Israel

7.3%CHE/GDP

20.3%OOP/CHE

13%GGHE-D/GGE

524BGDP (USD)

9.1MPopulation

Israel has a national health insurance (NHI) system that is a centralized health system, in which the ministry of health plans, makes policy, and regulates and enforces universal health coverage for a defined benefit package, and also owns some health facilities. Four nationwide health plans (HPs) provide and pay for services.

Since the enactment of the National Health Insurance Law in 1995, coverage is for a defined benefits package and is mandatory for all residents, who can freely choose among the four health plans. The National Insurance Institute (NII) collects and pools earmarked income-related contributions and general government funds and allocates these funds among the health plans based on a risk-adjusted capitation formula.

The NHI benefits package is explicitly defined using a positive list that includes primary, secondary and inpatient care; diagnostic tests; child development and rehabilitation services; mental health services; and some oral health services for children and so-called older adults. New services and medical technologies are added based on recommendations from a public interdisciplinary committee.

Several policy instruments promote patient centredness: the Patient Rights Law passed in 1996, the National Quality Measurement Programme launched in 2005, and biennial surveys on quality.

Several data give insight into spending on health in Israel in 2022, especially as compared to data for European Union (EU) countries. Per capita spending on health amounted to US$ 4,224 in 2022, which was more than the average for the EU countries (US$ 3,461) in that year. Out-of-pocket (OOP) spending, at 20.2% of current health expenditure (CHE), was similar to the average of EU countries of 19.2% in 2022. But voluntary health insurance (VHI) (11.3% of CHE) played a more important role in financing health in Israel than it did in the EU countries, for which health insurance averaged 3.8% in 2022.^[1]

Public spending on health in Israel accounted for 7.2% of gross domestic product (GDP) in 2022, which was below the corresponding average of 8.7% for EU countries in 2022. General government health expenditure accounted for 66.5% of health spending; OOP spending accounted for 20.2%; and VHI accounted for 11.3% of CHE.^[1]

Unmet needs and forgone care

In 2021, long waiting times for specialist care led 35% of adults, particularly those with higher incomes or with voluntary health insurance, to forgo publicly funded health services. Many sought private care instead, exacerbating health inequities, as public facilities faced workforce shortages. Yet even among people who could pay for private care, 18% of adults seeking private care reported unmet needs due to the distance between their home and points of service.^[2]

The strides Israel has made in mortality prevention and life expectancy are often referred to as its health paradox. However, several health indicators serve as warning signs for policy makers: rising smoking and obesity rates, air pollution and diabetes prevalence. Israelis report relatively low subjective health assessments, highlighting persistent disparities in health indicators, access to health care services and long waiting times for consultations and procedures.

References

[1] World Health Organization, Global Health Expenditure Database, Indicators and Data (choose country)

[2] Health Systems in Action, Israel, 2024 Edition