Like other advanced market economies, Israel has been engaged in a reform of its health care system, more intensely so since 1994. The first two sections describe the key features of the Israeli health care system before the reform, and their strengths and weaknesses. A State Commission of Inquiry, established by the government in 1988, proposed in its 1990 report two different reform strategies, respectively developed by the majority and the minority in it. The Commission diagnoses, recommendations and strategies are assessed and explained in the next sections. Legislators and policy makers opted for the incremental, evolutionary reform strategy, proposed by the minority in the Commission. The essence of the reform strategy being implemented as from 1995 is presented and examined in the penultimate section. In the concluding part, the Israeli experience with the formulation and implementation of a health care reform is discussed.