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"Chernichovsky, Dov"
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Not “Socialized Medicine” — An Israeli View of Health Care Reform
The latest comparable data indicate that Israeli life expectancy at birth is 80.3 years, as compared with 77.8 years in the United States. [...]all Israelis have the peace of mind and the income protection that come with the right to medical care, whereas at any given time, some 15% of U.S. citizens lack health insurance and are therefore deprived of orderly access to care and protection of their incomes from unforeseen medical spending.
Journal Article
Reforms Are Needed To Increase Public Funding And Curb Demand For Private Care In Israel’s Health System
Historically, the Israeli health care system has been considered a high-performance system, providing universal, affordable, high-quality care to all residents. However, a decline in the ratio of physicians to population that reached a modern low in 2006, an approximate ten-percentage-point decline in the share of publicly financed health care between 1995 and 2009, and legislative mandates that favored private insurance have altered Israel's health care system for the worse. Many Israelis now purchase private health insurance to supplement the state-sponsored universal care coverage, and they end up spending more out of pocket even for services covered by the entitlement. Additionally, many publicly paid physicians moonlight at private facilities to earn more money. In this article I recommend that Israel increase public funding for health care and adopt reforms to address the rising demand for privately funded care and the problem of publicly paid physicians who moonlight at private facilities. [PUBLICATION ABSTRACT]
Journal Article
Food Prices Policy in Israel: A Strategic Instrument
The goal of this research is to demonstrate a significant importance of state policy of food prices supervision in Israel. The article begins with a detailed discussion of the healthy food basket's components, based on the Israeli Ministry of Health recommendations. Next, we present the prices of the goods included in the basket, and a calculated estimate of the per capita cost of funding the basket. Based on this cost figure, we assess the economic ability of Israeli households to purchase the basket. The results show that two lowest quintiles would have trouble paying the price of a basic health food basket. Further, it describes the food prices in Israel and its significance, Israel's food market and the major regulatory tools associated with the food market. In the end, we define the need for short-term and longer-term regulation of food costs, and the necessity of expanding competition in the food market.
Journal Article
Impact of desertification and land degradation on Colombian children
ObjectivesDesertification affected more than 24% of Colombia’s land mass in 2012. The study aims to establish the singular impact of desertification on under-five mortality in Colombia.MethodsDescriptive statistics and multivariate logit regressions are applied to the population of live births and under-five deaths in Colombia 2008–2011.ResultsChildren have a higher probability to die in rural communities and among mothers with low education who also have inferior health insurance. Controlling for those, desertification below about 50% of the land, lowers child mortality and increases it after that percentage. The impact of extraction of hydrocarbons is 12.45, metals 5.73 and others 4.91 times higher in municipalities with more than 50% of desertification territory. Rural areas with high desertification have 2.25 times higher risk of mortality due to malnutrition.ConclusionsIn the short term, when mines have less or no effect on desertification, living conditions may improve and reduce child mortality. In the long term, however, as desertification intensifies affecting the ecosystem, child mortality increases. More research is needed, and policy formulated accordingly.
Journal Article
Israeli Views of Health Care Reform
The U.S. health care system has probably unparalleled achievements in medical and management technologies, but it performs quite poorly because of structural deficiencies that other developed countries, including Israel, have managed to address. [...] in spite of comparatively lower funding and probably inferior clinical operations, the Israeli system evidently functions better.
Journal Article
Ajustes a la arquitectura del sistema general de salud de Colombia: una propuesta
El modelo de competencia regulada establecido por la Ley 100 de 1993 para el funcionamiento del sistema de salud en Colombia presenta fallas de mercado y fallas de gobierno. A la luz del modelo conceptual del «Paradigma Emergente», este artículo presenta una propuesta de adaptación de la arquitectura del sistema de salud de Colombia a la arquitectura de sistemas internacionales considerados exitosos, identificando instituciones, roles y competencias. Dado lo anterior, las recomendaciones más importantes son: impulsar el sistema dual de competencia regulada en zonas densamente pobladas y monopolios en zonas sin densidad geográfica y regionalizar el sistema. También se sugiere la adopción de instrumentos de regulación de la oferta como el certificado de necesidad.
There are both market and government failures in the Colombian managed competition model of delivering healthcare established by Law 100 of 1993. Following the “Emerging Paradigm” this paper suggests how to adapt the architecture of the current health sector system to those already in place and considered successful in other countries, including identifying institutions, roles and responsibilities. The most important recommendations are: promote a dual system in which managed competition is allowed in densely populated areas and monopolies in less dense geographic areas, and promote a regionalization of the system. In addition, the paper suggests adopting supply regulatory mechanisms such as a certificate of need.
O modelo de competência regulada estabelecido pela Lei 100 de 1993 para o funcionamento do sistema de saúde na Colômbia apresenta falhas de mercado e falhas de governo. À luz do modelo conceptual do «Paradigma Emergente», este artigo apresenta uma proposta de adaptação da arquitectura do sistema de saúde da Colômbia à arquitectura de sistemas internacionais considerados êxitos, identificando instituições, papéis e competências. Dado o anterior, as recomendações mais importantes são: impulsionar o sistema duplo de competência regulada em zonas densamente povoadas e monopólios em zonas sem densidade geográfica e regionalizar o sistema. Também se sugere a adopção de instrumentos de regulação da oferta como o certificado de necessidade.
Journal Article
Scaling up affordable health insurance
As the world recently turned its attention to the struggle of expanding health insurance coverage for 40 million people in the United States, it is important not to forget the 4 billion people in low- and middle-income countries that face the same hardship. Millions of the poor have already fallen back into poverty as a result of the ongoing global financial crisis. Millions more are at risk before full recovery. It is the poor and most vulnerable that are at greatest risk due to lack of protection against the impoverishing effects of illness. The research for this volume shows that, when properly designed and coupled with public subsidies, health insurance can contribute to the well-being of poor and middle-class households, not just the rich. And it can contribute to development goals such as improved access to health care, better financial protection against the cost of illness, and reduced social exclusion. Opponents vilify health insurance as an evil to be avoided at all cost. To them, health insurance leads to overconsumption of care, escalating costs-especially administrative costs-fraud and abuse, shunting of scarce resources away from the poor, cream skimming, adverse selection, moral hazard, and an inequitable health care system. Today many low-and middle-income countries are no longer listening to this dichotomized debate between vertical and horizontal approaches to health care. Instead, they are experimenting with new and innovative approaches to health care financing. Health insurance is becoming a new paradigm for reaching the Millennium Development Goals (MDGs). They emphasize the need to combine several instruments to achieve three major development objectives in health care financing: 1) sustainable access to needed health care; 2) greater financial protection against the impoverishing cost of illness; and 3) reduction in social exclusion from organized health financing instruments. The use of insurance was recommended to pay for less frequent, higher-cost risks and subsidies to cover affordability for poorer patients to higher-frequency, lower-cost health problems.
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