Epidemiology, health policy, and resource allocation: the Israeli perspective.

Israel represents a developed country as far as demand and consumption of health services are concerned. The analysis of the Israeli health system reveals a significant trend of expansion in the intensity and the utilization of health services as well as an accelerated development of sophisticated technology, while the percentage of Gross National Product used for health expenditure remained constant and even decreased. Competing needs, reflecting population growth, a rapid aging process, new areas of treatment, and changes in use of health services, illustrate the aggravating issue of setting priorities. The permanent dilemma of the health system is oscillation between opposite trends: enlargement of public eligibility and technological capabilities and economic reduction and budget limitations. Is there a possibility that the insufficiencies of the system are built into patterns of thinking of those in the system, into its structure, and into its organization of health services delivery? Does the formulation of health policy influence, in terms of the outcomes of the system, priorities and allocation of resources? Does the process of decisionmaking reflect in an appropriate manner the epidemiologic data? Under the objective constraints, decisionmaking and health policy formulation become critical determinants of the ability to cope more efficiently and effectively with growing and changing needs. The authors suggest an alternative strategy of health decisionmaking that is more instrumental in order to prevent setbacks and to open new horizons for the future.