Researching Tomorrow’s Headlines: Long-Term Care

In February 2017, a Taub Center research team – Principal Researcher and Health Policy Program Chair Prof. Dov Chernichovsky, Dr. Avigdor Kaplan (who was appointed Director General of the Ministry of Labor and Social Welfare in January 2017), Senior Researcher Dr. Eitan Regev, and Prof. Yochanan Shtessman – published a study on the state of long-term care in Israel. The study found that Israeli long-term care arrangements are both inefficient and unequitable.

The system is inefficient because, despite the national level of income and relatively young population, Israel spends as much as wealthier and older European countries on long-term care. It is unequitable because households in need of long term care must rely largely on their own resources to cover such care.

The researchers proposed several policy options for restructuring long-term care including a universal long-term care basket (separate from the medical care basket to which every Israeli is already entitled), more funding sources for this coverage, and concentrating long-term care services under one authority.

For long-term care coverage, about four and a half million Israelis rely on extra group insurance provided through the HMOs, about one million Israelis rely on private group insurance provided through places of work, and about three million people remain uninsured altogether. For a number of years the group insurance provided through employers has been considered an unsustainable option, and has recently become the topic of heated public debate in Israel.

According to Prof. Chernichovsky, the study had been “in the works” for a while, but the authors were waiting for the right time to publish it. Early 2017, when this issue was already brewing under the surface of Israeli society, proved an optimal release time for two reasons. First, part of the new government’s coalition deal in 2016 was a renewed long-term care plan by the Ministry of Health that the Taub research team considered insufficient. Second, the prospect that the Ministry of Finance would eliminate private group insurance policies through work places seemed imminent.

The study’s publication in February coincided with news reports about abuse of elderly Israelis in nursing homes. Its findings raised broader questions about Israel’s treatment of its elderly population and the availability and affordability of long-term care and was therefore covered substantially by the press at the time of its release.

Over the past few months, Taub Center research on this topic has resurfaced and become indispensable in the wake of the Ministry of Finance plan to terminate group insurance through places of work (as expected) beginning on January 1, 2018, and the subsequent threats of a general strike by Israel’s labor union – The Histadrut.

In the months following the study’s publication, Prof. Chernichovsky met with (at the time) Minister of Health Rabbi Yaakov Litzman (United Torah Judaism), Minister of Finance Moshe Kahlon (Kulanu), and Minister of Labor and Social Welfare Haim Katz (Likud), as well as their senior advisors. More recently, Prof. Chernichovsky has had multiple meetings with MK Itzik Shmuli (Zionist Union), who is leading an initiative to establish universal long-term care, to discuss the Center’s findings and the policy options presented in the study.

Prof. Chernichovsky also met with MK Yaakov Perry (Yesh Atid), who is particularly involved in the issue. In early November, MK Perry and MK David Amsalem (Likud), Chairs of the Knesset Caucus to Advance the Country’s Preparedness for the Aging of the Population, invited Prof. Chernichovsky to speak to the caucus as an expert in this field. The Minister of Health participated in the caucus meeting as well. Subsequently, Prof. Chernichovsky was asked by MK Tali Ploskov (Kulanu), who was also involved in the caucus meeting, to serve as an economic advisor to a Knesset sub-committee she is heading on the welfare of the elderly.

Prof. Chernichovsky has leveraged the opportunity provided by the heated policy debate over group insurance provided through places of work to publically discuss the need for a larger reform in long-term care policy in Israel. He has been consulted by and quoted in the media on the study specifically and the subject that it addresses in general. Its findings have become a trusted reference to those currently engaged in the debate over long-term care in Israel.