Expanding Canadian Medicare to include a national pharmaceutical benefit while controlling expenditures: possible lessons from Israel

Rosen, Bruce

doi:10.1017/s174413311700041x

Cited by 15 publications

(8 citation statements)

References 25 publications

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“…In contrast, most US and Canadian citizens 20 are not enrolled in large-scale integrated delivery systems that have clear responsibility for their health and health care [ 28 , 34 ], that can quickly organize and staff sites for large-scale vaccination efforts, and which can promptly address the logistical challenges involved in bringing together – in terms of time and place - the right mix of staff, patients, and vaccines.…”

Section: Selected Factors Contributing To Israel’s Successmentioning

confidence: 99%

“…However, it is likely that Israel’s ability to lock-in an early and adequate supply of vaccines was due to the combination of: Political leadership, including the active personal involvement of the prime minister, A willingness to pay premium (i.e. higher) prices [ 46 ], A highly professional purchasing division within the Ministry of Health [ 28 ], and An understanding on the part of the pharmaceutical companies that Israel has an unusually strong capacity to showcase the feasibility, and assess the impact of, a rapid rollout. …”

Section: Selected Factors Contributing To Israel’s Successmentioning

confidence: 99%

“… 18 This is true for efforts to improve ongoing care, such as nation-wide, collaborative systems for monitoring and improving quality [ 27 , 28 ]. It is also true for efforts to address new challenges, such as the rise in obesity [ 29 ] and efforts to arrange health insurance for undocumented migrants [ 30 ].…”

mentioning

confidence: 99%

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Israel’s rapid rollout of vaccinations for COVID-19

Rosen

Waitzberg

Israeli

2021

Isr J Health Policy Res

Self Cite

232

224

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As of the end of 2020, the State of Israel, with a population of 9.3 million, had administered more COVID-19 vaccine doses than all countries aside from China, the US, and the UK. Moreover, Israel had administered almost 11.0 doses per 100 population, while the next highest rates were 3.5 (in Bahrain) and 1.4 (in the United Kingdom). All other countries had administered less than 1 dose per 100 population.While Israel’s rollout of COVID-19 vaccinations was not problem-free, its initial phase had clearly been rapid and effective. A large number of factors contributed to this early success, and they can be divided into three major groups.The first group of factors consists of long-standing characteristics of Israel which are extrinsic to health care. They include: Israel’s small size (in terms of both area and population), a relatively young population, relatively warm weather in December 2020, a centralized national system of government, and well-developed infrastructure for implementing prompt responses to large-scale national emergencies.The second group of factors are also long-standing, but they are health-system specific. They include: the organizational, IT and logistical capacities of Israel’s community-based health care providers, the availability of a cadre of well-trained, salaried, community-based nurses who are directly employed by those providers, a tradition of effective cooperation between government, health plans, hospitals, and emergency care providers – particularly during national emergencies; and support tools and decisionmaking frameworks to support vaccination campaigns.The third group consists of factors that are more recent and are specific to the COVID-19 vaccination effort. They include: the mobilization of special government funding for vaccine purchase and distribution, timely contracting for a large amount of vaccines relative to Israel’s population, the use of simple, clear and easily implementable criteria for determining who had priority for receiving vaccines in the early phases of the distribution process, a creative technical response that addressed the demanding cold storage requirements of the Pfizer-BioNTech COVID-19 vaccine, and well-tailored outreach efforts to encourage Israelis to sign up for vaccinations and then show up to get vaccinated.While many of these facilitating factors are not unique to Israel, part of what made the Israeli rollout successful was its combination of facilitating factors (as opposed to each factor being unique separately) and the synergies it created among them. Moreover, some high-income countries (including the US, the UK, and Canada) are lacking several of these facilitating factors, apparently contributing to the slower pace of the rollout in those countries.

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Section: Selected Factors Contributing To Israel’s Successmentioning

confidence: 99%

Section: Selected Factors Contributing To Israel’s Successmentioning

confidence: 99%

See 1 more Smart Citation

Israel’s rapid rollout of vaccinations for COVID-19

Rosen

Waitzberg

Israeli

2021

Isr J Health Policy Res

Self Cite

232

224

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“…Canada is still struggling to introduce a universal pharmaceutical scheme (Gagnon, 2010; Boothe, 2012; O’Brady et al ., 2015; Morgan and Boothe, 2016; Morgan et al ., 2016) and could well draw on lessons from Australia about a scheme which provides universal coverage, at a reasonable cost, albeit with structured co-payments. The main lessons for Canada in the design of a new Pharmacare scheme are:The scheme should involve rigorous assessment of what is included in a national formulary, including assessing cost-effectiveness of listed drugs.Monoposonistic purchasing helps to depress prices.Strategies to ensure rational prescribing and avoid over-prescribing (described as ‘quality use of medicines’ in Australia) should be introduced (Smith and McGettigan, 2000; Weekes et al ., 2005; Beilby et al ., 2006); see also Rosen (2018) on similar strategies in Israel.…”

Section: The Pbsmentioning

confidence: 93%

“…• Strategies to ensure rational prescribing and avoid over-prescribing (described as 'quality use of medicines' in Australia) should be introduced (Smith and McGettigan, 2000;Weekes et al, 2005;Beilby et al, 2006); see also Rosen (2018) on similar strategies in Israel.…”

Section: The Pbsmentioning

confidence: 99%

Expanding the breadth of Medicare: learning from Australia

Duckett¹

2018

HEPL

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Comparative Health Systems

Toth

2021

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In this chapter, we shall focus on how financial resources that are destined to the payment of healthcare costs are collected and utilized. To this purpose, we shall present seven different models based on how healthcare services can be financed. For each model discussed in the following sections, it is essential to pay attention to the dimensions listed:(1) who pays and who benefits from the system;(2) the number and legal status of the insurers;(3) the methods by which users contribute financially;(4) the freedom of choice granted to citizens;(5) the relationships between insurers and providers;(6) the level of public intervention (i.e., the role played by the State). .    The "direct market" system (which can also be referred to as the "simple market") differs from other models in that it does not envisage the figure of insurers. The "healthcare triangle" is therefore left with only two vertices: providers and users.In this model, providers and users of healthcare services interact with each other directly, without the intermediation of third parties.Providers set the price of their services without restrictions; users are free to select their provider of preference, and each time they avail themselves of a service, they pay the provider directly, out of their own pocket.

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Expanding Canadian Medicare to include a national pharmaceutical benefit while controlling expenditures: possible lessons from Israel

Cited by 15 publications

References 25 publications

Israel’s rapid rollout of vaccinations for COVID-19

Israel’s rapid rollout of vaccinations for COVID-19

Expanding the breadth of Medicare: learning from Australia

Comparative Health Systems

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