Cost containment: the Middle East. Israel.

The Israeli Health Service was established with the intent of providing an equal standard of care to the entire Israeli population. The Health Service has dealt with changes over the years, including the governing of large populations of Judea, Samaria, and Gaza. In 1990, mass immigration brought 500,000 more individuals to Israel, putting an additional burden on medical services. ICUs in Israel began to emerge after the Six Day War in 1967. The government's Ministry of Health has approved a limited amount of ICU beds. Beyond this set amount, hospital directors decide whether to establish additional ICU beds, weighing departmental pressures from within the hospital to create beds against the knowledge that the hospital will not be reimbursed more than the per diem rate of an ordinary hospital bed ($US 265). Hospital directors and administrators, knowing that the average daily cost of an ICU bed is close to $US 800, turn to their supporting organization to finance the uncontrollable deficit, seek aid from the Ministry of Health to make the per diem rates or diagnosis-related group reimbursements more realistic, and/or implement hospital policies aimed at cutting costs and personnel.