Physicians and the state in the U.S.A. and Israel

The paper focuses on two patterns of policy-making: a professional pattern in which physicians dominate, and a political pattern in which state authorities take the lead. It looks into the causes of the emergence of each of these patterns and their consequences, in terms of the equity of the health services and their efficiency. The U.S.A. and Israel provide examples for the professional and political patterns of health policy making. The causes for the development of the political pattern in the U.S.A. are grounded in the social salience of medical care, in physicians' economic power, and in the individualistic political culture. The politicization of health services in Israel came about owing to the low placement of health on the social agenda, the proletarianization of physicians, and the hierarchical administrative culture. Analysis of the results indicates that Israel portrays more equity in health services. However, in terms of efficiency results are mixed. In both countries, changes are taking place in opposite directions: more politicization in the U.S.A.; less in Israel.