Geoffrey Boner describes the Healthcare System in Israel
The medical system, which I found on my arrival in Israel at the end of 1960, was completely different to that I had known in South Africa. The population was approximately 2.1 million. Primary care was provided by physicians associated with one or other of the health funds. The largest fund was Kupat Holim Clalit, or General Health Fund. This fund had been established by the Federation of Trade Unions in 1911 and developed a system of clinics providing primary care throughout the country.
The other funds were: Leumit or National Health fund, established by the Revisionist party in 1933; Maccabi, established by the World Maccabi movement in 1940; and Meuhedet or United formed by the union of smaller funds in 1974.
All these funds provided health care through clinics belonging to each fund, or through physicians who were associated with each fund. Membership of a specific fund was obtained by paying a fee. Each fund had its own conditions for membership, own fees and own spectrum of care.
Almost all citizens belonged to one or other fund. There were many hospitals in all areas of the country. Most of the hospitals were government controlled, the government having taken over the hospitals established during the British Mandate in Palestine. The Clalit Health Fund established several hospitals for its members. There were also a small number of hospitals belonging to non-profit organizations.
Treatment in hospitals was paid for by the various health funds. Ambulatory specialist care was provided within the hospital setting or within specialist clinics organized by the funds. There was almost no private care for patients. The only medical school was at the Hebrew University in Jerusalem in conjunction with the Hadassah Medical Center. The Sackler Faculty of medicine was established at the Tel Aviv University in 1964.
Since then there has been a sharp increase in the population, both as a result of immigration and a high birth-rate amongst all sectors of the population, especially the ultra-orthodox Jews and the Arabs. The population at the end of 2019 was approximately 9.2 million. With the increase in the population and improvement in the economic status of large sections of the population, some people took out private insurance in addition to the traditional form of insurance and this led to the opening of private clinics and hospitals.
The National Health Insurance Law was passed and instituted in 1995. According to the law all citizens were required to belong to one of the four active Health Maintenance Organizations (HMO). All employed or self-employed citizens are obliged to contribute to National Insurance. With the passage of the new law the contribution to National Insurance was increased. National Insurance reimburses each HMO, taking into account the number of members, the age distribution of the members, number of members living in the periphery of the country and the number of members with chronic diseases which required special care, e.g. hemodialysis.