First, we describe the extent of the problem occasioned by the exclusion of long-term inpatient care from the services covered by National Health Insurance. Second, we present the value and organizational perceptions that are crucial in policymaking. Several issues are taken up in this context. The first concerns the kind of health expenditure that policy should address – should it assure a given level of national expenditure or only a given level of public expenditure? The second issue concerns funding and, especially, whether long-term inpatient care and general health insurance should be funded separately. The third issue is which institutional player to prefer as the manager of long-term care insurance, in view of the challenges in regard to coordination and continuity of health services. Some of the discussion of these issues is enriched by other countries’ experience.
This paper appears as a chapter in the Center’s annual publication, Israel’s Social Services 1999-2000, Yaakov Kop (editor).