[The national health status]

During the Golden Age of Medicine (20th Century), scientific and technological breakthroughs enabled physicians to treat diseases that were previously incurable. The idealist, romantic approach of medical practice believed in the right of every human being to receive the best treatment possible, regardless of cost. However, the rise in health care expenditure at the end of the last century made this approach impossible to follow. The growing health expenses are due to the increased percentage of chronically sick patients and elderly population, costs of novel technologies and public expectations. Israel spends 7.9% of its GDP on health, a figure which has not changed in the last fifteen years, while other western countries spend a considerably higher and increasing percentage of their GDP on health. Public resources must be allocated in order to maintain the health of the population and to decrease inequities. A data-based demonstration of the population health status and health care system is therefore mandated. in this issue of the Harefuah, three articles are presented which try to show different aspects of the measurement of Israeli heath status. The data accumulated is used to improve the health status of the Israeli people. The Israel Medical Association (IMA) has assumed responsibility for the creation of an objective index for the measurement and evaluation of the public state of health and the healthcare system. The goal of the IMA National Health Index is to promote discussions regarding medicine and health in Israel, and to serve as a tool to be used by relevant policy makers. Prof. Israeli et al discuss the merits of the National Health Index as well as delineate the difficulties regarding the methodology and choice of parameters. They suggest methods for its improvement. Dr Cohen and his colleagues of Clalit Health Services present the Quality Health indicator program in the community. In effect over the past fifteen years, this program is based on seventy evidence-based quality indicators and has brought real progress in several domains reflecting both teamwork as well as improvement of clinical quality. The question of inequity is a major problem in the Israeli health care system. According to one indicator, private out-of-pocket financing has reached 44% of the health care budget, more than other European countries. Maccabi Healthcare Services has implemented a multi-annual strategy to promote equity which is presented in this issue of Harefuah by Dr Wilf-Miron. Common to all these important papers is their emphasis on the measurement of health care indicators as a method for promoting better and more equally provided healthcare services to the Israeli population.