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TheScientificWorldJOURNAL
Volume 6, Pages 81-95
http://dx.doi.org/10.1100/tsw.2006.06
Research Article

The Influence of Israel Health Insurance Law on the Negev Bedouin Population — A Survey Study

1Clalit Health Service, Beer-Sheva, Israel
2Division of Community Health, Beer-Sheva, Israel
3Center for Multidisciplinary Research in Aging, Beer-Sheva, Israel
4National Institute of Child Health and Human Development, Beer-Sheva, Israel
5Center of Health Policy in the Negev, Beer-Sheva, Israel
6Division of Pediatrics, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
7Office of the Medical Director, Division for Mental Retardation, Ministry of Social Affairs, Jerusalem, Israel
8Department of Family Medicine, Brown University, Providence, RI, USA

Received 25 May 2005; Revised 2 November 2005; Accepted 3 November 2005

Academic Editor: Hatim A. Omar

Copyright © 2006 Mohammed Morad et al.

Abstract

The extension of universal health service insurance to national populations is a relatively new phenomenon. Since 1995, the Israeli National Health Insurance Law (NHIL) has provided universal health services to every resident, but the effect of this law on health and health services among minorities has not been examined sufficiently. The goals of this study were to track some of the first changes engendered by the NHIL among the Negev Bedouin Arabs to examine the effects of universal health care services. Methods included analysis of historical and health policy documents, three field appraisals of health care services (1994, 1995, 1999), a region-wide interview survey of Negev Bedouins (1997), and key informant interviews. For the interview survey, a sample of 515 households was chosen from different Bedouin localities representing major sedentarization stages. Results showed that prior to the NHIL, a substantial proportion of the Negev Bedouins were uninsured with limited, locally available health service. Since 1995, health services, particularly primary care clinics and health manpower, have dramatically expanded. The initial expansion appears to have been a marketing ploy, but real improvements have occurred. There was a high level of health service utilization among the Bedouins in the Negev, especially private medical services, hospitals, and night ambulatory medical services. The NHIL brought change to the structure of health services in Israel, namely the institution of a national health system based on proportional allocation of resources (based on size and age) and open competition in the provision of quality health care. The expansion of the pool of potential members engendered by the new universal coverage had profound effects on the Health Funds' attitudes towards Negev Bedouins. In addition, real consumer choice was introduced for the first time. Although all the health care needs of this rapidly growing population have yet to be met fully, the assurances under the Law and the new level of competition promise a higher level of service in the future.