Researchers: Joshua Shemer¹, Yossi Weiss¹, Ruti Berger¹

Background: Timely and geographically accessible healthcare services are essential for equity in universal health systems. In Israel, the National Health Insurance Law guarantees access to care within “reasonable” time and distance, yet these terms are not operationally defined, limiting their use for entitlement-setting and service planning.

Objectives: To define perceived reasonable waiting times and travel distances for different healthcare services and to compare expectations between the public and health policymakers and academic experts.

Method: A cross-sectional survey was conducted in August-September 2023 among a representative sample of the Israeli public (n = 1,025) and a purposive sample of policymakers and academic experts (n = 114). A validated, purpose-built questionnaire assessed acceptable waiting times and travel distances for primary care, specialist services, diagnostic imaging, mental health, dental, and pediatric care. Respondents also ranked preferred policy solutions to reduce access barriers. Non-parametric tests were used for subgroup analyses.

Findings: Both groups prioritized short waiting times and geographic proximity, particularly for children and older adults. 65% of the public viewed a 1–2 day wait for primary care as reasonable, while only 27% accepted a three-month wait for elective surgery. The public consistently showed lower tolerance for delays than experts, especially for mental health and imaging services. Supply-side measures, including workforce and infrastructure expansion, were favored, whereas demand-side measures such as higher co-payments were widely rejected.

Conclusions: The study establishes the first empirically based access benchmarks in Israel, reflecting both public and expert perspectives on reasonable healthcare access.

Recommendations: Defined thresholds, such as 1–2 days for primary care, up to three months for elective services, and travel times within 30 minutes for core services, can inform legal entitlements, guide health fund planning, and promote equity, transparency, and public trust.

Research end date: 12/2025