Black-market Medicine and Public Opinion Towards the Welfare State: Evidence from Israel

Based on a survey and interviews, this article presents and analyses Israeli public opinion toward black-market medicine (BMM) and the welfare state. In addition to providing quantitative and qualitative evidence of the existence of under-the-table payments in Israel, we suggest various insights into this phenomenon. While most citizens admit that they would consider making under-the-table payments in order to receive preferential medical treatment, when the questions mention words such as illegal or bribe, respondents tend to be less tolerant of such activities. We find that, first, there is a basic willingness among Israeli citizens to use BMM. Second, despite this predilection, Israeli citizens are reluctant to articulate their willingness to engage in such illegal activities. This reluctance implies the existence of a moral barrier among the population as far as identifying themselves with illegal behaviour is concerned. We may infer the existence of a gap between declared attitudes and behaviour. Third, the fact that people's willingness to engage in BMM is greater than their willingness to adopt black-market strategies in other areas signifies the special nature of health care. Finally, by connecting the phenomenon of BMM to public opinion regarding the welfare state, we point to a possible gap between normative attitudes and preferences produced by structural conditions.