Redesigning a national healthcare system: the Israeli experience.

In 1988 the Government of Israel appointed a Commission of Inquiry (of which the authors were members) to examine the state of its health-care services. Although relating to Israel, some of the problems contributing to the crisis in the health services are shared by other industrialized nations. In 1991 the findings and recommendations of the Commission were adopted by the Government. They related to the major problem areas analysed by the Commission: poor standard of service to the public; health ministry structure and performance; funding and budgeting; poor labour relations in the public health sector; surplus of physicians; mix of public and private health care; shortage of qualified health-care managers. The main recommendations adopted were: legislation for compulsory health insurance (due to be effective on 1 January 1995), establishing a National Health Authority, running of hospitals by autonomous corporations and reform in salary structure.