Health InsuranceAll respondents have been asked if they are covered by Health Insurance.
Government health insurance covers expenses connected to the utilization of government health services (IGHS) (Israel Ministry of Health, 1992). Government health services are not available in all districts in the occupied territories (Barghouti and Daibes, 1990, 1991a, 1991b, 1991c). Refugees are covered through the UNRWA system. Relatively many refugees report having health insurance, and they probably mean government health insurance.
Only 30% of the total population are covered by health insurance, that is, 33% of the men and 27% of the women. Among young people (15-19 years) the rate is 23%. The rate increases gradually up to 44% among those above 60 years of age. Health insurance coverage varies with socioeconomic factors. In the lower third wealth group only 25% are insured, versus 37% in the upper third of the wealth scale. This contrasts with the rates of acute and chronic illness and with the amount of problems created by illnesses in the different wealth groups, as measured in terms of absence from normal duties and difficulties in going out without help from others.
Interestingly, the coverage is at the same level in camps as it is in Gaza and the West Bank outside camps - approximately 27%. In Arab Jerusalem 49% are covered through health insurance.
Results from the FAFO survey (table 4.11) indicate a lower coverage rate than do official figures from Israel (Israel Ministry of Health, 1992). The Ministry of Health reports that 'Gaza has experienced a marked increase in coverage in the IGHS health insurance plan from 22% of the population at the beginning of 1991, to over 50% in early 1992.' There is a discrepancy between these figures and the FAFO figures, although they cannot be compared directly as children are not included in the FAFO study, and the method is not described in the Israeli report. But the low coverage among people aged 15 to 19 may indicate that the coverage would have been lower in the FAFO study also if children had been included. The West Bank Rural Primary Care Survey (Barghouti and Daibes, 1990, 1991a, 1991b, 1991c) reports dramatically low rates of health insurance, but it has data from rural areas only, and at an aggregate level, which makes comparison difficult.
Table 4.11 Health insurance coverage rates. Per cent (respondents).