Featured Country: Israel

Israel benefits from a strategic location on the Mediterranean Sea, making it a hub for the transit of various products in the region and in the world. The recent expansion of the Haifa, Ashdod and Eilat ports have enhanced these capabilities.

The Israeli economy is services-oriented, with the sector employing more than 75% of the population and contributing to 65% of GDP. Science and high technology industries are the most developed, representing about 40% of the GDP. Israel invests the most in R&D in the world (4.8% of the GDP) according to the Israeli Central Bureau of Statistics and the Israeli Economic Mission to the U.S. Industry contributes to approximately a quarter of the Israeli GDP. Main industries are diamond cutting, textile and pharmaceutical sector.

The United States and Israel are linked by a Free Trade Agreement (FTA) since 1985, under which all custom duties have been eliminated.

The Israeli government provides many investment incentives in the fields of the tourism industry, employment, international trading company, the building of dwellings for rental, Research and Development (R&D) and training programs to support small businesses. For more information, consult Invest in Israel Website. And if you want to spend time doing business in Israel, take a look at "Doing Business in Israel," a guide produced by a leading Israeli-American communications firm.

For more information, visit the website of the Embassy of Israel in the United States. And the website of the U.S. Commercial Service in Israel has extensive information about the market, with news, business guides and the Commercial Service programs conferences, trade missions and training. If that's not enough, you'll also find plenty of good research at the FITA Mini Portal of Israel a feature of the FITA Web site.

On August 5, 2010 the U.S. Department of State issued the following Travel Warning:

Israel, the West Bank and Gaza

The Department of State warns U.S. citizens of the risks of traveling to Israel, the West Bank, and the Gaza Strip, and about threats to themselves and to U.S. interests in those locations. The Department of State urges U.S. citizens to remain mindful of security factors when planning travel to Israel and the West Bank and to avoid all travel to the Gaza Strip. This replaces the Travel Warning issued June 20, 2010 to update information on the general security environment in Israel, the West Bank, and the Gaza Strip.

The Gaza Strip and Southern Israel

The State Department strongly urges that U.S. citizens refrain from all travel to the Gaza Strip. This recommendation applies to all U.S. citizens, including journalists and aid workers. U.S. citizens should be aware that as a consequence of a longstanding prohibition on travel by U.S. government employees into the Gaza Strip, the ability of consular staff to offer timely assistance to U.S. citizens there is extremely limited.

The Israel Defense Forces (IDF) strictly controls the crossing points between Israel and the Gaza Strip, and has essentially sealed the border. The security environment within Gaza and along its borders, including its border with Egypt and its seacoast, is dangerous and volatile. U.S. citizens are advised against traveling to Gaza by any means, including via sea. Previous attempts to enter Gaza by sea have been stopped by Israeli naval vessels and resulted in the injury, death, arrest, and deportation of U.S. citizens. From December 27, 2008, through January 17, 2009, the IDF conducted a major military operation in Gaza. Israel and Hamas, a State Department-designated foreign terrorist organization that violently seized power in Gaza in June 2007, declared separate truces to end the fighting. Occasional small clashes continue to occur along the border. Rockets and mortars are still occasionally fired into Israel from Gaza, and the IDF continues to conduct military operations inside Gaza, including airstrikes. The IDF has also declared an exclusion zone inside Gaza along the border with Israel and has taken lethal measures against individuals who enter it. In addition, rockets have been fired recently into the Eilat and Aqaba areas. U.S. citizens in Eilat and southern Israel are advised to ascertain the location of the nearest bomb shelter.

In the past, some rockets have travelled more than 40 km (24 miles) from Gaza and landed as far north as Yavne and Gadera and as far east as Beer sheva. As a result of possible IDF military operations in Gaza and the ever-present risk of rocket and mortar attacks into Israel from Gaza, U.S. government personnel traveling in the vicinity of the Gaza Strip border, to include the city of Sderot, require approval from the Embassy’s Regional Security Office.

The West Bank

The Department of State urges U.S. citizens to exercise caution when traveling to the West Bank. Palestinian Authority (PA) security forces are now deployed throughout the West Bank, including all major cities. As a result, violence in recent years has decreased markedly throughout the West Bank. Nonetheless, demonstrations and violent incidents can occur without warning. Vehicles have also been the target of rocks, Molotov cocktails and gunfire on West Bank roads. The IDF continues to carry out security operations in the West Bank. Israeli security operations, including incursions into Palestinian population centers, can occur at any time and lead to disturbances and violence. U.S. citizens can be caught in the middle of potentially dangerous situations. Some U.S. citizens involved in demonstrations in the West Bank have sustained serious injuries in confrontations with Israeli settlers and the Israel Defense Forces (IDF). The State Department recommends that U.S. citizens, for their own safety, avoid demonstrations.

During periods of unrest, the Israeli government sometimes closes off access to the West Bank and those areas may be placed under curfew. All persons in areas under curfew should remain indoors to avoid risking arrest or injury. U.S. citizens have been killed, seriously injured, or detained and deported as a result of encounters with IDF operations in Gaza and the West Bank. Travel restrictions may be imposed by Israel with little or no warning. Strict measures have frequently been imposed following terrorist actions, and the movement of Palestinian Americans, both those with residency status in the West Bank or Gaza as well as foreign passport holders, has been severely impeded. Current security-related restrictions on travel by U.S. government employees to the West Bank hinder the ability of consular staff to offer timely assistance to U.S. citizens.

Jerusalem

The State Department urges U.S. citizens to remain vigilant while traveling throughout Jerusalem, especially within the commercial and downtown areas of West Jerusalem and the city center. Spontaneous or planned protests within the Old City are possible, especially after Friday prayers. Some of these protests have led to violent clashes. Travelers should exercise caution at religious sites on holy days, Fridays, Saturdays, and Sundays. Isolated street protests and demonstrations can also occur in areas of East Jerusalem, including around Salah Ed-Din Street, Damascus Gate, and the Sheikh Jarrah neighborhood. U.S. government employees are authorized to visit the Old City during daylight hours only except between the hours of 11:00 a.m. and 2:00 p.m. on Fridays. The area of the ramparts on the city wall between Herod’s Gate and Lion’s Gate is off-limits to U.S. Government personnel at all times. The Sherover or Haas Promenade (scenic overlook) located in Armon Hanatziv is open to U.S. government personnel during daylight hours only.

Travel Restrictions for U.S. Government Personnel

Personal travel in the West Bank for U.S. government personnel and their families is allowed for limited mission-approved purposes in the areas described below. They may travel to Jericho, or to transit through the West Bank using Routes 1 and 90 to reach the Allenby/King Hussein Bridge, or the Dead Sea coast near Ein Gedi and Masada. They may also travel north on Route 90 from the Allenby/King Hussein Bridge to the Sea of Galilee. Use of these routes is approved for transit purposes during daylight hours, with stops permitted only at Qumran National Park off Route 90 by the Dead Sea. Each transit requires prior notification to the Consulate General’s security office.

U.S. Government personnel and family members are permitted both official and personal travel on Route 443 between Modi’in and Jerusalem without prior notification, during daylight hours only. All other personal travel in the West Bank, unless specifically authorized for mission-approved purposes, is prohibited.

General Safety and Security

Israeli authorities remain concerned about the continuing threat of terrorist attacks. U.S. citizens are cautioned that a greater danger may exist around restaurants, businesses, and other places associated with U.S. interests and/or located near U.S. official buildings, such as the U.S. Embassy in Tel Aviv and the U.S. Consulate General in Jerusalem. U.S. citizens are also urged to exercise a high degree of caution and to use common sense when patronizing restaurants, nightclubs, cafes, malls, places of worship, and theaters, especially during peak hours. Large crowds and public gatherings have been targeted by terrorists in the past and should be avoided to the extent practicable. U.S. citizens should take into consideration that public buses, and their respective terminals are “off-limits” to U.S. government personnel. U.S. government personnel have been directed to avoid protests and demonstrations. Personnel have also been urged to maintain a high level of vigilance and situational awareness at all times.

In the Golan Heights, there are live landmines in many areas and visitors should walk only on established roads or trails.

Entry/Exit Difficulties

U.S. citizens planning to travel to Israel or the West Bank should read carefully the detailed information concerning entry and exit difficulties in the Country Specific Information sheet at: http://travel.state.gov/travel/cis_pa_tw/cis/cis_1064.html
 
The Health System of Israel

According a study done by Marshall W. Raffel, Ph.D., Professor Emeritus of Health Policy and Administration at The Pennsylvania State University, State College, PA, all permanent residents in Israel are covered by health insurance, and the quality of care in the large urban centers is very high, comparable to that in the United States.

Americans can easily access the system for needed health care, and pay for whatever services are provided. For emergency care one should go to the nearest hospital that has an emergency department. An ambulance can be secured by dialing 101 on the telephone. For non-emergency services one can go to any community primary care clinic or for specialty consultation at a nearby hospital. A charge will be made for both emergency and non-emergency care. Americans can also contact the American Embassy in Tel Aviv for the names of hospitals and doctors who have been used by Americans in the past though the embassy cannot speak for their competence or quality of care.  Our Global Citizen, Global Navigator and Travel Gap international health insurance customers can access English speakers when logging into their online accounts.

Health insurance in Israel is mandatory. It is obtained by joining one of 4 sick funds, each of which operates like an American HMO. The sick funds (sometimes called health funds) all offer the same basic package of services including primary care, consultation services, and hospital care. The sick funds compete for members by offering supplementary benefits, some of which may require an additional premium and co-payments. In competing for members the sick funds may not reject an applicant because of their age or health status. The largest sick fund (Kupat Holim Clalit) provides coverage for about 60% of the population including a large majority of the elderly population. It is the only fund that has its own hospitals. The other 3 sick funds contract for the hospital care of their members in hospitals run by the university medical schools, nonprofit and religious organizations as well as those run by the Ministry of Health.  Our Global Citizen, Global Navigator and Travel Gap international health insurance customers have the freedom to choose any doctor or hospital which is important if you prefer to be able to choose your own physician or specialist.

The sick funds are primarily financed from monies collected by the government through general tax revenues and a tax on employee wages up to 4.8%, the actual percentage depending on income and family status. Lower income employees pay a lower percentage than middle-income persons. Monies collected are distributed to the sick funds on a per capita basis. The per capita amount is adjusted to take into account the age distribution in each sick fund. Costs are rising, and there have been efforts by the government to institute some form of co-payment for services provided in the basic system. The population, in this regard, vigorously opposes the government's efforts.

Israeli patients access their health system for routine care through primary care doctors listed by their sick fund. These doctors work in the over 2,000 community primary care clinics that are run by the sick funds. Efforts by the government to have the primary care doctor act as gatekeeper for specialty consultation and hospital care has met with strong public resistance. Patients are free to consult with hospital specialists, with some exceptions, without a primary care doctor's referral providing that the specialist is part of the patient's sick fund. There are, in addition, some 850 maternal and child health clinics.

Most doctors in Israel are paid by salary, but some senior doctors are able to supplement their incomes through limited private practice in public hospitals when a patient asks specifically for their services. The Israeli government wants to end this practice and it is under review. The payment of doctors' salaries is a contentious issue. Some 15,000 public sector and sick fund doctors went on strike for 127 days in the early part of the year 2000, seeking a new pay schedule. During the strike both hospital outpatient and community primary care clinics were closed, and both diagnostic work and surgeries were delayed except in emergency situations. Private practice is permitted in medical centers that are owned by voluntary or private organizations, and many doctors avail themselves of this opportunity to supplement their public sector salaries in off-hours.

There are 47 general hospitals in the country with some 13,000 acute care beds. Half (45%) of the beds are in government-operated facilities, 30% in hospitals run by the largest sick fund (Kupat Holim Clalit), 6% in two hospitals of the Hadassah Medical Organization, and 19% by private hospitals run by church groups and other non-profit organizations.  Within Tel Aviv, Global Citizen, Global Navigator and Travel Gap customers have access to Tel Aviv Sourasky Medical Center and 22 Bazel Recovery along with 8 other medical centers that direct bill medical expenses.

According to the U.S. Department of State Consular Information Sheet for Israel and the Occupied Territories, modern medical care and medicines are available in Israel.  Some hospitals in Israel and most hospitals in the West Bank and Gaza, however, fall below U.S. standards. 

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Israel. The Ministry of Health 'reserves the right' to deny entry to visitors who declare their status.

Contact Insurance Services of America at 800.647.4589 for more information regarding international health insurance and ask how you can access to city, health and security profiles for your destination country.