This article addresses a policy paradox that characterizes many health care systems and the Israeli system in particular, that is, the existence of two parallel yet seemingly contradictory policy trends: reducing public financing for health care services while increasing governmental involvement in health-system management. The authors characterize this process as privatization through centralization; that is, to control welfare-state expenses and be able to reduce them, the government must first control the funding and management of welfare-state mechanisms and organizations. They develop a theoretical rationale for explaining this policy paradox and demonstrate it through analyzing the legislative changes that followed the legislation of the National Health Insurance Law in Israel.
ArianA. (1998). The second republic: Politics in Israel. Chatham, NJ: Chatham House.
2.
AtkinsonS. (2002). Political cultures, health systems and health policy. Social Science & Medicine, 55, 113-124.
3.
AvimelechM.TamirY. (2002). Economic and politics of welfare in Israel. Tel Aviv, Israel: Hakibbutz Hameuchad Press (Hebrew).
4.
BareliA.GutweinD.FrilingT. (Eds.). (2005). Society and economy in Israel: Historical and contemporary perspectives. Beer Sheva, Israel: Ben-Gurion Research Institute (Hebrew).
5.
BeissingerM. R. (2002). Nationalist mobilization and the collapse of the Soviet State. New York, NY: Cambridge University Press.
6.
Ben-BassatA. (2001). From government involvement to market economy: The Israeli economy 1985-1998. Tel Aviv, Israel: Am Oved (Hebrew).
7.
Bin NunG.KaidarN. (2007a). 13 Years of the National Health Insurance Act, Statistical data for the period 1995-2007. Jerusalem: Israel Ministry of Health (Hebrew).
8.
Bin NunG.KaidarN. (2007b). International comparison of health care systems: Israel and OECD member states 1970-2005. Jerusalem: Israel Ministry of Health (Hebrew).
9.
ChernichovskyD.ChinitzD. (1995). The political economy of health system reform in Israel. Health Economics, 4, 127-141.
10.
ChernichovskyD.ElkanaY.AnsonJ.ShemeshA. (2005). Equality and the Israeli health care system: Relative poverty as a health risk factor. Jerusalem, Israel: Taub Center for Social Policy Studies (Hebrew).
11.
ChinitzD. (1995). Israel’s health policy breakthrough: The politics of reform and the reform of politics. Journal of Health Politics Policy and Law, 20, 909-932.
12.
CohenN.MizrahiS.YuvalF. (in press). Public attitudes towards the welfare state and public policy: Israel (2008).Israel Affairs.
13.
DoronA. (1999). Welfare policy in Israel during the 1980s and 1990s. In NachmiasD.MenachemG. (Eds.), Public policy (pp. 437-474). Jerusalem: The Israeli Democracy (Hebrew).
14.
FilkD. (2000). The neo-liberal project and the privatization processes of the health system. In MautnerM. (Ed.), Distributive justice in Israel (pp. 375-391). Tel Aviv, Israel: Ramot (Hebrew).
15.
GrinbergL. (1993). The Histadrut above all. Jerusalem, Israel: Nevu (Hebrew).
16.
GrinbergL. (1996). Weak workers, strong workers: Trends in the Israeli political economy 1967-1994. Theory & Criticism, 9, 61-80 (Hebrew).
17.
GrossR.Barmeli-GrinbergS. (2001). Public attitudes on service and functioning in the health system in the years 1995, 1997, 1999. Jerusalem, Israel: Myers-JDC-Brookdale Institute (Hebrew).
18.
GrossR.RosenB.ChinitzD. (1998). Evaluating the Israeli health care reform: Strategy, challenges and lessons. Health Policy, 45, 99-117.
19.
GruberJ. (2007). Public finance and public policy. New York, NY: Worth.
20.
HackerJ. S. (2002). The divided welfare state: The battle over public and private social. Cambridge, MA: Cambridge University Press.
21.
HackerJ. S. (2004). Privatizing risk without privatizing the welfare state: The hidden politics of social policy retrenchment in the United States. American Political Science Review, 98, 243-260.
22.
HelerA. (2002). Parliamentary report on social gaps in Israel. Jerusalem: Information Center of the Israeli Parliament (Hebrew).
23.
HorevT. (2004). Health policy and legislation: Changing the rules of the game. Jerusalem: Taub Center for Social Policy Studies in Israel (Hebrew).
24.
HorevT.BabadY. M. (2005). Healthcare reform implementation: Stakeholders and their roles-the Israeli experience. Health Policy, 71, 1-21.
25.
HorevT.BabadY. M.ShvartsS. (2003). Evolution of a healthcare reform: The Israeli experience. International Journal of Healthcare Technology and Management, 5, 463-473.
26.
HorowitzD.LissakM. (1989). Trouble in Utopia. Albany, NY: SUNY Press.
27.
KatznelsonI.WeingastB. R. (2005). Intersection between historical and rational choice institutionalism. In KatznelsonI.WeingastB. R. (Eds.), Preferences and situations: Points of contact between historical and rational choice institutionalisms (pp. 1-26). New York, NY: Russell Sage Foundation.
28.
LindblomC. E. (1959). The science of “Muddling Through.”Public Administration Review, 19, 79-88.
29.
MahoneyJ. (2000). Path dependence in historical sociology. Theory and Society, 29, 507-548.
30.
MamanD. (2002). The emergence of business groups: Israel and South Korea compared. Organization Studies, 23, 737-758.
31.
MautnerM. (2000). Distributive justice in Israel. In MautnerM. (Ed.), Distributive justice in Israel (pp. 9-51). Tel Aviv, Israel: Ramot (Hebrew).
32.
MizrahiS.MeydaniA. (2003). Political participation via the judicial system: Exit, voice and quasi-exit in Israeli society. Israel Studies, 8, 118-136.
33.
MizrahiS.Vigoda-GadotE.CohenN. (2009). Trust, participation, and performance in public administration: An empirical examination of health services in Israel. Public Performance and Management Review, 33, 7-33.
34.
NirelN.RosenB. (2004). Trends in physician labor in the era of National Insurance Law. Social Security, 65, 55-83.
35.
NorthD. C. (1990). Institutions, institutional change and economic performance. Cambridge, MA: Cambridge University Press.
36.
PiersonP. (1995). Dismantling the welfare state. Cambridge, MA: Cambridge University Press.
37.
PiersonP. (2004). Politics in time: History, institutions, and political analysis. Princeton, NJ: Princeton University Press.
38.
PiersonP.SkocpolT. (2002). Historical institutionalism in contemporary political science. In KatznelsonI.MilnerH. V. (Eds.), Political science: The state of the discipline (pp. 693-721). London, England: Norton.
39.
SavasE. S. (2005). Privatization in the city: Successes, failures, lessons. Washington, DC: CQ Press.
40.
ShalevM. (2004). The changing role of the state in the Israeli economy. In NaorM. (Ed.), State and community (pp. 20-25). Jerusalem, Israel: Magnes.
41.
ShovalH.AnsonJ. (2000). Social structure and health in Israel. Jerusalem, Israel: Hebrew University (Hebrew).
42.
StandingH. (1999). Frameworks for understanding gender inequalities and health sector reform: An analysis and review of policy issues, Gender and Health Equity Project. Boston, MA: Harvard Centre for Population and Development Studies.
43.
StarrP. (1989). The Meaning of privatization. In KamermanS. B.KahnA. J. (Eds.), Privatization and the welfare state (pp. 15-48). Princeton, NJ: Princeton University Press.
44.
SteinmoS. (2001). Institutionalism. In SmelserN. J.BaltesP. B. (Eds.), International encyclopedia of the social and behavioral sciences (pp. 7554-7558). Amsterdam, Netherlands: Elsevier Science.
45.
StreeckW.ThelenK. (2005). Beyond continuity: Institutional change in advanced political economies. Oxford, UK: Oxford University Press.
46.
SwirskiS. (1999). Politics and education in Israel: Comparisons with the United States. New York, NY: Falmer Press.
47.
SwirskiS. (2005). 1967: Political-economic turn in Israel. In BareliA.GutweinD.FrilingT. (Eds.), Society and economy in Israel: Historical and contemporary perspectives (pp. 91-116). Beer-Sheva, Israel: Yad Izhak Ben-Zvi and B. G. U Press. (Hebrew).
48.
VoosR. T. (2001). Institutions. In SmelserN. J.BaltesP. B. (Eds.), International encyclopedia of the social & behavioral sciences (pp. 7561-7566). Amsterdam, Netherlands: Elsevier Science.
49.
WildavskyA. B. (1984). The politics of the budgetary process (4th ed.). Boston, MA: Little, Brown.
50.
World Bank. (1993). World Development Report: Investing in Health. Washington, DC: Oxford University Press for the World Bank.
51.
National Health Insurance Law, 5754-1994, Sefer Huqim 1469, June26, 1994 (Hebrew).
National Health Insurance Law, 5754-1994 (Amendment 5), Sefer Huqim 1607, January7, 1997 (Hebrew).
54.
National Health Insurance Law, 5754-1994 (Amendment 6), Sefer Huqim 1630, July17, 1997 (Hebrew).
55.
National Health Insurance Law, 5754-1994 (Amendment 7), Sefer Huqim 1645, January15, 1998 (Hebrew).
56.
National Health Insurance (Amendment 20) (Transfer of Responsibility for Inpatient Services to Health Funds) Bill, 5763-2002 (Hebrew), presented on October21, 2002.
57.
National Health Insurance Law, 5754-1994 (Amendment 21), Sefer Huqim 1882, December29, 2002 (Hebrew).
58.
National Health Insurance Law, 5754-1994 (Amendment 22), Sefer Huqim 1892, June1, 2003 (Hebrew).
59.
National Health Insurance Law, 5754-1994 (Amendment 26), Sefer Huqim 1920, January18, 2004 (Hebrew).
60.
National Health Insurance Law, 5754-1994 (Amendment 38), Sefer Huqim 2125, August1, 2008 (Hebrew).
61.
Recovery Program for the Israeli Economy2003(Legislative Amendments for the Attainment of Budget Goals and Economic Policy for Fiscal 2003–2004) Bill (Hebrew).
62.
ChernichovskyD., Former Member of the Netanyahu Investigation Committee (November12, 2007. Beer Sheva).
63.
HorevT.Acting Manager, Taub Center for Social Policy Research (September21, 2008. Jerusalem).
64.
GafniM., Member, Lobby for Public Health in the Israeli parliament (May1, 2008. Interviewed by telephone).
65.
GalanteeY., Chairman, Labor, Welfare, and Health Committee in the Israeli parliament (March23, 2008. Tel Aviv).
66.
OronH., Member, Finance Committee, the Israeli parliament (January24, 2008. Tel Aviv).
67.
ShaniM.Former Director General of the Israeli Ministry of Health (April22, 2008. Tel Aviv).
68.
SharpM., Director, Soroka University Medical Center (June5, 2008. Beer Sheva).
69.
ShemerS., Former Director General of the Israeli Ministry of Health (June13, 2008. Tel Aviv).
