Healthcare in Israel
The Israeli healthcare system is based on the National Health Insurance Law of 1995,[1] which mandates all citizens resident in the country to join one of four official health insurance organizations, known as Kupat Holim (קופת חולים - "Patient Funds") which are run as not-for-profit organizations and are prohibited by law from denying any Israeli resident membership.
The British consulate in Jerusalem established a clinic providing free medical care in 1838, which was turned into a hospital run by a missionary organization in 1844.
Jews who worked as ordinary laborers and were not members of a moshava were consequently forced to pay for medical care or rely on the benevolence of doctors to treat them.
In Jerusalem, accumulated refuse heaps were removed, public rubbish bins were installed; the entire population was vaccinated against smallpox, and pools and cisterns were covered with mosquito repellent as part of the campaign to eradicate malaria.
[9] Family health centers known as "Tipat Halav" (from Hebrew: a drop of milk) were founded for the care of newborns, child development and vaccinations.
[10][11] In 1929, the Zionist Commission and the British authorities sent the Jewish epidemiologist Gideon Mer to Rosh Pinna to establish a laboratory for malaria research.
With the expansion of the Yishuv through the Third and Fourth Aliyah, new Jewish medical facilities were established and the number of Hadassah hospital beds tripled.
The other major provider of healthcare aside from Hadassah was the Histadrut labor federation, which established its own sick fund, Kupat Holim Clalit, and by 1946 operated two hospitals and hundreds of clinics and health centers.
Kupot Holim) were modeled after the medical mutual-aid societies that were formed in Germany following Otto von Bismarck's social legislation of the late 19th century.
Although they have undergone significant reform since, to this day they are an integral part of Israel's universal healthcare system (as they are in present-day German-speaking countries).
[16] According to a 1994 study, "Israel maintains a comprehensive health sector that is practically a universal coverage system, without being formally defined as such.
In 1988, the government appointed a National Commission of Inquiry to examine the effectiveness and efficiency of the Israeli healthcare system, headed by Shoshana Netanyahu.
[25] In general, each Kupat Holim allows members to choose a primary care physician and specialists from a list of healthcare providers associated with the fund.
[24] Availability of services differs by location, as each of these organizations operate their own medical facilities, including private hospitals.
[28] Those receiving old-age pension benefits from Bituah Leumi (i.e., most of the elderly people in Israel) pay a reduced flat rate and any additional income they have is exempted from the health tax.
[30] Although most residents are covered under the National Health Insurance Law, some exceptions apply to people who receive state-funded healthcare through other means.
In addition, some disabled World War II veterans and victims of the Nazis are eligible for certain types of health benefits from the Ministry of Finance.
The price of these supplemental plans is relatively modest (costing an equivalent of US$10 to $40 per month for an adult depending on age group and coverage tier in 2019).
For example, in the area of elective surgery, a participant in a private insurance plan may choose the surgeon, anesthetist, and hospital anywhere in Israel or around the world.
[40] There are also severe physician shortages in specific specialties, such as anesthesia, general surgery, geriatrics, and primary care [41] Israel has five university medical schools which typically follow the European 6-year training model.
Tel Aviv University also offers a four-year program similar to the American system for students who hold a bachelor's degree in certain biological sciences.
Immigrant doctors who graduated from an American, British, Canadian, French, Australian, New Zealand, or South African medical school are exempt, provided they have 14 years of experience, including residency, and undergo a six-month internship-like "adjustment period" in Israel.
The development of Physician Assistants in Israel was in a constant debate for years until a committee appointed by the Ministry of Health Director General recommended on 2013 on the development of an Israeli version of Physician Assistants in five areas that are currently in great need: Internal Medicine, Surgery, Anesthesiology, Emergency Medicine and Pathology.
There are also four MBB Bo 105 utility helicopters staffed with MDA paramedics owned by Lahak Aviation operating as air ambulances throughout the country.
Magen David Adom is supplemented in some areas by Hatzalah, an emergency ambulance services network serving Jewish communities worldwide, and ZAKA, a series of community emergency response teams staffed by Orthodox Jews, who in addition to providing medical services and evacuation, also aid in the identification of terrorism victims and gather spilled blood and body parts for burial.
The ambulance system, for the most part, conforms to the Franco-German model of EMS care, and the presence of physicians at high-acuity emergencies is not uncommon.
[56] According to a report in 2013, the number of patients from Eastern Europe, Cyprus and the United States seeking treatment at Israel's public and private hospitals is growing.
Nevertheless, as of 2016, there are roughly 250,000 non-tourists that stay in Israel for long periods that are not entitled to the benefits of the National Health Insurance Law.
The remaining 50,000 are work immigrants, asylum seekers and refugees, mainly from Eritrea and Sudan, who entered Israel illegally through the Egyptian border (prior to the construction of the Egypt–Israel barrier).
[70] Of the general hospitals, 11 are government-owned and operated by the Ministry of Health, 9 are owned by Clalit, and the rest are private, such as Herzliya Medical Center.
