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Israel’s Health Care In The Spotlight After Romney Cost Comments

Mitt Romney caused quite a stir earlier this week when he applauded Israel for spending far less on health care than the United States but neglected to mention that the Israeli system depends on the kind of government regulation he has decried at home.

(Photo by J.D. Pooley/Getty Images)

Romney on Monday highlighted the fact that Israel spends 8 percent of its gross domestic product on health care, compared with 18 percent in the U.S.

“We have to find ways — not just to provide health care to more people, but to find ways to fund and manage our health care costs,” he said at a breakfast fundraiser in Jerusalem, according to the New York Times.

So what exactly does health care look like in Israel?  A handy explainer prepared for the Jewish Healthcare Foundation gives the rundown.  Here are some key features:

  • Under the country’s 1995 National Health Insurance (NHI) law, Israelis can choose one of four, nonprofit health plans.
  • The health plans must provide a benefit package set in law.
  • Israel pays each plan a capitated rate that primarily takes into account the number of members and their ages.  Some funding is distributed based on how many members have rare but expensive conditions.
  • The NHI system is financed mostly by income taxes, but 40 percent of the funding comes from out-of-pocket payments, such as co-pays or supplemental insurance purchases.
  • The Ministry of Health operates about half of the country’s hospital beds.

Romney’s comments rocketed around the blogosphere as numerous articles pointed out that the Israeli system is highly centralized — and similar in some ways to the federal health law that Romney has vowed to repeal.  For example, Israel’s requirement that everyone have insurance is much like the individual mandate.  Plus, as Sarah Kliff explained on the Washington Post’s Wonkblog, researchers have attributed Israel’s ability to hold down costs without skimping on quality to the “strong government influence” over the system.

A Romney spokesman told the Boston Globe that his comments were not intended to praise the entire Israeli system but simply to comment on the need to lower costs in the U.S.