Reform of Child Immunization Service Delivery in Israel

Gary L. Freed, MD, MPH; Kathleen Abu-Saad, MA; Carmi Z. Margolis, MD
JAMA. 1995;273(24):1909-1912. doi:10.1001/jama.1995.03520480029035.
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Overall immunization rates for 2-year-old children in Israel have consistently been higher than 90%,1 a particularly impressive figure given the country's absorption of millions of immigrants from diverse cultural backgrounds. Historically, Israel has maintained strong government control of immunization delivery. However, despite the success of this system, the country is now moving to limit direct government involvement in this area. Conversely, the uncoordinated mix of public and private sector activity in the United States has yielded low 2-year-old immunization rates, prompting the Clinton administration to call for greater government control of immunization delivery.2 Examining the impetus for, and consequences of, changes in the Israeli system as it moves away from strict government control may provide insight into the implications of health care reform efforts in the United States and other countries.

Current System of Immunization Delivery in Israel  In Israel, children's preventive services and curative care are provided


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