January 13, 2021
Hanoch Lis, 84 , receives a Pfizer-BioNTech coronavirus vaccine at a COVID-19 vaccination center in Jerusalem during a nationwide lockdown to curb the spread of the coronavirus on Jan. 10, 2021.
Israel has become a world leader in the COVID-19 vaccination campaign, with nearly 20% of its population vaccinated in less than three weeks.
The opposite development is unfolding in New York State and across the U.S. New York has vaccinated its population at a rate of less than three doses (2.85) per 100 people, according to data compiled by Bloomberg. In New York, vaccine distribution was initially complicated by strict eligibility guidelines that forced medical providers to discard unused doses; the state expanded eligibility on Jan. 8, and again this week, in hopes of accelerating the vaccine rollout.
It would stand to reason that New York can learn from Israel when it comes to vaccine distribution, but the narrative is not what initially meets the eye. The press has largely attributed Israel’s vaccination success story to the country’s “national health-care system,” but that assumption may cause Americans to misunderstand the Israeli medical system and implement the wrong improvements to the U.S. vaccine effort.
Unlike the U.K. and a number of European countries, Israel does not have a national governmental health care system. It has some government-owned hospitals, but most of the medical care system is either private or nonprofit-driven.
What Israel does have is national health insurance, and that system has indeed paved the way for a seamless vaccine rollout. Israeli citizens pay a health care tax of 4 or 4.5% of their income, representing the premium for their health insurance. The government, via its Ministry of Health, functions as the insurance company. Like insurance companies, the government publishes an insurance policy, known in Israel as the health care basket. This policy includes all medical needs covered by the health care tax.
For more exotic diseases, Israelis can and do take out private insurance.
The actual care is provided by a network of health maintenance organizations. Today, every Israeli belongs to an HMO, with four options of plans nationwide. The HMOs own and operate neighborhood clinics and hospitals and work with private practitioners. The private clinic cooperates with the HMO and bills them for care provided to patients.
Private medical care is also available in Israel. While most doctors work for or work with an HMO, all doctors are able to accept private patients. Many doctors both work with an HMO and run a private practice. However, most Israelis receive medical care via their HMO.
As a result, unlike the U.S., Israel does not have city or government hospitals for the indigent. Ability to pay is not an issue in Israel since the entire population is covered by national health insurance via the taxing system. Under this system’s structure, all care is provided to an individual through a single provider (the HMO) with a single-payer (the government).
When a woman gives birth to a child, she arrives at the hospital, gives birth, and goes home two days later — without pay anything. If a person has surgery at a hospital, however long the stay, they go home without paying. If a person needs to visit their family doctor, the same applies.
Israelis do not fill out an array of forms. Each HMO member is issued a card with a magnetic tape that contains his/her personal details and the HMO they belong to. When a person visits a doctor or hospital, the insurance card is swiped like a credit card and the insurer (government) is billed.
As a single payer, the government has a collective agreement with the HMO regarding the fee for each type of care. The Israeli HMOs, in turn, maintain computerized records of their patents.
When the COVID-19 crisis broke out, each HMO possessed complete medical records of its members and contacted those in high-risk categories to follow up on them. When vaccines arrived, the HMOs contacted their members in accordance with the government’s priority standards and invited them to the nearest clinic to receive their shots.
Some HMOs opened up additional sites exclusively for COVID-19 vaccinations; they did not even have to call. Due to their existing communications, the HMOs can send mass text messages with one click of a button. High-risk patients were contacted, next-day appointments were made, and patients were swiftly vaccinated.
That is how a vaccine is rolled out in Israel. Although New York does not possess the capability to overhaul the American health care system, the Empire State can still glean best practices from the highly efficient Israeli rollout for the purpose of enhancing the efficiency of the state’s vaccine distribution.
Humphries is an industrial marketing and management lecturer at the Jerusalem College of Technology – Lev Academic Center and vice chair of the Business Administration Department/Faculty at Touro College Israel.