Israelis cover about a quarter of their healthcare expenses out-of-pocket, more than four times the rate in The Netherlands and France, according to figures released on Thursday by the Organization for Economic Cooperation and Development.
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The 25% includes direct out-of-pocket expenses, above and beyond what is paid in health insurance fees or in premiums on commercial medical insurance policies, the organization said, using 2011 figures.
The countries where out-of-pocket medical costs were the lowest were The Netherlands at 6%, France at 7.5% and Britain at 9.9%. Americans pay 11.6% and the OECD average was 19.6%. Israelis paid a larger portion of their healthcare costs than all OECD countries except Hungary, Portugal, Greece, South Korea, Chile and Mexico, the OECD said.
On the other hand, Israeli national healthcare spending per capita rose in 2009-2011, according to the OECD report, Health at a Glance. After discounting for inflation, spending grew 3.4% in each of the three years, accelerating from an average of 1.3% in 2009-2009.
That put Israel in rare company, as most OECD members either reduced or slowed national spending on health care as a result of the global financial crisis and its effects on government finances. Spending fell in 11 of the 33 OECD countries surveyed, with Greece slashing it by 11.1% and Ireland by 6.6%.
Apart from Israel, only Japan saw healthcare spending growth in the past three years, the OECD figures showed. Israel's increased spending was primarily due to collective labor agreements that raised salaries for doctors and nurses. Nevertheless, Israel spends a relatively low percentage of its gross domestic product on health, compared to other OECD countries.
The outbreak of the financial crisis in 2008 and 2009 had the effect of raising suicide rates and alcohol consumption in many member countries, although they have stabilized recently. In Israel, death rates from suicide and auto accidents are lower than the OECD average, as are rates for smoking and alcohol consumption.
Israel’s suicide rate was 7.4 per 100,000 people in 2012, compared to an OECD average of 12.6. Israelis over age 15 consumed an average of 2.4 liters of alcohol in 2007, the second lowest after Muslim Turkey, the figures showed.
The OECD figures showed that Israel has the largest percentage of doctors aged over 50 among member countries, mainly due to the fact that a large number of qualified doctors arrived in the country during the wave of immigration from the former Soviet Union in the 1990s. But that generation is approaching retirement age, while the rate of medical school graduates is low by OECD standards, with just 4.99 graduate for 100,000 people and 14.5 per 1,000 practicing doctors. That compares with rates of 10.6 and 33.7, respectively, on average for OECD countries.