Yesterday the government approved a cut in the Ministry of Health budget. It is not enough that we are in the midst of a pandemic - which in recent days has just proved that we are far from ending - but this epidemic has also flooded all the distortions in the Israeli health system. And yet - trim. Immediately upon taking office, MK Health Minister Yuli Edelstein announced that "more needs to be invested in Israel's health care system, more investment in hospitals, more equipment, and above all - more investment in medical teams." ?

The Israeli health system has entered the Corona crisis in the face of a continuing shortage of manpower (training and standards) and infrastructure (hospital beds per capita, delay in the establishment of new hospitals, imaging, laboratories, computing and more), increased queues and the erosion of the health basket. This shortage has led to increased privatization processes and weakening public confidence in the public health system. This is even more pronounced for public health services that rely on morbidity monitoring and outbreaks and epidemiological investigations. The Corona crisis has redefined erosion of public health infrastructure - shortages of laboratories, public health infrastructure, respirators, ICU beds and manpower - and has highlighted the magnitude of health disparities. 

Social-economic status is a factor of health inequality. Various studies in Israel have shown that the chances of mortality increase as the neighborhood becomes poorer and that living in the periphery adversely affects health. Infant mortality, for example, is significantly higher in the south and north than in the center. National affiliation also has a significant impact on the state of health: life expectancy of Arab men and women is lower than that of Jews, infant mortality is twice as high, and morbidity from chronic illnesses such as diabetes and hypertension. 

To improve the system, to tackle inequality and to improve the quality of health care, courageous measures are needed: reversing the health care system's tendency to privatize, as there is a direct link between privatization and access inequality. To that end, public funding should be raised from the national health investment at least to the OECD average (about 75 percent). To achieve this goal, public spending must be increased (by returning the corresponding tax, raising the percentage of health tax and raising the funding from the total budget). In addition, the main components of supplementary insurance should be incorporated into state insurance, and the public and private system must be clearly separated across all levels. 

Other important measures are also needed to strengthen public health services: the enactment of a modern public health law (contrary to the old-fashioned mandatory public health ordinance); Substantial improvement of infrastructure and labor supply in the periphery, with an emphasis on Arab localities, and as is common in many European countries, the inclusion of state health insurance law for migrant workers and asylum seekers. The continued starvation of the health system, and in particular public health services, is no longer possible, not only because there may be a second wave of the Corona epidemic, but it is now clear how important health is to the economy and security of citizens.

Dr. Nihaya Daud and Prof. Nadav Davidovich are public health experts and members of the Corona Crisis Expert Teams