rose by 62% and expenditure on direct services by 79%.

There is considerable scope for additional private provision, which is met by a range of providers. Social security amounts have been shown in local currency. At the time of writing the ROE was NIS 4.2: USD1.

The financing of National Insurance Institute benefits comes from four sources:

  • Receipts from national insurance contributions collected from employers, employees and the self-employed. This includes an amount paid by the state as part of government policy to reduce labour costs.
  • State involvement in the financing of contributory national insurance benefits. The state contributes a prescribed percentage towards some contributory benefits e.g. 15% of old age pension contributions.
  • Direct state involvement in the financing of non-contributory benefits e.g. income support.
  • Receipts from interest and investments. NII expenditure on old age pensions and other benefits in 1998 was NIS 31.7bn (est.), equal to 36.1% of total social services expenditure; health system expenditure was NIS 19.6bn or 22.3%. Education and higher education cost NIS 25bn (28.5%) and social affairs and other items NIS 11.5bn (13.1%).

The National Insurance Institute provides the following major benefits:

  • Old age pension
  • Survivors benefit
  • Permanent disability benefit
  • Work injury benefit
  • Unemployment benefit
  • Family allowance

Benefits are linked to the national average wage, which at 1 January 1999 was NIS 71,772. Generally speaking all residents and employees are covered by the national insurance system. There are one or two exceptions, e.g. new immigrants over 60 are not eligible for the old age pension. A special payment is made for the coming of age (or bar mitzvah) at age 13 of orphan boys.

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