Survey: Health care gaps between Jews and Arabs

Posted on Nov 10, 2019

Forwarded by peace activist Adam Keller

Yotam Rosner, Physicians for Human Rights Israel

Dear Friends,

Equality in health is a fundamental civil and human rights principle, enunciated in many international covenants and treaties. Aspiring for equality in health is aspiring for justice, and it means fighting against the exclusion of certain groups from the center of economic, social and political life.

Israel has raised the banner of equality and solidarity, maintaining that everyone deserves proper treatment regardless of religion, place of residence or financial capabilities. Its actions, however, do not match its words. In practice, people living in Israel’s social and geographic periphery have a separate health care system, continually plagued by a shortage of medical care professionals, hospital beds and specialized medicine. This shortage undermines the early diagnosis and treatment of patients.

Primary care is one of the pillars of the health care system. Family physicians are the first and most significant line of care in the community. The family physician is someone with whom the patient is familiar, a care provider who addresses all health indicators and maintains a continuum of care over time.

A survey on family physician satisfaction we conducted with the help of iPanel reveals that the gaps between Jews and Arabs affect primary care as well.

The survey which included 600 respondents across a geographically representative sample shows significant gaps between the Jewish and Arab sectors with respect to multiple parameters: wait times for appointments, wait times at the clinics themselves, clinic accessibility by public transportation and clear differences in the attention, time and patience physicians give patients.

In recent years, the gaps in health care between Jews and Arabs have been the focus of public and academic discourse. Different studies point to differences between Jews and Arabs in average life expectancy, morbidity rates, infant mortality and more. There is evidence on the ground that medical care professionals working in the Arab sector lack sufficient training.

The quality of primary care has a tremendous impact on inequality in health between Arabs and Jews. Inaccessibility deters patients from going to see physicians, an experience that can be unpleasant even in optimal conditions. There is little wonder, therefore, that preventable or curable diseases are much more prevalent in the Arab sector, from smoking-related diseases to diabetes rates.

Without proper investment in primary care, conditions that could have been diagnosed and prevented or treated early, are discovered only at a stage where treatment and rehabilitation are more expensive – with the cost borne by the health care system and taxpayers. The “savings” on preventative medicine are swallowed by the high cost of emergency care, long hospital stays, medication and everything these involve.

This state of affairs is enabled by the capitation system, which mostly hurts disempowered groups that require multiple services, particularly preventative care. Under this system, Israeli health funds have little incentive to improve the quality of the services they provide and prefer not to invest too much in these population groups.

The Ministry of Health and the Ministry of Finance bear a responsibility to find a solution for this situation and ensure a fair and equal distribution of resources within health funds,  while strengthening the geographic and social periphery.

Yotam Rosner
Residents of Israel Department Director