The Politics of Evidence-Based Health Policy-Making

Israel's National Health Insurance Law which came into effect in January 1995 required a substantial reform of the country's health-care system. Health care in Israel was decentralized, lightly regulated, dominated by politicised decisions, under-funded and inefficient. Health policy was poorly grounded in data and largely influenced by political considerations. The main thrusts of the reform were to universalize health insurance coverage, increase freedom of choice, depoliticize the system, stabilize the system financially, and decrease service provision by the state by transferring some responsibilities to 'sick funds' to be regulated by the Ministry of Health. Data were to play an important role in de-politicizing and making decision-making more rational. This article gives some encouragement to proponents of evidence-based policy-making but shows that, even where the intention is to use data, political motives are a strong force.