טכניון מכון טכנולוגי לישראל
הטכניון מכון טכנולוגי לישראל - בית הספר ללימודי מוסמכים  
M.Sc Thesis
M.Sc StudentAbba-Bendor Hanny
SubjectThe National Health Insurance Law and The Israeli Health
System
DepartmentDepartment of Industrial Engineering and Management
Supervisor Dr. Benjamin Bental


Abstract

The National Health Insurance Law of 1995 was enacted following a financial crisis in the health system, as well as low satisfaction levels of the citizens with the health funds. Its purpose was to create equality among the insured, uniformity in services rendered, and also to stabilize the health system financially. This paper presents some of the many changes that have occurred in the public health system in Israel, and summarizes the literature and empirical data concerning the health system after the law’s enactment.

The paper begins with a review of the health system prior to the new law, of the factors which led to the enactment of the law, and discusses some of the law's main principles. While the law has produced changes in many areas, this paper focuses on the following fundamental issues:

·        Changes in the health system in terms of funding methods, which switched to progressive fees instead of a fixed fee.

·        The unresolved question of continued deficits. One of the objectives of the law was to reduce the accumulating deficits of the health system. The paper presents various explanations for the health funds’ continued deficits, and discusses the policies applied to achieve stabilization of the health system.

·        The issue of health-care quality. The paper reviews whether the national health insurance law achieved its goal in providing service quality, and whether the programs for improving health system efficiency and attempts to balance the system’s budget had any effect on the services.

·        Increased competition. The last part of the paper examines whether the new law achieved its objectives in terms of increasing the competition among the health funds, improving services, gaining greater equality and allocating resources in a way that enables all health funds to provide the same level of service.


Many other changes have occurred after the enactment of the law. For example, the provision of supplementary and private insurance policies, which has accelerated since the law was enacted, results from the fact that the uniform health basket is not comprehensive and does not include a range of various medications and treatments. Similarly, night services have emerged, a service that has practically not existed before the law’s enactment. Such topics constitute a source for further studies about the health system in Israel and the reforms that followed the National Health Insurance Law.