Israel's National Health Insurance law requires that the country's 8 million citizens belong to one of the four national health plans. The health plans compete for members by emphasizing the quality of care provided, the range of services offered, and the levels of satisfaction that current members have with the plans.
The primary source of this information is MJB's biennial national consumer health survey, Israel’s most important independent resource on public opinion about the performance of Israel's health care system. In fact, the entire health care system—from the senior decision makers in government to the health care plans to consumer organizations—sees MJB's survey as a broad and unbiased tool for evidence-based planning for health care in Israel.
Smokler Center Senior Researcher Dr. Shuli Brammli-Greenberg has been involved with the survey since 1999 and has led it since 2012. "The report generates great interest among policymakers, the press, and the public," she explains. "Already months before the report comes out, we get requests from people wanting advance results to help with their planning."
This spring, MJB released the results from the eleventh round of the survey. The results present a complex picture. On the one hand, levels of satisfaction remain high—89% of respondents were satisfied with their health plan. Yet only 44% felt certain that they would get the best and most effective treatment if they had a serious illness.
To allow for analysis of the trends over time, the core of the survey has remained constant over the years and covers key indicators of the consumer experience, such as access to and availability of care. According to the new findings, waiting times continue to be a problem in several key service areas of the health care system. For example, 25% of Israelis wait more than a month to see a specialist, a level that has stayed the same since 2012.
In contrast, fewer patients reported foregoing medical treatment or medication because of the costs. Similarly, there was a considerable decline in the percentage of respondents who had gone without dental treatment because of the cost. This may be related to the recent reform to improve access to dental care for children.
In addition to the core questions, the survey also incorporates one-time questions related to current pressing issues on the health care agenda. This year, one of the new set of questions looked at the choice of surgeon within the public hospital system. (Currently, in almost all of the non-private hospitals, Israelis cannot choose their surgeon.) A large majority of the respondents (84%) felt that everyone should be given the choice of surgeon in public hospitals at no extra cost. 90% reported that it was important to know who would be operating on them in advance.
An important contribution of the survey is that it provides an international comparison between developments in Israel and those in other countries with advanced health care systems. This international comparison has been made possible through a collaboration between MJB and the prestigious New York-based Commonwealth Fund, which carries out an annual cross-national survey of health care system performance.
Another powerful aspect of MJB's biennial consumer health survey is that it is accompanied by a national steering committee with representatives from all the health plans, the Ministry of Health, the Ministry of Finance, the Social Security Administration, and consumer organizations. In the committee, a consensus develops about what is most important to measure in order to support concrete efforts for change. In addition, this committee provides a unique conduit for directly feeding the results to the key decision makers and players in the health care system.