The Taub Center recently co-hosted a roundtable discussion, “Building a National Plan for Israel’s Aging Preparedness: Lessons from Singapore” with the Israel-Asia Center, which included remarks from guest speaker Christopher Gee from Singapore. We’ve asked the moderator of the event and Chair of our Health Policy Program Prof. Dov Chernichovsky five questions about why this topic is so important.
1. Why is the aging population such an important topic to be discussing right now in Israel? Isn’t Israel a relatively young country?
Israel’s population is relatively young (because of migration and high fertility rates), and only about 10% of the population is aged 65 and above, compared with almost double that share in the U.S. Europe, and Japan. Nonetheless, Israel’s population is rapidly aging. The number of seniors in Israel ages 70 and older is projected to double by 2035. As a result, functional impairment is expected to rise 16% faster than population growth. Another big concern in Israel is that about a fifth of senior citizens in Israel live under the poverty line. To meet the growing demand for long-term care that is bound to come with an aging population, Israel will have to confront shortages in long-term care resources, evaluate current and future potential methods of funding long-term care, and address inefficiencies in the way benefits and services for the elderly are distributed.
2. How does long-term care currently work in Israel?
As opposed to most developed nations (with the exception of the U.S.), Israel currently does not have comprehensive universal long-term care insurance. Only about half of spending on long-term care in Israel is publicly funded and the share of private expenditure on this type of care is 45% – triple that of the OECD, which stands at 16%, on average. The extensive reliance on private funding leads to inequality in the long-term care received by Israel’s elderly from different socioeconomic backgrounds. Furthermore, the system for receiving benefits and services is fragmented and confusing. The responsibility is spread across several government ministries and authorities, and senior citizens have a difficult time understanding how to get the benefits due to them.
3. What recommendations have been made in Israel to change the long-term care system and prepare for the changes in Israel’s age-structure?
The Knesset Subcommittee on the Status of the Elderly, headed by MK Tali Ploskov (who spoke at the event), and advised by Prof. Yitzhak Brick (who also participated in the discussion), has prepared recommendations regarding Israel’s long-term care system that include eradicating poverty among Israel’s senior citizens, addressing retirement age policies to make them more in line with increased life expectancy, providing more support for primary care givers, and streamlining the provision of benefits and services for the elderly. The subcommittee has not, however, dealt with the financial implications of its recommendations.
4. Why compare Israel to Singapore?
Israel and Singapore have some key characteristics in common, both being young, small, developed, “isolated,” and having limited natural resources. More importantly, however, Singapore has been a leader in future policy planning, particularly when it comes to preparing for an aging population. Singapore’s population is the second most-rapidly aging population in the world and is in the process constructing policies to ease the dramatic shift in age-structure they will experience in the coming few decades. Therefore, as Israel faces its own challenges arising from an aging population, we can draw on Singapore’s experience.
5. What are a few things that Israel can learn from Singapore about preparing for an aging population?
It is important to note that there are many central differences in culture and government structure between Singapore and Israel, so we should be cautious about mapping solutions from one country onto the other. That being said, there are a number of aspects of Singapore’s approach to an aging population that might be useful in building a national plan for aging preparedness in Israel. These include universal public housing subsidies that help the elderly meet their housing needs (a huge cost for the elderly in Israel), compulsory savings accounts that can be used to finance long-term care, daycare center models for the elderly, formal arrangements for family care-givers, and inter-ministerial cooperation in forming a large-scale plan to address the aging population.