Abstract
The Long-Term Care Insurance Program (LTCIP) in Israel is a social security program administered by the National Insurance Institute (NII) since 1988. LTCIP focuses on home-based personal care services. Differently from most other programs under the responsibility of the NII, LTCIP benefits are in-kind benefits and are delivered via multiple for-profit and not-for-profit organizations. In recent years LTCIP has been the target of various legal amendments and numerous administrative changes. While many of these changes may have had significant effects on individuals, they have not altered the fundamental principles of the program. Thus, many of the characteristics of beneficiaries have remained quite stable over the years; other characteristics of the population of beneficiaries have changed over the years reflecting the aging of Israeli society. A central issue related to LTCIP is whether benefits are adequate to meet the needs of the growing elderly population of Israel. While the generosity of LTCIP benefits is questionable, economic and political struggles have limited the scope of changes introduced thus far.
Highlights
Home care for the elderly is the main long-term care (LTC) service to the elderly in Israel
Spending for Long-Term Care Insurance Program (LTCIP) represents the majority of public spending on home care and institutional LTC services in Israel – 69% of total public spending in 2010
The under-70 age group has consistently included only 1% or fewer LTCIP beneficiaries
Summary
Home care for the elderly is the main long-term care (LTC) service to the elderly in Israel. The dependency score represented the “desired” number of daily hours of home care needed to help a frail elderly individual with activities of daily living or with supervision; each 0.5 point represented a daily half an hour required for helping one’s activity of daily living, based on analysis of experts [39,54]. Increasing the number of weekly home care hours is required to support the needs of those employing Israeli caregivers, but as long as the legal framework for employing non-Israeli caregivers is not changed, a radical reform in LTCIP benefits would face difficulties. From a distributive justice point of view, resources are not adequately distributed according to need
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