Israel is unprepared for a rapidly aging population, the State Comptroller’s Office said on Sunday, projecting that the National Insurance Institute’s reserve fund could be depleted by 2035. The report also found widening gaps in elder care, leaving many elderly citizens without adequate support in an under-resourced and poorly coordinated system.
The report released by State Comptroller Matanyahu Englman examined Israel’s preparedness in areas including government planning, nursing care insurance, the health system, and welfare services for older people. The State Comptroller’s Office is Israel’s independent public oversight authority, responsible for auditing government ministries and evaluating the effectiveness of public policy.
The conclusions are stark. “The gap between planning and practice remains large,” the report stated, noting that more than a decade has passed since the government first designated population aging as a strategic national priority, with little to show for it.
Israel’s population of citizens aged 65 and over stood at approximately 1.286 million at the end of 2024, representing 13% of the population. By 2050, that figure is expected to nearly double to around two million. Life expectancy has risen sharply over the past half-century, reaching 81.4 years for men and 85.5 years for women as of 2023. These demographic shifts, seen across many developed countries, place growing pressure on health, welfare and pension systems that the report says Israel has failed to adequately reform.
At the heart of the financial concern is the National Insurance Institute, Israel’s equivalent of a social security administration. A 2018 reform to nursing care benefits more than doubled the number of eligible recipients—from 180,000 to 392,000—and caused annual spending on long-term care to triple, rising from 7 billion shekels ($2.37 billion) to 21.1 billion shekels ($7.14 billion) by 2025.
The report found that these changes were made without actuarial review, meaning their long-term financial implications were not properly assessed before implementation. As a result, the reserve fund that the National Insurance Institute relies upon to pay future benefits is projected to be fully depleted by 2035. “The NII will be unable to fulfill its commitments to insured persons,” the report warned, adding that the accelerated timeline “undermines confidence in the social security system.”
Gaps in elder care
The problems extend well beyond finance.
Israel’s health system is struggling to keep pace with the growing elderly population. The ratio of geriatric hospital beds per thousand people aged 75 and over fell by 16% between 2020 and 2023, and the number of specialist geriatric physicians has barely changed. The Comptroller’s Office projected that both figures will continue to decline through 2040 unless urgent action is taken.
Preventive care—the most cost-effective way to keep elderly people healthy and independent—is significantly underused. According to the report, around 91% of documented prevention activities were not carried out. Just 1.5% of the Ministry of Health’s 2025 budget is allocated to preventive medicine.
The report also highlighted significant social challenges. Around 26% of elderly Israelis report feeling lonely, yet only 18% of them have been identified and reached by welfare agencies. Among elderly Arab citizens, the gap is even wider: 53% report loneliness, but only 8% have been identified. Seventy-seven percent of Israelis aged 60 to 75 received no retirement preparation before retiring, despite research consistently showing that such preparation improves financial planning, mental health and social engagement in later life.
The report concluded with a call for collective responsibility. “This is not only about meeting the needs of those who have reached old age,” Englman wrote, “but also about understanding the collective need to continue appreciating their contribution to society and learning from them. We must strive not only to safeguard the well-being of senior citizens but also to maximize their potential for the benefit of us all, while upholding their dignity, independence and social integration.”
