Israeli Health Insurance Model Focuses on Mental Resilience and Social Gaps
תומצת מתוך Calcalist על ידי baba
Margareta Sarur of Clalit Health Services presented a new health insurance model in Israel focusing on mental resilience, social equality, and preventive care. The model returns 90% of premiums as direct services and addresses underutilization among Arab Israelis through targeted outreach. It also supports a new social group of "coping individuals" needing comprehensive care, aiming to strengthen national resilience.
הידיעה ב-6 שורות · תקציר של baba
- Clalit returns 90 agorot per shekel paid as direct medical services to insured members.
- About 4 million Israelis, 80% of Clalit clients, hold supplementary health insurance (Shaban).
- Arab Israelis underutilize health services despite equal premiums; outreach increased usage by 10%.
- Health system shifts from reactive to preventive care, including combating elderly loneliness.
- New social category of 'coping individuals' requires integrated mental and physical health support.
- Clalit aims to provide accessible, simple, and immediate health services nationwide.
Margareta Sarur, head of health insurance and "Clalit Mushlam" at Clalit Health Services, highlighted at the National Economic Conference how health insurance policies can actively reduce social disparities in Israel. Speaking at the event organized by Calcalist, Bank Leumi, and Clalit, she emphasized that economic resilience depends on mental and physical health, especially during periods of extreme uncertainty. Sarur explained that the new model of supplementary health services (Shaban) differs from traditional insurance by providing daily value to healthy citizens, not just coverage when illness occurs.
Sarur detailed Clalit’s economic model, noting that 90 agorot of every shekel paid by insured members is returned directly as medical services. Approximately 4 million insured individuals, representing 80% of Clalit’s clients, hold Shaban insurance. The system’s goal is to ensure accessible, simple, and prompt medical services nationwide, rather than accumulating funds within the organization.
Addressing social inequality, Sarur pointed to lower utilization of health rights among Arab Israelis despite equal premium payments. To tackle this, Clalit launched the "Mushlam Ambassadors" project, recruiting Arabic-speaking professionals to educate and facilitate access to medical rights. This initiative led to a 10% increase in rights utilization within two years.
Sarur also described a shift from reactive to preventive medicine, including combating loneliness among the elderly through community programs and personalized preventive care using advanced apps, nutrition models, and genetic sequencing to anticipate diseases years in advance.
Finally, Sarur introduced the concept of a new social category in Israel: "the coping individuals," such as reservists returning from combat who require comprehensive support including complementary medicine and psychological aid. She concluded that Israel’s health services must serve not only the sick and healthy but also those coping with trauma, which is essential for national resilience.