Public Opinion on the Level of Service and Performance of the Health Care System Ten Years after the Introduction of National Health Insurance

Since the implementation of the National Health Insurance law in 1995, the Myers-JDC-Brookdale Institute has been studying the performance of the health care system from the point of view of consumers. The follow-up surveys are conducted every two years in order to examine the extent to which the law’s main objectives – the improvement of the quality of health services and the enhancement of equity among population groups – have been obtained. The study is monitored by a joint steering committee with representatives of the Ministry of Health, the Ministry of Finance, the health plans, the National Insurance Institute and consumer organizations.

The findings of the survey conducted at the end of 2005, the sixth in the series, are presented in this report. A synopsis of the findings has been widely disseminated, and the report offers an in-depth analysis of the findings, comparing health plans and population groups. The main issues discussed in the report include:

  • Trends over time in satisfaction with health plan services, availability, waiting time, preventive services, health status and mental distress, supplemental insurance, and the burden of payments for health
  • Accessibility of services: forfeiting medical care and prescription medications due to cost, forfeiting dental care due to cost, forfeiting services due to distance and administrative restrictions by the health plans
  • Transfers among health plans: analysis of the characteristics of those who are considering transferring their membership, their preferred health plan and barriers to implementing the transfer
  • Public opinion with respect to major policy issues, such as updating the basket of services and involvement in decisions on medical care
  • Experiences of chronically ill patients in the health care system, in comparison to others, and their evaluation of the quality of explanations given by physicians, care coordination, communication with medical staff and particular problems in obtaining  medical care
  • Consumer’s overall evaluation of the functioning of the health care system and their suggestions for  improving health care.

The importance of this study lies in providing ongoing information to assist directors in the health plans and policymakers in monitoring measures of the performance of health services. The study highlights trends that should be reinforced and areas in which the level of performance is deficient. In this way the study contributes to the public discussion and promotes planning of appropriate responses by policymakers. In addition, the study gives voice to the opinions of consumers and thus makes it possible to consider them when setting policy.

This survey was funded with the assistance of the Government of Israel, Clalit Health Services, Macabi Healthcare Services, Leumit Health Fund and Meuhedet Health Services.

Citations in the professional and academic literature

Rosen, B., Waitzberg, R., & Merkur, S. (2015). Israel: Health system review.

Feder-Bubis, P., & Chinitz, D. (2010). Punctuated equilibrium and path dependency in coexistence: the Israeli health system and theories of change. Journal of health politics, policy and law35(4), 595-614.

Shadmi, E., Admi, H., Ungar, L., Naveh, N., Muller, E., Kaffman, M., … & Reis, S. (2010). Cancer care at the hospital–community interface: Perspectives of patients from different cultural and ethnic groups. Patient Education and Counseling79(1), 106-111.

Rayan, N., Admi, H., & Shadmi, E. (2014). Transitions from hospital to community care: the role of patient–provider language concordance. Israel journal of health policy research3(1), 24.

Rosen, B., Waitzberg, R., & Merkur, S. (2015). Health systems in transition. Health17(6).

Factor, R., & Kang, M. (2014). Priority setting in health care as portrayed in South Korean and Israeli newspapers. Health policy114(2-3), 226-235.

Chinitz, D., & Meislin, R. (2009). Israel: Partial Health Care Reform as Laboratory of Ongoing Change. Six Countries, Six Reform Models: The Healthcare Reform: Experience of Israel, the Netherlands, New Zealand, Singapore, Switzerland and Taiwan: Healthcare Reforms” under the Radar Screen”, 25.