It also operates many of the nation’s mother and child preventive health centres. Every citizen or permanent resident of Israel is free to choose from among four competing, non-profit-making sickness funds, called health plans (HPs). These HPs must provide their members with access to a statutory benefits package.
The system is financed primarily via a combination of a health-specific payroll tax and general taxation. While public financing remains the primary source of health system resources, the share of private financing has been increasing in recent years, primarily through a sharp increase in spending on voluntary health insurance.
Primary care is provided almost exclusively by salaried physicians (and other professionals) employed by the HPs, and independent physicians with whom the HPs contract. Primary care doctors play a gatekeeping role for access to secondary care. Most specialized ambulatory care is provided in community settings, despite recent hospital efforts to attract activity to their outpatient departments. In contrast, the hospitals are the main source of emergency care, with a relatively small but growing role for community-based providers (e.g. evening service centres sponsored by HPs and independent urgent care centres).