Countries can and should be preparing now for the aging of their populations in the future. How can Israel prepare for this phenomenon in the coming decades, and how must we adapt our health and welfare services accordingly?
We spoke with Dr. Yoram Ma’aravi, a geriatric specialist at Hadassah Hospital, and with Prof. Alex Weinreb, Research Director at the Taub Center, to discuss aging in Israel and its potential impact on society at large.
This episode, recorded in Hebrew, is the third and final episode in our “Israel 2040” series, in which we examine the phenomena that will characterize Israel’s society and economy in about 20 years and are already being shaped today.
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Aging is a phenomenon that affects the vast majority of the population. As Yoram explains, “People don’t understand that we basically start the aging process at age 20…Our aging process is the longest of all other beings as far as I know,” he continues, “and it is the slowest, longest, and most imperceptible process. We mistakenly think that we suddenly start aging at 65.”
Israel is a relatively young country compared to other developed nations, due in large part to its high fertility rates. Nonetheless, the number of Israelis ages 70+ – the group usually considered “elderly” for policy purposes – is still expected to double by 2040, and this group’s share of the population is expected to grow from 8.5% to 11%.
On the one hand, Yoram reminds us that as life expectancy and healthy life expectancy improve, there are more and more elderly people who are independent, in good physical and mental health, and who continue to contribute greatly to society. On the other hand, the sheer increase in their number in Israel indicates that there will also be an increase in those who need care. Furthermore, as Alex adds, the elderly suffer more from chronic diseases and social isolation and often need care specifically tailored to this period of life.
This points to one of the major challenges Israel faces in preparing for an aging population, according both to Yoram and Alex – a lack of appropriate health professionals. “The first challenge…is a professional one,” says Yoram. “The population is aging, the number of older people is increasing, the skills and insights required to care for these people are very different from those used for younger people, and we don’t have enough professionals who have undergone the appropriate training.” He then elaborates, “Just to illustrate this, today there are over a million people in Israel considered elderly and only 400 geriatric specialists. The gap is unfathomable.”
Alex adds that this kind of gap is not something that can be fixed instantaneously, but rather requires forward thinking and long-term planning. “If it takes six or seven years to complete medical school, then it means that if we want to double the number of doctors in the health system to maintain the current ratio of patients to doctors, we actually already need to build more medical programs and everything that goes along with that,” he says.
Given that training the appropriate number of doctors and specialists is both a tall order and a solution that will take years to implement, what other steps can be taken now to prepare for the aging population? Yoram says that one option is to invest more in preventative medicine. “Our country, and I think a lot of other countries as well, are too busy putting out fires instead of preventing them,” he says. That is, we should not be waiting for people to develop serious chronic conditions before treating them, but rather invest more in younger Israelis so that these conditions do not develop in the first place.
Another thing that could ease the burden on Israel’s future healthcare system, notes Alex, is to move more care for the elderly out of hospitals and into health clinics and the community. “But this will require systemic flexibility,” Alex warns, “and a change of mindset from an outlook that caring for the elderly takes place only in hospitals and nursing homes to an outlook where they are also cared for within the community itself.”
When both Alex and Yoram look a few decades into the future and imagine Israel caring for its elderly, they each have a vision for how a better-prepared society should look. As Alex says, “I think if we ask the elderly where they want to be, what would be optimal for them, they would want to be with their families. They would generally want to be cared for within the community.” Thus, strengthening care in the community could not only ease the burden of hospitals and nursing homes, but also provide a more preferable situation for the elderly.
Yoram, for his part, thinks that preparing well could make us all view aging in a more positive light and help us enjoy our later years. “It depends on whether or not we do the right things,” he says. “If we do the right things and an 80-year-old is able to live, get by financially, and be surrounded by a diverse enough environment to allow him to continue living a functional and healthy life, I think his life will be a full and happy life.”
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Press here to open in your favorite player This episode, recorded in English, was produced as part of the Taub
This episode, recorded in English, was produced as part of the Taub Center's 2021 Herbert M. Singer International Policy Conference:
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