Israelis evaluate their health care system before and after the introduction of the national health insurance law.
This article reports on the evaluation of the Israeli health care system made by samples of Israeli Jewish urban citizens aged 45-74 at two points in time: 1993 and 2000. In 1993, 44% of the population thought that only minor changes were needed; 47% stated that fundamental changes were needed, and 9% thought that the system should be completely rebuilt. In 2000 the respective percentages were 37, 49 and 14%. In the 2 years of the survey, 40% thought the health sector should receive top national priority in government spending. The findings are analyzed with respect to the changes that occurred between 1993 and 2000-in particular, the introduction of the National Health Insurance Law (NHIL) in 1995 and subsequent related legislation. It is argued that while the NHIL has been an important social achievement, its micro-management details and subsequent legislation failed to keep up with the public expectations. Similar changes in public opinion of health systems occurred over the last decade in several other western nations, which reformed their systems. Policy makers should find ways to assure that reforms, which might be necessary for a more efficient allocation of resources from society's point of view, will also respond to the individuals' expectations.
Shmueli
Amir
A
Department of Health Management, Hadassah School of Public Health and the Gertner Institute, The Hebrew University, PO Box 12272, 91120, Jerusalem, Israel. ashmueli@md2.huji.ac.il
D000368:Aged; D001294:Attitude to Health; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D005260:Female; D006292:Health Priorities; D006302:Health Services Research; D006801:Humans; D007557:Israel; D007585:Jews / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D009936:Organizational Innovation; D011050:Policy Making; D011639:Public Opinion; D014505:Urban Population