A comparative report on health systems, including Israel, published today by the Organization for Economic Cooperation and Development (OECD) cites several critical problems that the German Committee did not managed to solve, or did not address at all.

For example, the report indicated that as of 2012, the number of general hospitalization beds in Israel (excluding psychiatric and geriatric institutions) was only 1.9 per thousand residents, compared with 7.9 in Japan and the OECD average of 3.3. According to the figures, only Canada and Mexico were worse in this category.

As a result, the average occupancy rate in hospitals was 96.6% - the highest in the OECD. The OECD average was 75.1%, with the lowest rates being in Turkey (64.1%) and the Netherlands (only 45.6%).

The Ministry of Health responded that this figure was only an average. During winter, the peak time for seasonal diseases, occupancy rates in Israel were in excess of 100%, sometimes reaching as high as 170% - a well-known phenomenon referred to as the "corridor patient." The OECD report shows that the number of hospitalization days per patient was among the lowest in the OECD, 4.3, versus the OECD average of 6.5, and one place above Turkey, which was in last place.

The figures show that the number of nurses actually employed in Israel was the lowest in the OECD, except for Mexico - 4.8 per thousand residents, compared with the OECD average of 9.1, 11.3 in Germany, and 16.6 in Switzerland three times as many as in Israel.

The Ministry of Health said that despite efforts to expand training frameworks, the number of nurses is still falling. At 3.3 per thousand residents, the number of doctors in Israel is close to the OECD average, but Ministry of Health figures indicate a consistent negative trend in the number of doctors. A large number of doctors are retiring, mostly immigrants from the former Soviet Union who arrived in Israel in the 1990s. The number of those graduating from medical schools in Israel and overseas is lower than the number of doctors retiring. With the opening of the medical school in Tzfat and concessions made for graduates of overseas medical schools, this trend is projected to slow with the number of doctors in Israel expected to reach 2.9 per thousand residents in the coming years.

Not for the first time, the report singled out a severe shortage of MRI machines in Israel, a device that provides clear and precise diagnoses without radiation. Although MRIs are now considered fairly standard in the Western world, the Ministry of Finance rarely grants licenses for new MRI machines. The number of MRI machines in Israel is only three per million residents, compared with an OECD average of 14, 19.1 in Austria, and 46.9 in Japan. The number of CT machines, which are much cheaper to buy and maintain, is one of the lowest in the OECD at 9.2 per million residents, compared with the OECD average of 24.

The OECD report includes other troubling data, but at least some of them provide a partial answer to the recommendations issued last week by the German Committee, which included increasing the Ministry of Health budget by NIS 700 million and banning the introduction of additional private medical services in the public hospitals. According to the report, national spending on health is Israel as a proportion of GDP was only 7.3% - the same proportion spent in 1995 - compared with the OECD average of 9.3%.

The proportion of private expenditure spent by people in addition to the monthly health tax, is one of the highest in the OECD, amounting to 38.6% of national spending on health. Among other things, this figure is due to the fact that dentistry in Israel is not included in the state health basket (except for children up to the age of 12), while the proportion of people with supplementary and commercial health insurance is 80%. Private spending on health also includes deductible payments for medication, visits to the doctor, purchases of medical equipment, etc.

Good news, too

Not all the news is bad: other than the fact that the mortality rate in Israel from breast cancer is the second highest in the OECD (32 deaths per 100,000 women), the situation of Israelis in general is better than elsewhere. According to the report, Israel has one of the world's highest life expectancies, the infant mortality rate is fairly low, and Israel is a global leader in fertility with an average of 3.1 children per women - first place in the OECD, far ahead of Mexico in second place (2.2).

Published by Globes [online], Israel business news - www.globes-online.com - on June 30, 2014

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