Table of Contents

1.0 Introduction...........................................................................................................................................1

2.0 Israeli vs. Danish healthcare..................................................................................................................2

2.1 Leadership, administration, provision of services, and healthcare system.........................................2

2.3 Population characteristics, health risks, and clinical outcomes..........................................................5

3.0 Israel's health policymakers favor efficiency and equality.....................................................................6

4.0 Discussion.............................................................................................................................................6

5.0 Conclusion.............................................................................................................................................7

6.0 References.............................................................................................................................................8
1.0 Introduction
While both Denmark and Israel possess highly esteemed and effective healthcare systems, there
seem to be substantial differences between the two countries in terms of how primary healthcare
is funded and organized. Israel has far lower healthcare costs than Denmark while having worse
population health results. On the other hand, Denmark spends significantly more on healthcare.
As a result of this, Danish politicians have taken an interest in the community care groups that
operate in Israel. As a consequence of this, it is intended to give a more in-depth look into the
disparities between the health systems and costs of the two nations, in addition to variances in
the healthcare consequences.

2.0 Israeli vs. Danish healthcare

The trade union representing general practitioners and the national organization representing
Denmark's five regions meet once every few years to negotiate the compensation of general
practitioners in Denmark. These discussions take place at the national level. Educational trips are
conducted jointly by delegates consisting of members from both of these associations; the tour
for the year 2020 went to Israel, which was chosen because it has a healthcare system that has
the ability to inspire others (Rotenberg et al., 2022). Both before and immediately following this
excursion, elected representatives, researchers, and policy experts from both nations decided to
visit the regions of the world of the other, and there's an ongoing controversy among some of the
Danish leaders and medical practitioners on what they could learn from the ostensibly less
expensive and more effective public health system in Israel. This discussion inspired us to
present a more in-depth explanation, and as a consequence, we are making available the option
of a more adequately informed assessment of the variations in the total expenditures and
outcomes of healthcare (Pedersen et al., 2019).
Both Denmark and Israel are recognized for having high-quality national healthcare systems that
are highly integrated, are well-funded by taxes, and cover the whole of the population. These
systems also include robust general healthcare sections and comprehensive digital health records
(OECD, 2012, OECD, 2013). Nevertheless, there are significant disparities in both the
performance and the structure of the two medical systems, with Israel's system seeming to
provide greater results while also spending less overall money. Despite the fact that both systems
have garnered attention on a global scale, Israel is particularly notable for its excellent health
results despite its relatively low spending (Miller and Lu, 2018).
2.1 Leadership, administration, provision of services, and healthcare system
Denmark has a higher doctor-to-population ratio than Israel, although the headcount for certain
professions may not have been exactly applicable, since Israeli physicians typically split their
time between hospitals and society-dependent treatment, a session that is uncommon in
Denmark. This is especially true for experts in society-dependentsecondary care, where the
number of Israeli medical specialist is three times that of their Danish counterparts. Due to the
fact that some of them professionals work part-time in society-dependent secondary healthcare,
Israel's specialist capacity is not three times that of Denmark. In the core regions of both nations,
people have greater access to health services, and it is easier to fill healthcare posts. Owing to
Israel's smaller volume and continuous landmass compared to Denmark's bridge-linked
archipelago, travel lengths for medical treatment is typically lower in Israel, although both
nations have a great infrastructure with fast transit times for healthcare professionals (Agency,
2011).
In Denmark, almost all the legal occupants are provided with a registered General Practitioner
(GP) who is responsible for their accessibility, health problem monitoring, incoming letters, and
diagnostic testing. For Israeli GPs, the situation is same, while with tougher rules about the GP's
responsibility for follow-up communique and diagnostic testing, as well as automatic reminders
for quality indicators incorporated into the computerized filing system. In Denmark, general
practitioners provide basic pediatric, obstetrical, and gynecological care, whereas in Israel, it is
often handled by society-dependent experts in these specialties. Patients in Israel often get
primary care from general practitioners or, for infants, pediatricians. Referring to general
practitioners, we include Israeli pediatricians providing primary care. Depending on the HMO,
Israeli patients may access obstetric and gynecological care, ENT (ear, nose, and throat),
reconstructive surgery, and treatment of skin evaluation without a recommendation. However,
other specialties often need a referral.
Figure 1: A comparison of the organizational frameworks of the 4 Israeli medical insurance
companies and the regions from Denmark (Rotenberg et al., 2022).

Both Danish and Israeli general practitioners provide remote consultations through video, text
message, or telephone, with the option to send images as a complement. In both nations, all
laboratory and imaging findings and discharge letters are accessible immediately to the patient's
primary care physician. Both nations have adopted national guidelines for digital hospital-to-
hospital and hospital-to-health care provider communication. In Denmark, all primary care
physicians and society-dependent secondary care medical professionalists may choose any
digital file system that is suitable. In Israel, general practitioners use the HMO's computerized
system, which is also consistent with the national standard (Rosen, 2011).
In Israel, HMOs negotiate payment terms with individual physicians, several of those result in a
number of options spanning from pay, which is the most common, to a number of administrative,
consulting, and compulsory insurance fees. Proportional capitation, which demands a minimum
of one visit per quarter and therefore does not pay for excess visits, is the most common among
GPs. If the patient sees many doctors throughout the quarterly, the public insurance fee is split.
Both primary care doctors and secondary care physicians may negotiate work schedules and
locations with one or more HMOs and other employers.
Israelis pay for additional health treatments via personal medical insurance in addition to self-
pay options copayments. In Denmark, the majority of medical treatments are free at the moment
of delivery, but co-payments are often required pertaining to services that are not medical.
Insurances offered by private companies in Denmark cannot purchase or accelerate treatments in
the public system since they are designed for the considerably a more limited scope of private
medical treatment industry in Denmark. The use of private health insurance by patients is
incorporated into the public system in Israel, which has a sizable private healthcare industry
(Politzer et al., 2019).
Figure 2: Service delivery and medical personnel (Rotenberg et al., 2022).

In Denmark, general practitioners are compensated use a combination of an unqualified and

conditional probabilities capitation fee and consultation and procedure fees, which account for
the remainder of their revenue. Society-dependent specialists in secondary care in Denmark get
just consultation and procedure fees, but all physicians in public hospitals are paid workers,
independent of their specialized position. Conditions and compensation are renegotiating once in
a couple years, resulting in contracts with minimal flexibility for customization on a national
scale. Society-dependent secondary care experts in Denmark are often prohibited from working
in hospitals. Professionals in general practitioners who are capable to get a commercial fee
license may see patients in a range of settings that are funded by national insurance coverage, but
they must cease operating within the hospital's management framework within two years. Just
under 10 percent have indeed been granted approval to keep working extra, despite the fact that
they may submit a request for this privilege. In Denmark, general practitioners seldom perform
therapeutic clinical work. In Denmark, hospital-based and society-dependent doctors seldom
work part-time.
2.2 Financing
Adjustments, such as whether or not to account for long-term care and whether or not to
compensate for age, are absolutely necessary for accurate comparisons. This is owing to the fact
that Israel has a younger population, as well as the fact that Israel's healthcare expenditures
contain just a tiny a portion of the costs associated with long-term healthcare expenditures that
are included in Denmark's healthcare expenditures. In addition, since the GDP in Denmark is 37
percent higher per person than the GDP in Israel, the disparity in the amount spent on medical
care relative to each country's GDP is reduced even more. In point of fact, the correlations of
healthcare spending ranging between 92 percent increased costs and expenses in Denmark to 9
percent spending that is far less than that of Israel. This variation is attributable to the acceptance
or rejection of lengthy care services, either the percentage is age-adjusted, and whether it is
conveyed as PPP or as a percentage of GDP. In addition, our comparisons also depend on
whether long-term care is included or excluded (Grigorakis et al., 2021).
Figure 3: Dangers to one's health and possible results (Rotenberg et al., 2022).

2.3 Population characteristics, health risks, and clinical outcomes

The Israeli and Danish ways of life are quite different, especially in a number of areas that have
substantial effects on health. We picked some important figures relating to food that reveal
significant disparities, particularly with respect to the use of alcoholic beverages, but also with
relation to the consumption of sugar and vegetables. While both nations had a comparable
proportion of persons who were overweight and obese, Denmark had a higher prevalence of
those who were obese on their own. Both nations have almost the same amount of smokers per
capita. Although their life expectancies may seem to be comparable, Israel ranks high in the
OECD for average lifespan in women and men aged 65 years old and above, placing 11th and
12th respectively, whereas Denmark ranks low, placing 35th and 30th respectively, out of 38
countries. While the statistics for cardiovascular mortality are more comparable between the two
countries, the incidence of cancer, there is a significant improvement in both the cancer chance
of survival and the cancer death rate. in Israel than they are in Denmark. On the other hand, the
statistics for cancer mortality are significantly lower in Israel than they are in Denmark. In
Denmark, the number of potentially lost years of life is substantially greater. Israel has a lower
newborn mortality rate than most other countries, although the death rate for older children is
considerably greater (Bray et al., 2018).
When compared to Denmark, the population of Israel is more diversified in terms of both culture
and ethnicity, and there is also a wider range of economic levels. The GINI index has become the
standard method for analyzing the differences in income. A technique that scores ethnic
fractionalization and cultural variety in a manner comparable to this was also discovered. With
86 percent of the population being Danish, Denmark is considered to be a predominantly
monocultural state. Nine percent of the population is made up of immigrants from non-western
countries or their descendants (mostly from North Africa, Middle East, and Central Asia), and
five percent is made up of immigrants from western nations or their offspring.
Israel's population statistics are notoriously difficult to decipher. Mizrahi Jews, who are
descended from refugees and immigrants from the Middle East, make up a small majority of the
population, while Ashkenazi Jews, who are descended as a result of displaced people and
immigration from European countries, make up the second most numerous category of people. It
is safe to say that approximately three quarters of the population is Jewish. It is reasonable to
conclude that about three quarters of the population is comprised of Jewish people, despite the
fact that the categorization of the population may be contentious. In addition, there are a great
number of unique subgroups, such as Ethiopian Jews, Yemenite Jews, and Georgian Jews. The
significant majority of Israel's Jewish population was born in the country, and as families
continue to reside there for many generations and begin to intermarry, the cultural distinctions
between the different Jewish subgroups are beginning to fade away. A person's religious
affiliation is now the most obvious way to differentiate people. The ultra-orthodox Jewish
community is renowned for its major divergence from mainstream Jewish culture. This group,
which consists of Jews of a wide variety of nationalities, is known for its membership.
There are significant cultural and economic distinctions, as well as variances in the overarching
attitude to wellness and the medical care delivery system. The population that is not Jewish is
mostly Arab and is likewise divided along the basis of religion and ethnicity. There is also a
significant cultural divide between the countryside and the city populations of the country. Arab
Christians, Druze, and Bedouins make up the majority of this population, while Arab Muslims
may be broken down into urban, rural, and Bedouin subgroups. Working inhabitants come from
every corner of the globe, and there are also tiny communities of people who adhere to a wide
range of other religious and ethnic traditions, such as the Armenian Christians and the Black
Hebrew Israelites (Stobbe et al., 2021).
Citizens who are required to undertake national service in either country have the option of
serving in the public healthcare system rather than the military services, and the public
healthcare systems in both countries are supported financially by contributions. Despite the fact
that both of these forms of contributions are increasingly widespread in Israel, the overall
amounts are quite low when compared to the entire expenditure for healthcare.

3.0 Israel's health policymakers favor efficiency and equality

Regarding health care systems across the industrialized world, there is rising need for the
formulation of guidelines and instructions for those who set policies, so that their judgments are
open and unambiguous with respect to the criteria employed, and are in keeping with societal
norms of efficiency and equality. Israel is not an exception. The process of adopting new
technology in Israel is well-structured, but decision-making itself lacks standards and
suggestions. Because of this, the nature of the choices has varied significantly during the course
of time, including both perspectives of the particular perspectives held by participants of the
Basket Committee during the course of a given year and the opinions of other committees
towards certain technologies across history. The whole of Israeli medical care system is marked
by such contradictions and opaqueness (Shmueli et al., 2017).
4.0 Discussion
In comparison to Danes, Israelis have much improved access to society-dependent secondary
medical care services. General practitioners in Denmark are all experts, giving them access to a
wider range of therapeutic options. In spite of the fact that these two aspects may to some degree
cancel each other out in terms of determining which nation's healthcare system is superior, they
are both laudable and ought to serve as a source of inspiration for the healthcare leadership in
both countries. The management styles, working environments, and quality control standards that
vary from one company to another each have their own unique set of advantages and
disadvantages (Hayek et al., 2020).
Danish healthcare organizers could be interested in Israel because of the rapid speed of change in
the regulatory procedures that are in place there. Israeli general practitioners and patients would
find the almost universality of self-employment in Denmark, as well as the associated
responsibility, liability, and continuity that comes with it, relating their patients, to be fascinating
(Villanueva et al., 2013).
Patients in Israel have additional options available to them within the public healthcare system,
especially if they want to pay a copayment and/or make use of supplemental or private health
insurance. In Denmark, practically all general practitioner (GP) consultations are carried out by
family medicine experts, with the exception of those carried out by younger physicians in
training; nevertheless, Denmark does not have a quality indicator program like to that of Israel.
Regardless of the reality that the primary care physician training course in Israel is smaller than
in other nations, slightly greater than 50% of Israeli primary care doctors are professionals, and
less than one-third of these professionals are family medicine experts. The most notable
difference, even so, would be that the 4 Israeli HMOs are capable of competing for customers by
supplying healthcare in a fashion that is distinguishable from each other, while the Danish Areas
are motivated to supply healthcare in a fashion that is significant compared, and Danish patients
are frequently handled in the region in which they reside.
Despite a lower population density that is spread out throughout an archipelago that is connected
by bridges and ferries, the Danish system, which is based on geographical divisions, is designed
to provide a a very high degree of attention to detail and organization that is standardized at the
national level. Because the Israeli population is more densely packed within a contiguous
landmass, the country does not have to geographically split its healthcare system to the same
amount as other countries do in order to provide a higher quality of managed care and
organizational standards. The center regions of both nations have an easier time recruiting
enough medical professionals, allowing them to provide the requisite level of care in a more
effective manner (Egede, 2006). This phrase refers to the lowlands along the coast of Israel that
extends between Haifa and Tel Aviv as well as the territory around Jerusalem, which is home to
the majority of the country's population. The population centers that make up Denmark are
spread out further, which results in longer travel times between them. These institutions are now
financially sustainable and capable to retain their level of competence as a result of the spread of
healthcare establishments throughout Denmark and the supply of adequate patient volume. This
has resulted in tighter regulation of general practitioner locations and patient alternatives
(Pedersen et al., 2012).

5.0 Conclusion
Is the Israeli healthcare system more efficiently run, and is it possible that this results in lower
costs than the Danish healthcare system? Although Israel spends a lesser percentage of its GDP
on healthcare than Denmark does, Denmark rates higher in other categories, such as having
fewer economic obstacles to accessing secondary and tertiary levels of medical treatment. When
age and the need for long-term care are taken into account, the differences in expenditures are
rather minimal. The organizational distinctions across the Israeli and Danish health services are
intriguing, but the impact of cultural influences on healthcare expenditures and results should not
be minimized. In particular, the Danish propensity for drinking more than three times as much
alcohol as Israelis does should not be overlooked. After making adjustments for age and
excluding the cost of long-term care, our most educated guess is that this may explain the
majority of the remaining 25 percent lower cost in health care, as well as the majority of the
differences in health outcomes that were observed. An increasing alcohol intake is known to
raise the prevalence and intensity of most illnesses, as well as diminish the therapeutic effects
and prolong therapy. All of these issues may lead to rising healthcare costs and worse health
outcomes. In addition, there is evidence that suggests that heavy drinking may also reduce the
therapeutic response. While we believe that the Danish policy makers should focus on reducing
the amount of alcohol that Danes consume as a result of our paper, we also believe that further
research should study the ways in which the two nations may benefit from the experiences of the
other. organizational structures. This is because we find that both countries have many
interesting and unique characteristics.

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