Do rich Israelis wait less for medical care?

Waiting time to receive medical care is a disturbing phenomenon in many healthcare systems. Furthermore, waiting times are usually distributed in the population in an inequitable way.

In this paper we focus on one aspect of the possible inequities associated with waiting times for MRIs and elective surgeries – different waiting times by income level.

We used the CBS’s 2009-2010 linked health-income data, which included 7,175 households (24,595 individuals). Actual waiting time for MRI and expected waiting time for surgeries were measured on a 4-categories ordinal scale. Both ordered probit and sample selection ordered probit – to account for possible correlation between the need for these services and the waiting time for them – were used to estimate the income effect on waiting time, controlling for a vast set of personal characteristics.

Rich Israelis are more likely than poor ones to be, controlling for health state, on the waiting list for MRI, but not for surgeries. Income has no effect on the actual waiting time for MRI. Income has no effect on the expected waiting time for surgeries in the probit model, but has a significant negative effect in the sample selection model. Ownership of voluntary insurance increases the probability to be on the waiting list for both MRI and surgeries, but has no effect – as does having public finance only of the care – on waiting time. The results also show that sicker persons and those residing in the periphery wait longer for surgery.

We found some evidence that rich persons expect a shorter wait for surgeries, which is not explained by voluntary insurance ownership or by using private finance. We found solid evidence that the expected waiting time for surgeries is longer for sicker persons and those in the periphery. Further research with a larger sample based on actual waiting times might shed more light on the issue of waiting time for medical care and its distribution in Israel.