A State Comptroller report released Sunday says Israel is not prepared for the challenges of an aging population. The report says no multi-year, system-wide plan has been formulated, and although some decisions have been taken for older adults, implementation has remained limited and problematic. The review was conducted alongside similar reports being prepared in other European countries.
A major section focuses on the National Insurance Institute. According to the report, 90% of frail elderly people receive care at home through caregivers employed by nursing companies paid by National Insurance. That covers about 30% of retirement-age adults, or roughly 400,000 people. The comptroller says the 2018 nursing reform harmed the institute’s long-term financial stability, raising annual nursing spending from 7 billion shekels before the reform to about 21 billion shekels in 2025. If nothing changes dramatically, National Insurance will enter a cash-flow deficit in 2035 and will not be able to meet all its legal obligations without additional funding.
The report also says the social-economic cabinet has not discussed National Insurance’s balance or long-term stability in recent years, despite three actuarial reports finding the situation worse than previously thought and advancing the expected depletion date of the fund. In June 2025, the Finance Ministry, National Insurance and others formed an interministerial team on the nursing benefit, which met 12 times but had not published recommendations by the end of the audit. The comptroller adds that National Insurance does not conduct annual monitoring of benefit recipients, and that insufficient oversight exists over payments to family members serving as substitute caregivers.
On retirement policy, the report says Israel lacks an orderly government policy to prepare citizens for retirement, and labor-force participation among older adults is low. The retirement age for men remains 67, while women’s retirement age rose from 62 to 65, despite a 15% increase in life expectancy to 81.4 for men and 85.5 for women. Among ages 67 to 74, participation stands at 22.3% for women and 35.4% for men, below the 2030 targets of 28.5% and 43.5%. The report also cites a 16% drop in geriatric hospital beds from 2020 to 2023, near-flat growth in geriatric doctors at 0.86 per 1,000 people aged 65 to 75, and failures in health-promotion and frailty-prevention efforts.
The comptroller says none of the strategic directions for dealing with aging has been fully implemented, and that cooperation between ministries is only moderate or worse. It notes that 35% of officials interviewed did not know about the mapping process, and says the advisory public council for senior citizens has not functioned since 2021 and has had no new members appointed since August 2023, leaving it effectively nonexistent in practice. Comptroller Matanyahu Englman said, "Population aging is one of the central challenges facing the State of Israel. Providing an adequate response to the older population is a moral and values-based obligation."
