2017 - Dov Chernichovsky

Pictured above: Knesset Meeting: Left to right: Prof. D. Chernichovsky; MK Rabbi Y. Litzman, Health Minister; MK Y. Perry; and MK T. Ploskov

While long-term care has been a pressing issue in Israel for some time, it assumed center stage in Israeli politics in recent weeks as the Ministry of Finance decided to abolish, as of Jan. 1st, 2018, the group insurance held by 1 million Israelis through their places of work. This action has exposed this group, in addition to 3.5 million other Israelis who have no private insurance, to under-coverage for long-term care. Earlier this year, a Taub Center research team -- Prof. Dov Chernichovsky, Dr. Avigdor Kaplan, Mr. Eitan Regev, and Prof. Yochanan Shtessman -- published a study on the state of long-term care in Israel. The study, which can be found here in Hebrew or here in English (abridged), concludes that long-term care in Israel is neither efficient nor equitable and sustainable due to a combination of fragmented entitlements and poor oversight, with heavy reliance on private finance. The research team proposed the establishment of a universal basic long-term care basket funded by mandatory contributions, and overseen by a single authority.

Since the publication of the study in February 2017, Prof. Chernichovsky, who led the work on the basis of previous work, which can be found here, met with the Minister of Finance, Mr. M. Kahalon, the Minister of Welfare and Social Services, Mr. H. Katz, and Minister of Health, Rabbi Y. Litzman. In addition, Prof. Chernichovsky has had meetings with parliament member MK Itzik Shmuli, who is leading an initiative to establish universal long-term care. Prof. Chernichovsky was also invited by MK Yaakov Perry and MK David Amsalem to speak as an expert at the Knesset Caucus to Advance National Preparedness to Support the Aging Population. Following the caucus MK Tali Ploskov invited Prof. Chernichovsky to serve as an economic advisor to a Knesset sub-committee that she heads regarding elderly wellbeing. Prof. Chernichovsky has also appeared on Israeli television regarding this issue. The segment can be found here (Hebrew).

For some additional background on the issue please follow this link to the Jerusalem Post article (English) from earlier this year, regarding the issue.

The Risk Adjustment Network met in the Hague, Netherlands, from October 11th to 14th, 2017. The meeting’s program is attached, as is the presentation I gave titled, “Risk Adjustment, Big Data, and Machine Learning.” The presentation, co-authored with Alvaro Riascos, Los Andes University, Colombia and Ran Bergman, Deloitte, Israel, is our preliminary effort in this direction.

More work is planned with one of Israel’s sickness funds (health care plans) with the goal of (a) establishing the advantages and limitations of Big Data and Machine Learning vis a vis more conventional statistical methods, and (b) identifying big data typologies for consistent estimation across systems and over time.

My other work on risk adjustment includes:

• “Changes in the Allocation of Healthcare in Israel to Advance Equality Between the Center and the Periphery: Are they affected?”(Hebrew)

• “Health Status and Healthcare System Budgeting in Israel in the Context of Disability-Adjusted Life Years (DALYS)”(English)(Hebrew)

The first article concerns the underdeveloped nature of Israel’s risk-adjusted allocation formula, especially its inability to help combat growing regional disparities.The second piece suggests that, in spite of its shortcomings, the overall allocation – by age groups – is more consistent with combating years lost due to disability – measured in Disability Adjusted Years of life lost – Dalys- rather than combating mortality.

Additionally, last year I was part of a World Bank effort in Chile which dealt with risk adjustment. This was in response to a government request for assistance in organizing the financing of the health system. This work is another good example of using risk adjustment to finance health systems and solve real world problems.

For more information on the meeting's full program please see the first link below.

To view the full presentation given by Professor Chernichovsky, and co-authored with Alvaro Riascos and Ran Bergman, please see the second link below.

Available in English here.

Available in English here.