page_title: List of countries with universal health care
section_title: Israel
hierarchical_section_title: List of countries with universal health care / Asia / Israel
caption_attribution_description: English: This image indicates Israeli health care spending as a percentage of GDP. An 'OECD Health Data 2010' report is used for the information, which is available here.
context_page_description: Universal health coverage is a broad concept that has been implemented in several ways. The common denominator for all such programs is some form of government action aimed at extending access to health care as widely as possible and setting minimum standards. Most implement universal health care through legislation, regulation and taxation. Legislation and regulation direct what care must be provided, to whom, and on what basis.
  The logistics of universal healthcare vary by country. Some programs are paid for entirely out of tax revenues. In others tax revenues are used either to fund insurance for the very poor or for those needing long term chronic care. In some cases such as the UK, government involvement also includes directly managing the health care system, but many countries use mixed public-private systems to deliver universal health care. In twenty five European countries, universal healthcare entails a government-regulated network of private insurance companies.
context_section_description: Israel has a system of universal healthcare as set out by the 1995 National Health Insurance Law. The state is responsible for providing health services to all residents of the country, who can register with one of the four national health service funds. To be eligible, a citizen must pay a health insurance tax. Coverage includes medical diagnosis and treatment, preventive medicine, hospitalization (general, maternity, psychiatric and chronic), surgery and transplants, preventive dental care for children, first aid and transportation to a hospital or clinic, medical services at the workplace, treatment for drug abuse and alcoholism, medical equipment and appliances, obstetrics and fertility treatment, medication, treatment of chronic diseases and paramedical services such as physiotherapy and occupational therapy.
  In Israel, the National Health Insurance Law is the legal framework that enables and facilitates basic, compulsory universal health care. Promoted by health minister Haim Ramon in the early 1990s, the Knesset put the law into effect on January 1, 1995—basing it on recommendations from a National Committee of Inquiry headed by Shoshana Netanyahu, which examined restructuring the health care system in Israel in the late 1980s. Prior to the law's passage, over 90% of the population was already covered by voluntarily belonging to one of four nationwide, not-for-profit sickness funds. These operated some of their own medical facilities, funded in part by employers and the government, and in part by the insured via levies that varied according to income. However, there were three problems associated with this arrangement. First, membership in the largest fund, Clalit, required one to belong to the Histadrut labor organization, even if a person did not want to (or could not) have such an affiliation, and other funds restricted entry to new members based on age, pre-existing conditions, or other factors. Second, different funds provided different levels of benefit coverage or services to their members. Lastly, some of the population, albeit a small percentage, had no health insurance.
  Before the law went into effect, all the funds collected premiums directly from members. However, upon passage of the law, a new progressive national health insurance tax was levied through Bituah Leumi (Israel's social security agency), which then re-distributes the proceeds to the sickness funds based on their membership and its demographic makeup. This ensured that all citizens would now have health coverage. While membership in one of the funds now became compulsory for all, free choice was introduced into movement of members between funds (a change is allowed once every six months), effectively making the various sickness funds compete equally for members among the populace. Annually, a committee appointed by the ministry of health publishes a "basket" or uniform package of medical services and prescription formulary that all funds must provide as a minimum to all members. Achieving this level of equality guaranteed basic healthcare regardless of fund affiliation, which was one of the principal aims of the law. An appeals process handles rejection of treatments and procedures by the funds and evaluates cases that fall outside the "basket" of services or prescription formulary.
  The law is generally considered a success, and Israeli citizens enjoy a high standard of medical care comparatively, with more competition in the country's health care, and with order having brought to what was once a somewhat disorganized system—the law nevertheless has its critics. First among the criticisms is that the "basket" may not provide enough coverage. To partly address this, the health funds began offering "supplementary" insurance to cover certain additional services not in the basket. However, since this insurance is optional (though rather modestly priced, costing the equivalent of about US$10 to $35 a month depending on age and coverage for an adult in 2019), critics argue that it goes against the spirit of the new law, which stressed equality o
caption: Health care in Israel as a percentage of GDP
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