Health in Israel

Since its inception, Israel has been very successful in pursuing effective Public Health policies. The country maintains one of the highest average life expectancies in the world, despite its status as a young nation composed of immigrants, who have arrived during the past 58 years principally from North Africa, the former Soviet Union and Central Europe. Israel has also managed to absorb Holocaust survivors and a large proportion of immigrants suffering from tuberculosis, malnutrition, heart disease and every type of cancer. The 2006 life expectancy estimate for Israeli men is 77.33 years, and is 81.7 years for females. The infant mortality rate is 6.89 deaths/1,000 live births.

Public Health

The Zionist Movement in pre-state Israel, which combined the traditional Jewish concern for all people with an emphasis on societal needs, regarded public health as a top social, political and economic priority. By the time Israel declared its independence in 1948, a national health infrastructure was already in place. Mother-and-child care centers (Tipot Halav) administered vaccinations to new-born babies and advised parents on proper care of infants. Health insurance funds (Kupot Holim) offered day-to-day consultations with doctors and specialists, and insured members for hospitalization.

Despite Israel's commitment to providing health services for all of its citizens, by the early 90's some six percent of Israelis were not insured through one of the four existing health funds - Kupat Holim Clalit, Maccabi, Me'uhedet and Le'umit. In 1994, the National Health Insurance Law was enacted and it was implemented the following year, rectifying this situation. Since then, all citizens have their health insurance paid by a tax on income (up to 4.8%) while their employer's portion is collected by the National Insurance Institute and passed on to the health insurance fund of the individual's choice. The country’s sick funds and the Ministry of Health provide health services, including public clinics, preventive medicine, hospitals, research, dental care, private physicians, and government administration.

National Expenditure

Israel's national expenditure on health is typical for a western country. In 2004, the country spent approximately NIS 46 billion, forty percent of which was allotted to sick funds, twenty-eight percent to private hospitals and households, twenty percent to government, local authorities, the National Insurance Institute, and national institutions, and twelve percent to private nonprofit institutions. In 2003, the main causes of death were malignant neoplasms (25% of all deaths), heart disease (20%), cerebrovascular disease (6%), and deaths due to external causes unrelated to disease (6%). At the end of 2004, there were 3,336 HIV carriers and 344 AIDS patients in the country.

Successes in Israel

University research results are put into practice by the public health system, while the Israel Council for Public Health runs campaigns to raise public awareness of relevant issues. In addition to increasing longevity and reducing infant mortality, Israel has completely eradicated a range of diseases, such as malaria, polio and diphtheria, which had plagued the country in its formative years.

As in most western countries, heart disease and cancer are the biggest killers. Successful educational campaigns have greatly reduced the level of smoking and the incidence of skin cancer caused by the sun's rays. Israel has the lowest percentage of new HIV positive victims in the western world, with just a few hundred new cases each year. This is largely attributable to comprehensive sex education programs offered in the country's high schools.

The country has also made significant strides in combating nutritional deficiencies. In the early years of the State, agricultural infrastructure was, in part, planned in conjunction with the Ministry of Health's nutritional recommendations. Today, the diet of Israelis favors vitamin-rich fresh fruit and vegetables.

Medical Technology Innovations

Israelis have made significant contributions to research and development in cardiology, genetics, neurology, ophthalmology, and other medical sciences. Israeli medical and biotechnological scientists have created state-of-the-art surgical lasers; computerized no-radiation diagnostic instrumentation for breast cancer; an intelligent medical sensor used to track and direct instruments to an exact location in the heart or other organs via a real-time virtual image; the fully flexible wave guide fiber for endoscopic surgery; unique computerized monitoring systems for critical care patients; pain-relieving transcutaneous devices; a revolutionary autoclave design to combat AIDS and other infectious diseases; and many more.

Local scientists have developed methods for producing a human growth hormone and interferon, a group of proteins effective against viral infections. Copaxone, a medicine effective in the treatment of multiple sclerosis, has been developed in Israel. Genetic engineering, including cloning, has resulted in a wide range of diagnostic kits based on monoclonal antibodies, along with other microbiological products.

In aesthetic medicine, Israel has pioneered electro-optic medical devices that apply proprietary pulsed light technology for non-invasive treatment of skin cancer and benign lesions, as well as for treatment of varicose veins, skin rejuvenation and hair removal. In neonatology, Israel has introduced an early warning monitor, which senses lowered breathing and pulse levels and could prevent SIDS.

Israel has made significant theoretical and practical contributions to the biotechnology revolution and has developed an advanced infrastructure of medical and paramedical research as well as bioengineering capabilities. Biotechnology, biomedical and clinical research account for more than half of all scientific publications. Israeli scientists developed a pill-size combination of a digital camera, battery, radio transmitter, and light source, which patients can swallow as a non-surgical imaging of the gastrointestinal tract.

Israeli companies have developed a broad range of innovative optical glass rods as active media for solid-state medical lasers and high intensity luminescence (replacing gas and dye media). Israel has also developed a system for real-time thermal images of blood flow through exposed coronary arteries, without ingesting toxic contrast materials or exposure to radiation. Also newly introduced is an infrared-based bloodless blood test of hemoglobin and hematocrit and an award-winning device that attaches to a standard catheter to indicate correct insertion of an infusion needle into a vein.

Public Aging

One trend that strains health services is the aging of the Israeli population. In the 2006 estimate, Israelis aged 65 and over represent 9.8% of the population, those ages 15-64 make up 63.9%, and children up to the age of 14 and younger represent 26.3%. As the proportion of elder Israelis increases, the drain on healthcare services will progressively worsen.

The Cost of Medical Technology

The introduction of increasingly expensive equipment for diagnosis and treatment as well as costly innovative medications, poses one of the greatest challenges to public health policy. Doctors and health officials are finding that they must now choose between life and death for population groups suffering from various diseases. The economics of health care are further complicated by the fact that research and development of such equipment and medication are inordinately expensive. Thus health care professionals must choose between allocating funds for short-term medical needs, or for investing in R&D for long-term benefits.