The Long-Term Care Insurance Program in Israel: solidarity with the elderly in a changing society

Israel Journal of Health Policy Research

Sharon Asiskovitch¹ 

[1]Social Policy Analyst, Research and Planning Administration, Israel National Insurance Institute, 13 Weizmann Blvd 91909, Jerusalem, Israel

关键词: Benefits;    Beneficiaries;    Solidarity;    Israel;    Home-based personal care;    Long-term care insurance program;    Long-term care;   

Others  :  804957
DOI  :  10.1186/2045-4015-2-3

 received in 2012-06-05, accepted in 2012-11-26,  发布年份 2013

【 摘 要 】

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.

【 授权许可】

   
2013 Asiskovitch; licensee BioMed Central Ltd.

【 参考文献 】

• [1]National Insurance Institute: Annual Survey 2011. Jerusalem: National Insurance Institute; 2012. [Hebrew]
• [2]Horev T, Kaidar N, Hershkovitz I: Public Long-Term Care Insurance: A Reform Proposal. Jerusalem: Ministry of Health; 2011. [Hebrew]
• [3]Brodsky J, Schnoor Y, Beer S: The Elderly in Israel: The 2010 Statistical Abstract. Jerusalem: Brookdale Institute; 2011. [Hebrew]
• [4]Central Bureau of Statistics: Long Range Population Projections for Israel: 2009–2059. Jerusalem: Central Bureau of Statistics; 2012. [Hebrew]
• [5]Rodger JJ: Social solidarity, welfare, and post-emotionalism. J Soc Policy 2003, 32:403-421.
• [6]Baldwin P: The Politics of Social Solidarity: Class Bases of the European Welfare State 1875–1975. Cambridge: Cambridge University Press; 1990.
• [7]Campbell LJ: Globalization and Social Change. Princeton, NJ: Princeton University Press; 2004.
• [8]Miller SM: Introduction: The legacy of Richard Titmuss. In The Philosophy of Welfare: Selected Writings of Richard Titmuss. Edited by Abel-Smith B, Titmuss K. London: Allen and Unwin; 1987:1-17.
• [9]Ajzenstadt M, Rosenhek Z: Privatization and new modes of state intervention: The long-term care programme in Israel. J Soc Policy 2000, 29:247-262.
• [10]Baitch-Moray S, Zipkin A, Morginstin B: Analysis of the Evaluation Dependency Test in the Long-Term Care Program. Jerusalem: National Insurance Institute; 1993. [Hebrew]
• [11]Baitch-Moray S, Zipkin A, Morginstin B: Some issues in the use of dependency tests for determining eligibility for long-term care. Soc Secur 1996, 4:103-122.
• [12]Bank of Israel: Annual Report 2011. Jerusalem: Bank of Israel; 2012. [Hebrew]
• [13]Ben-Zvi B: The contribution of the Long-Term Care Insurance Law to the welfare of severely dependent elderly. Soc Sec 1990, 2:100-116.
• [14]Ben-Zvi B: Long-Term Care Insurance Program: Implementation achievements and unexpected outcomes. Soc Secur 1994, 3:84-100.
• [15]Ben-Zvi B: Thoughts about the Long-Term Care Insurance Program and lessons to the future. Soc Secur 2001, 60:31-45. [Hebrew]
• [16]Borowski A, Schmid H: Israel's Long-Term Care Insurance Law after a decade of implementation. J Aging Soc 2000, 12:49-71.
• [17]Chernichovsky D, Koreh M, Soffer S, Avrami S: Long-term care in Israel: Challenges and reform options. Health Pol 2010, 96:217-225.
• [18]Cohen S: The Long-Term Care Insurance Law: Background, principles, and organization toward implementation. Soc Secur 1988, 1:4-22.
• [19]Gharrah R: Cash Long-Term Care Benefit Experiment: Accompanying Research. Jerusalem: National Insurance Institute; 2010. [Hebrew]
• [20]Iecovich E: The system of community and institutional services for the elderly. In Aging and Gerontology in Israel. Edited by Rosin A. Jerusalem: JDC-ESHEL; 2003:685-706. [Hebrew]
• [21]Katan Y: Implementation of privatization policy in long-term care services: preliminary lessons. Soc Secur 2001, 60:129-155. [Hebrew]
• [22]Katan Y, Lowenstein A: A Decade of Implementing Long-Term Care Insurance Law: Implications and Lessons. Jerusalem: Taub Center For Social Policy Studies in Israel; 1999. [Hebrew]
• [23]Mann KY: The Long-Term Care Insurance Law: Vision and reality. Soc Secur 1988, 1:23-30.
• [24]Morginstin B, Baitch-Moray S: The Impact of the Long-Term Care Insurance Program on Informal Care for the Frail Elderly. Jerusalem: National Insurance Institute; 1992. [Hebrew]
• [25]Schmid H: The Israeli Long-Term Care Insurance Law: Selected issues in providing home care services to the frail elderly. Health Soc Care Community 2005, 13:191-200.
• [26]Schmid H: The Long-Term Care Insurance Program's scheme of coverage and services. Dorot Magazine 2009, 120:24-29. December [Hebrew]
• [27]Schmid H, Borowski A: Selected issues in delivery of home based care services to the elderly following a decade of implementation of Long-Term Care Insurance Program. Soc Secur 2004, 7:87-114.
• [28]Comptroller S: Annual Report 40. Jerusalem: State Comptroller; 1990. [Hebrew]
• [29]Comptroller S: Annual Report 50b. Jerusalem: State Comptroller; 2000. [Hebrew]
• [30]Comptroller S: Annual Report 61b. Jerusalem: State Comptroller; 2011. [Hebrew]
• [31]Stessman Y: Long-Term Care Insurance Program after twelve years: challenges and solutions. Soc Secur 2001, 60:8-30. [Hebrew]
• [32]Stessman Y: Long-Term Care Insurance Program: A timely review. In Home Care for Frail Older Adults: Issues, Services, and Programs. Edited by Iecovich E. Jerusalem: Eshel; 2011:173-194. [Hebrew]
• [33]Brodsky J: Issues and dilemmas in home care for chronically ill and frail elderly. In Home Care for Frail Older Adults: Issues, Services, and Programs. Edited by Iecovich E. Jerusalem: Eshel; 2011:89-129. [Hebrew]
• [34]Brodsky J, Habib J, Mizrahi I: Long-Term Care Laws in Five Developed Countries: A Review. Geneva: WHO; 2000.
• [35]Colombo F, Llena-Nozal A, Mercier J, Tjadens F: Help Wanted? Providing and Paying for Long-Term Care. Paris: OECD Publishing; 2011.
• [36]Huber M, Rodrigues R, Hoffmann F, Gasior K, Marin B: Facts and Figures on Long-Term Care: Europe and North America. Vienna: European Center for Social Welfare Policy and Research; 2009.
• [37]Kaye R: The future of long term care in Israel. Soc Sec 2000, 6:98-123.
• [38]Kaye R: Long-term care – The next revolution? In Health Systems: Are We in a Post Reform Era?. Edited by Rosen B, Saltman R, Shani M. Ramat Gan: NIHP; 2008:98-120.
• [39]Naon D: Standards for Translating Disabilities of the Aged to the Scope of Assistance Needed in Home-Based Care. Jerusalem: Brookdale Institute; 1989. [Hebrew]
• [40]Zipkin A: Use of marginal analysis to adapt Long-Term Care Insurance Program benefits. Soc Secur 2001, 60:156-193. [Hebrew]
• [41]National Insurance Institute: Statistical Quarterly, October-December 2011. Vol. 41(4). Jerusalem: National Insurance Institute; 2012. [Hebrew]
• [42]BL 1260/10 Lantzman-Noskin vs. The National Insurance Institute; 2010. [Hebrew]
• [43]National Insurance Institute: Guide for Conducting Functional Evaluation for Long-Term Care Insurance Program. Jerusalem: National Insurance Institute; 2012. [Hebrew]
• [44]National Insurance Institute: Long-Term Care Cash Benefit instead of In-Kind Benefit for Employers of Formal Caregivers. Jerusalem: National Insurance Institute; 2010. [Hebrew]
• [45]Asiskovitch S: Long-Term Care Cash Benefits – Research Findings, Presented at the Annual Conference of the Association for the Elderly in Israel: 22 December 2010. Kibbutz Shefayim; 2010. [Hebrew]
• [46]National Insurance Institute: Ten Years of the Long-Term Care Insurance Program: The Committee for Evaluating the Dependency Test – A Final Report. Jerusalem: National Insurance Institute; 1998. [Hebrew]
• [47]National Insurance Institute: Recommendations of the Committee for Examination the Dependency Test for Long-Term Care Insurance benefits [Brill Committee]. Jerusalem: National Insurance Institute; 2005. [Hebrew]
• [48]Tzadka Y, Rabin H: Survey of LTCIP Claimants regarding Dependency Tests. Jerusalem: National Insurance Institute; 2005. [Hebrew]
• [49]National Insurance Institute: General Order 10/2011 LTC 1375 – Dependency Evaluation in a Fast Track. Jerusalem: National Insurance Institute; 2011. [Hebrew]
• [50]National Insurance Institute: General Order 7/2011 LTC 1372 – A Change to the Dependency Score of 85 Years-Old Blind Person who Lives Alone. Jerusalem: National Insurance Institute; 2011. [Hebrew]
• [51]ABL 1165/04 Ben-David vs. The National Insurance Institute; [Hebrew]
• [52]Central Bureau of Statistics: Statistical Abstract of Israel. Jerusalem: Central Bureau of Statistics; 1990-2010
• [53]National Insurance Institute: Annual Survey. Jerusalem: National Insurance Institute; 1989-2012 [Hebrew]
• [54]Rice E: Unbalanced Allocation of Resources in Allocation of Resources in Long-Term Care in Comparison to the Distribution of Needs, Position Paper. Jerusalem: National Insurance Institute, Long-Term Care Department; 2008. [Hebrew]
• [55]National Insurance Institute: Benefit Levels and Spending Estimations: Long-Term Care – First Step, Draft for Discussion. Jerusalem: National Insurance Institute; 1983.
• [56]Brodsky J, Naon D, Resnizky S, Ben-Nun S, Morginstin B, Gharrah R, Shmeltzer M: Recipients of Long-Term Care Insurance Benefits: Characteristics, Formal and Informal Assistance Patterns, and Unmet Needs. Jerusalem: Brookdale Institute and National Insurance Institute; 2004. [Hebrew]
• [57]Brodsky J, Resnizky S, Citron D: Issus in Family Care of the Elderly: Characteristics of Care, Burden on Family Members, and Support Programs. Jerusalem: Brookdale Institute; 2011. [Hebrew]
• [58]Lowenstein A, Katz R, Halperin D: How to combine work with care for an elderly relative. In Home Care for Frail Older Adults: Issues, Services, and Programs. Edited by Iecovich E. Jerusalem: Eshel; 2011:245-270. [Hebrew]
• [59]Ben-Bassat A: The Israeli Economy 1985–1998: From Government Intervention to Market Economics. Cambridge, MA: MIT Press; 2002.
• [60]Ram U: The Globalization of Israel: McWorld in Tel-Aviv, Jihad in Jerusalem. New York: Routledge; 2007.
• [61]Shafir G, Peled Y: Being Israeli: The Dynamics of Multiple Citizenship. Cambridge: Cambridge University Press; 2002.
• [62]Shalev M: Have globalization and liberalization 'normalized' Israel's political economy? Israel Affairs 1999, 5:121-155.
• [63]Lavee Y, Katz R: The family in Israel: Between tradition and modernity. Marriage Fam Rev 2003, 35:193-217.
• [64]Toren N: Tradition and transition: Family change in Israel. Gender Issues 2003, 21(2):60-76.
• [65]Iecovich E: Policy issues on elder long-term care in Israel. In Aging and Gerontology in Israel. Edited by Rosin A. Jerusalem: JDC-ESHEL; 2003:669-684. [Hebrew]
• [66]Doron A: Welfare policymaking in Israel: Developments during the 1980s and 1990s. In Policymaking in Israel. Edited by Nachmias D, Menachem G. Jerusalem: Israel Democracy Institute; 1999:437-474. [Hebrew]
• [67]Doron A: Welfare policy in Israel, 2000–2005. In Formulating Social Policy in Israel: Trends and Issus. Edited by Aviram U, Gal J, Katan J. Jerusalem: Taub Center; 2007:33-57. [Hebrew]
• [68]Cohen N, Mizrahi S, Yuval F: Welfare state, public policy, and public opinion: Israel 2008. Soc Secur 2010, 82:47-77. [Hebrew]
• [69]National Insurance Institute: The Implications of the Economic Replenishing Bill on the National Insurance Institute. Jerusalem: National Insurance Institute; 2003. [Hebrew]
• [70]National Insurance Institute: Annual Survey 2002–2003. Jerusalem: National Insurance Institute; 2004. [Hebrew]
• [71]National Insurance Institute: Recommendations of the Committee for Evaluation of Long-Term Care Insurance Program. Jerusalem: National Insurance Institute; 2005. [Hebrew]
• [72]National Insurance Institute: Long-Term Care Insurance Program and the Economic Replenishing Bill, Correspondence from the Long-Term Care department to the Deputy Director General of the National Insurance Institute for Benefits. 2003. [Hebrew]
• [73]National Insurance Institute: Changes in LTCIP Benefits Scheme – A Response, Correspondence from the Research and Planning Administration to the Director General of the National Insurance Institute for Benefits. 2003. [Hebrew]
• [74]ATM 1003/09 Long-Term Service Providers Union and Others vs. The National Insurance Institute; 2009. [Hebrew]
• [75]Brodsky J, Habib J: New developments and issues in home care policies. Disabil Rehabil 1997, 19:150-154.
• [76]Brodsky J, Naon D: Home care services in Israel: Implications of the expansion of home care following implementation of the Community Long-Term Care Insurance Law. J Cross Cult Gerontol 1993, 8:375-390.
• [77]Naon D, Brodsky J, Ben-Nun S, Resnizky S, Morginstin B, Gharrah R, Shmeltzer M: Disabled Elderly Recipients of Cash and In-Kind Benefits: What Can be Learned from the Experience of Recipients of Disability Benefits – Both Cash and In-Kind – in Israel?. Jerusalem: Brookdale Institute and National Insurance Institute; 2004. [Hebrew]
• [78]Wertman E, Brodsky J, King Y, Bentur N, Chekhmir S: Elderly People with Dementia: Prevalence, Identification of Unmet Needs, and Priorities in the Development of Services. Jerusalem: Brookdale Institute; 2005. [Hebrew]
• [79]Schmid H: Evaluating the impact of legal change on long-term care insurance non-profit and for-profit organizations: The case of Israeli Long-Term Care Insurance Law. Public Manage Rev 2001, 3:167-189.
• [80]Schmid H: Review of Functioning of Organizations Delivering Home Care Service for Frail Elderly. Jerusalem: The Hebrew University; 1998. [Hebrew]
• [81]Schmid H: Non-profit and for-profit organizations in home care services: A comparative analysis. Home Health Care Serv Q 1993, 14:93-112.
• [82]Schmid H: Rethinking the policy of contracting out social services to non-governmental organizations: Lessons and dilemmas. Public Manag Rev 2003, 5(3):307-323.
• [83]Schmid H, Sabag C: The Functioning of Long-Term Care Service Providers. Jerusalem: The Hebrew University and Brookdale Institute; 1990. [Hebrew]
• [84]Schmid H, Sabag C: Organizational and structural dimensions of public and private organizations delivering services for frail elderly: A comparative analysis. Soc Secur 1991, 36:49-67. [Hebrew]
• [85]Schmid H, Sabag C: The Effectiveness of Long-Term Care Service Providers for the Aged: Evaluation of Formal Caregivers. Jerusalem: The Hebrew University and the National Insurance Institute; 1991. [Hebrew]
• [86]Abraham Y, Tamir Y: Minimizing the use of foreign workers: Alternative approaches to elderly care in Israel. Soc Secur 2012, 88:65-96. [Hebrew]
• [87]Bar-Zuri R: Holders of Permits for Employing Foreign Workers in Long-Term Care. Jerusalem: Ministry of Trade, Commerce, and Employment; 2010. [Hebrew]
• [88]Government of Israel: Report on the Employment in Long-Term Care. Jerusalem: Government of Israel; 2006. [Hebrew]
• [89]Government of Israel: Report of the Committee on Policymaking towards Non-Israeli Workers. Jerusalem: Government of Israel; [Hebrew]
• [90]Nathan G: Foreign Workers in Israel: Central Issues and State of Affairs. Jerusalem: Knesset Center for Research and Information; 2009.
• [91]Nathan G: The Rights and Obligations of Employers and Foreign Workers in the Long-Term Care Sector. Jerusalem: Knesset Center for Research and Information; 2010. [Hebrew]
• [92]Nathan G: The Cost of Employing a Foreign Caregiver, Letter to the Chair of the Knesset Committee on Foreign Workers. Jerusalem: Knesset Center for Research and Information; 2010. [Hebrew]
• [93]Nathan G: Services for People with Long-Term Care Needs – Employment Policies. Jerusalem: Knesset Center for Research and Information; 2011. [Hebrew]
• [94]Bramli-Grinberg S, Kaye R, Holtzman M: Long-term care insurance in international and Israeli perspectives. In Home Care for Frail Older Adults: Issues, Services, and Programs. Edited by Iecovich E. Jerusalem: Eshel; 2011:289-310. [Hebrew]
• [95]Ministry of Finance: The Capital Markets, Insurance and Savings Division – Annual Report 2010. Jerusalem: Ministry of Finance; 2011.
• [96]National Insurance Institute: Recommendations for Long-Term Care Insurance Program, Correspondence from the Research and Planning Administration at the National Insurance Institute to the Ministry of Labor and Welfare. National Insurance Institute to the Ministry of Labor and Welfare; 1984. [Hebrew]
• [97]Zilberstein Y, Zeltzer M, Ernest P, Bodansky Z, Kosowsky R, Shamir Z, Kestenbaum M, Lilus P: Medical and Social Needs of the Frail Elderly – Services and Costs [Part A: Bnei Brak]. Jerusalem: National Insurance Institute, Ministry of Health, and Tel-Aviv University; 1981. [Hebrew]
• [98]Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW: The index of ADL: A standardized measure of biological and psychological function. J Am Med Assoc 1963, 185(12):914-919.
• [99]Morginstin B, Shamai N, Cohen S: Planning a Long-Term Care Insurance Program. Social Security 1983, 24:77-99. [Hebrew]
• [100]Stone RI, Murtaugh CM: The elderly population with chronic functional disability: Implications for home care eligibility. Gerontologist 1990, 30(4):491-496.
• [101]National Insurance Institute: Protocol of Meeting No. 1 of the Committee on Need for Supervision in the Long-Term Care Insurance Program (Held on November 5, 1998 in Ramat-Gan Local Branch of the National Insurance Institute). National Insurance Institute; 1998. [Hebrew]
• [102]Arieli D, Horev T, Kaidar N: National Health Insurance Act – Statistical Abstract 1995–2011. Jerusalem: Ministry of Health; 2012. [Hebrew]
• [103]The Foundation for the Benefit of Holocaust Victims in Israel: Instructions for Applying for Additional 9 Long-Term Care Hours. Tel-Aviv: The Foundation for the Benefit of Holocaust Victims in Israel; 2012. [Hebrew]
• [104]National Labor Court and Others: HCJ 1678/07 Yolanda Gloten vs. 2009. [Hebrew]
• [105]Muiser J, Carrin G: Financing Long-Term Care Programmes in Health Systems; With a Situation Assessment in Selected High-, Middle-, and Low-Income Countries. Geneva: World Health Organization; 2007.
• [106]Theobald H: Long-Term Care Insurance in Germany: Assessments, Benefits, Care Arrangements, and Finding. Stockholm: Institute for Future Studies; 2011.
• [107]Ministry of Health: Financing additional institutional services according to the National Insurance Act, January – April 2008, Correspondence from Ministry of Health to the National Insurance Institute. National Insurance Institute; 2008. [Hebrew]
• [108]Ministry of Welfare and Social Services: Financing additional institutional services according to the National Insurance Act, January – December 2008, Correspondence from Ministry of Welfare and Social Services to the National Insurance Institute. National Insurance Institute; 2009. [Hebrew]
• [109]National Insurance Institute: Annual Survey 2009. Jerusalem: National Insurance Institute; 2010. [Hebrew]
• [110]Brodsky J, Schnoor Y, Beer S: The Elderly in Israel: The 2005 Statistical Abstract. Jerusalem: Brookdale Institute; 2006. [Hebrew]
• [111]Arlozerov M: A revolution in the National Insurance Institute: Payment of allowances would be secured in the future, the budget would be balanced. TheMarker; 2012. [Hebrew]
• [112]Arlozerov M: The response of the National Insurance Institute to the proposal of the Ministry of Health: Increasing home care hours. TheMarker; 2011. [Hebrew]
• [113]Tamir-Aviv I: Summary of conference on institutional long-term care: Issues and implications. EMDA 2012, 71:8-9. [Hebrew]
• [114]Government of Israel: The Report of the Committee for Social and Economic Change [Trachtenberg Committee]. Jerusalem: Government of Israel; 2011. [Hebrew]
• [115]Knesset: Protocol of the Knesset Committee on Foreign Workers, No. 77. 2012. [Hebrew]
• [116]Ministry of the Interior: Foreign LTC Caregivers, Regulation 5.3.0003. Jerusalem: Ministry of the Interior; 2010. [Hebrew]
• [117]Ministry of the Interior: Regulations for Private LTC Agencies Concerning the Management of Foreign Formal Caregivers, Updated August 2011. Jerusalem: Ministry of the Interior; 2011. [Hebrew]