New OECD Report Praises Israeli Healthcare Written by Linda Gradstein -debkafile Published Sunday, October 14, 2012
A new report by the Organization of Economic Development (OECD) finds that Israel’s primary care system effectively diagnoses and treats many chronic conditions despite spending less on healthcare than most other OECD members. The Jewish state spends just eight percent of GDP on healthcare and offers universal access through one of three HMOs. All conditions, including pre-existing conditions are covered, although some medicines must be purchased privately. Israelis pay a health tax as part of income tax in exchange for coverage. “Israel has an excellent family health care system and that is a very good point,” Francesca Colombo, a senior health policy analyst and one of the reports’ authors told The Media Line. “It has universal access and low spending which is an achievement.” One successful institution is a network of well-baby neighborhood clinics where newborns are given immunizations and other services. Some medical services such as eye tests are also provided in schools. The report cites the example of adult diabetes. The country has the same rate of diabetes – 6.5 percent of the adult population – as many other OECD countries, yet it has the second lowest rate of hospitalization for diabetes that has not been properly controlled. “There is a pioneering system of using 40 indicators to monitor the quality of primary care since everyone here is involved in one of the HMO’s,” Dr. Bruce Rosen, the Director of the Smokler Center for Health Policy Research at the Joint Distribution Committee (JDC) Brookdale Institute. “Israel has one of the highest longevity rates in the world for men and one of the highest for women.” In the US, says Rosen, only about one-third of the population is covered by HMOs which makes tracking health care more difficult. It also means that a greater proportion of the population uses the emergency rooms, which are far more expensive, than preventive care via doctors visits. At the same time, the OECD finds improvement needed in Israeli hospitals, where there is not as much information. “Israel has world-class community medical clinics and it must now invest efforts to bring its hospitals up to the same international standards,” the OECD report recommends. The relatively young population and an influx of doctors from the former Soviet Union in the 1990’s have made it easier for the health system to cope. But as these doctors retire and the elderly population grows, Israel’s health system will be under more pressure. The report also points out “inequities” between Arabs and Jews when it comes to health care. “Israeli-born Jews in urban centers and those able to pay rising out-of-pocket costs are getting better care, and living longer, than immigrants, Arabs and poor people,” the report says. Certain population groups have unique health problems. A higher percentage of Arab men than Jewish men smoke, and Arab women have higher obesity rates. “We encourage Israel to develop clinical guidelines which are culturally sensitive,” Francesco Columbo of the OECD said. “For example Israel must make more efforts in smoking cessation for Arab men and obesity reduction for Arab women.” Bruce Rosen of the JDC says that Israel’s hospital bed to population ratio is low and the average length of hospital stay is short. “In the US there is a lot more staffing and here more falls on the family,” Rosen said. Many Israeli hospitals expect family members to participate in patient care by feeding patients, changing sheets and taking patients for tests. The country also needs more doctors in “the periphery”, in the Galilee and the Negev. A new Israeli medical school in the northern town of Safed opened last year, and the government is giving grants to doctors who are willing to move to less populated areas.