Disparities in the Israeli oral healthcare delivery system

At the beginning of 1995 Israel implemented a health reform. A new National Health Insurance Law came into effect, mandating compulsory health insurance for all Israeli citizens. However, while the individual's right to health services is grounded in law, the basket of services provided under this law includes no components that can contribute to oral health of the population. The country's oral health system has always had minimal government involvement and relies largely on private funding. As such, it can serve as an appropriate model for observing the impact of such policy on economically weak population groups, and on the extent of system equity. The research goals were to examine gaps among various populations in service accessibility, knowledge and attitudes, preventive health behaviors, and perceived health within this unique oral healthcare system. The study population consisted of residents of Israel aged 22+ and living in the community--approximately 4.5 million persons. The data were gathered through telephone interviews based on a random sampling of the computerized telephone directory of Israel's domestic telephone company. The response rate was 82%, with 1,067 respondents representing the adult population of Israel. The current study found significant gaps among income groups for knowledge, attitudes, preventive oral-health behaviors and perceived oral-health. The findings can serve as a red flag for over-reliance on private funding in the health system, and may indicate the need for rethinking about the current oral healthcare policy in Israel.