A competitive national health insurance system was introduced in Israel in 1995. Consumer mobility has been traditionally a signal of market (managed) competition. However, since 1998, sickness funds' switching rate has been stable at around 1% of the population. The low switching rate is explained by limited real options and similarity in the sickness funds functioning, and reluctance to change providers. The paper aims to characterize the 1% of the population who switches sickness fund in relation to the stayers, and to examine the implications for public policy. The National Insurance Institute Health Registry was used to conduct two analyses: (i) bivariate comparisons on selected socio-demographic characteristics of the switchers to those of the stayers in the years 1999-2000, and (ii) a multivariate logistic analysis of the propensity to switch for the entire adult (21+) population in the years 2005-2006. The main result is that switching is an inferior good. Both the bivariate and the multivariate analysis show that persons with lower labor-income, receiving income support or unemployment benefits are more likely to switch. Switchers have more children up to age 18. Arabs and Orthodox Jews are more likely to switch sickness funds. The 1% of switchers does not form a random draw from the age-sex-adjusted population. The over-representation of poor persons among switchers is unique to the Israeli scene, which might have resulted from demand-side initiatives, but also from implicit risk-selection strategies exercised by the sickness funds under the Israeli incomplete age-based risk-adjustment system.

Delayed retirement is a policy measure aimed at ensuring financial stability in many countries, but this particular pension reform mechanism still lacks public support. Using data from the Israeli sample of the Survey of Health, Ageing and Retirement (SHARE) in Europe, this article examines factors which predict support for delayed retirement among older Israeli workers (n=556). Hierarchical regression analysis of agreement with recently instituted delayed retirement measures showed that the perceived societal consequences of the reform were the strongest predictors. Older and more educated respondents and those more confident in their present workplace were also more likely to support delayed retirement. Those who favour state responsibility for care of older people tended to support delayed retirement less. The findings suggest that information campaigns on the contribution of continued employment to health and family solidarity might diminish current fears regarding the delayed retirement-based pension reforms. They also imply that non-partisan leadership is needed in order to recruit broader public support for such reform.

The study examines the labor-force behavior of Israelis at older ages, focusing on the determinants of the transitions between states of labor-force participation between 2005 and 2010. The study uses panel data from the first two waves of the SHARE-Israel longitudinal survey. A multinomial logit model is used to examine the impact of sociodemographic characteristics, health state, and economic resources on labor-force transitions of people aged 50-67. The results emphasize the role of age and poor health in ''pushing'' older people out of the labor force or ''keeping'' them there. Spouse's participation is found to encourage individuals to leave the labor force or to refrain from joining it. However, living with a participating spouse is negatively associated with staying out of the labor force, consistent with the dominance of the complementarity of leisure effect found in the literature. Wealth as an economic resource available to individuals for retirement is also found to encourage individuals to leave the labor force or to refrain from joining it.

BackgroundThe mixture of public vs. private financing of the healthcare system has important fiscal and economic welfare implications. The consequences of this mixture for access to health services and for equity have become highly debated policy issues. In the first decade of 2000s, Israel experienced a continuous upward trend in the proportion of private financing, reaching a peak of 37–38%, which has subsequently leveled off. The 38% level is significantly higher than the 26% average across the Organization for Economic Co-operation and Development (OECD) countries.Main textA recent paper by Tur-Sinai et al. in this journal shows that private spending by Israelis on health care is positively related to the income of individuals and to the socioeconomic status of their place of residence. This commentary draws attention to studies that integrate into one model both demand-side and supply-side determinants of private expenditures on healthcare. It also discusses inequity.ConclusionsOverall, the financing of national health expenditures in Israel is slightly regressive, but the progressivity of public financing is almost enough to offset the regressive effect of out-of-pocket payments and payments for voluntary complementary insurance.