| From Israel's re-creation, in 1948, until 1970, massive immigration, lack of medical examinations prior to entry, temporary dwellings for immigrants, social and financial instability, high consanguinity rates, and the presence or threat of war contributed to a milieu of diseases. Tuberculosis, dysenteries, malaria, schistosomiasis, hookworm, and other parasitic diseases and zoonoses were common. The present health system has evolved to deal with these problems. It is guided and directed by the Ministry of Health, and comprises 15 districts, each supervised by an officer who oversees and coordinates all public health activities in his area. A health insurance fund, the Kupot Holim established by the Federation of Labour, operates ambulatory services for 2 million persons, and smaller schemes provide for the rest of the population. Although the ambulatory care is widely criticized, it is also widely used: the average Kupot Holim member sees the doctor nine times and obtains 18 prescriptions annually. Curative care on a fee-for-service basis is provided by the highest physician-to-population ratio in the world (1:422). The 7.9% of the national income spent on health covers free clinics and treatment for tuberculosis, free child delivery and immunization programmes, a cash benefit for each child, and 12 weeks paid maternity leave. An excellent reporting system exists whereby each citizen has an identity number; this enables the ministry's Division of Epidemiology to maintain a central file for regular analysis of health service utilization rates. National registers for tuberculosis, mental illness, and cancer, and records of work absenteeism provide additional information sources. |