JANUARY

What are the key entities for health system governance?
ISRAEL
Parliament (the Knesset) adopts and amends legislation related to the health system. The Cabinet, comprising
a selection of Knesset members from the ruling parties, has executive responsibility for the government as a
whole, including the Ministry of Health (MoH). The MoH has overall responsibility for population health and the
effective functioning of the health care system. It includes:
• The Minister, an elected member of the Knesset and typically also a member of the Cabinet. The Minister has
full authority and responsibility for the functioning of the MoH.
• The Director-General, the MoH’s top professional, who is appointed by the Minister to run the operations
of the MoH.
• A large number of departments, including those responsible for quality and safety, assessing costeffectiveness,
fee-setting, public information, and health IT.
• Various advisory bodies, including the National Health Council, a public advisory; the benefits package
committee, which advises on prioritization of new technologies for inclusion in the NHI benefits package; and
national councils in such areas as trauma care, mental health, and women’s health.
The Ministry of Health has an ombudsman’s office to help citizens realize their rights under the NHI law.
In addition, there are various nongovernmental patient advocacy organizations, many of which focus on
particular diseases.
The Budget Division of the Ministry of Finance prepares the budgets of all ministries, including the MoH, for
consideration by the Cabinet and then the Knesset. It also plays a major role in promoting and shaping major
structural reforms to the health system and partners with the MoH on interministerial committees, such as those
that set maximum hospital prices and the capitation formula. The Ministry of Finance Insurance and Capital
Markets Division regulates commercial health insurers. The government also has an antitrust unit responsible for
promoting competition, but it is not very active in the health area.
The Scientific Council of the Israel Medical Association is responsible for the specialty certification programs and
examinations, in coordination with the MoH. The Council for Higher Education is responsible for the
authorization, certification, and funding of all university degree programs, including those for training health
care professionals.
What are the major strategies to ensure quality of care?
For over a decade, Israel has had a well-developed system for monitoring the quality of primary care.
Comparative quality data for individual health plans has been made public since 2014 (Jaffe, 2012). While the
published data relate to the health plans as a whole, the plans have internal data by region, clinic, and
individual physician. The plans and their clinicians have made intensive use of this data to bring about
substantial improvements in quality (Rosen et al., 2011; Balicer et al., 2015).
The MoH publishes comparative data on the quality of hospital care. This system is much newer than the system
for primary care quality and is currently limited to a handful of indicators. However, it is expected to develop
rapidly over the coming years.
The MoH is in the process of launching a national initiative to reduce waiting times for surgical procedures, and
there are several initiatives focused on the care of particular diseases, such as dementia. The health plans are
increasingly active in implementing programs for the chronically ill, including disease management.
Hospitals and clinics require a license from the MoH, granted only when basic quality standards are met.
Hospitals are also increasingly seeking, and securing, accreditation from Joint Commission International.
International Profiles of Health Care Systems, 2015 91