Oh, what a period 2020 and 2021 were for the world – devastating, frightening, nerve-wracking, hopeful? In Israel, the ongoing COVID-pandemic forced its leaders to cope, think of new changes and make policy changes. 

Researchers at the Taub Center for Social Policy Studies in Jerusalem worked hard to take a broad look at a variety of subjects including healthcare, labor, demographics, vocational training, fertility, social welfare and more. Their report is aimed at helping decisionmakers make policies and the general public understand where they have been and where they are going

At the end of 2020, there were 32,000 physicians, including 8,300 hospital residents, in Israel, an increase over the previous year. However, the supply of medical personnel relative to population size is actually dropping due to the rapid growth of the population coupled with doctors getting older and retiring. There is also a shortage in certain medical specialties. Physicians report excessive workloads, tend to work in more than one place and pursue work in the public and private healthcare systems.

The numbers of physicians and nurses are declining relative to population growth, The past decade has witnessed a steep rise in the number of new physicians per year, but despite a 26% numerical increase, there were fewer physicians per 1,000 people, due to the rapid rate of Israeli population growth. In addition, Israel’s share of medical school graduates is among the OECD’’s lowest, and Israel has the highest percentage of graduates of foreign medical schools. There are differences in the quality of training between medical schools here and abroad, including medical licensing exam pass rates

Israel has one of the highest shares of older physicians among developed nations – half of the country’s doctors are aged 55 and over. This is partly due to the influx of many thousands of doctors from the former Soviet Union in the 1980s and1990s. During the coming decade, a third of the Israel’s veteran physicians are expected to retire. 

The share of female physicians is rising and this has an impact in a number of areas because they tend to work fewer hours than their male counterparts. 

As for vaccination rates against COVID-19, the poor are less immunized than those who are better off – even though Pfizer shots are available free to all. The poor don’t seem to have the time to go to the clinics or they have less faith in the government’s and medical authorities’ recommendations. As a result, Israel’s socioeconomic disparities are also manifesting in the pandemic’s impact on the population at large, and their impact may be expected to persist, given the disease’s long-term physical, mental and socioeconomic effects.

In 2020, Israeli social expenditure grew by NIS 55 billion, mainly due to the need to address the pandemic. 69% of the increase resulted from greater social welfare spending, spent mostly on increased unemployment benefits and the universal grants. Most of the resources allocated to social welfare in the pandemic relief plan were devoted to social protection programs for those who lost income due to the crisis, with only a small portion allocated to social investment programs aimed at developing human capital and adapting workers to the labor market.

Israeli governmental policy will benefit people with disabilities and senior citizens, but it may make things worse for those living in poverty. On the one hand, the government plans to continue with measures that were underway before the crisis and that aim to improve the way in which the needs of senior citizens and people with disabilities are addressed. On the other hand, planned policy for families with children could potentially worsen their status and raise the incidence of poverty among this population, due to stiffened eligibility criteria for unemployment insurance and a failure to address limitations within the income support program.

The labor market’s return to proper functioning in the second half of 2021 made it necessary to adjust the unemployment insurance program to the new reality and to strike a new balance between protecting the jobless and encouraging unemployment recipients to return to the labor market. 

It was decided to take a major step to strengthen the National Insurance Institute’s financial strength by raising the retirement age for women who can get a pension. 

No progress on implementation of the recommendations of the Committee for the War Against Poverty (the Elalouf Committee. In 2020, progress was made solely in the sphere of education, while there was no progress, and in fact reduced investment, in housing, employment and economic areas. 

The Covid-19 pandemic has driven mortality levels significantly upward, as 60% of Covid-19 deaths here occurred in the year now ending. The new variants (at least until Omicron) have raised the case fatality rate for the disease among younger people, which will push life expectancy in 2021 down to 2016-2017 levels. Pre-pandemic death patterns will probably not return because vaccination rates worldwide remain low and this allows more variants to emerge and spread across the globe and kill more people.

Israeli fertility rates are higher than those of other developed nations, but the patterns are changing: Between 2018 and 2020, even before the pandemic hit, Israeli fertility rates fell sharply in all sectors. In 2020, the fertility rate for Jewish women was 3.0 children per woman, while for Christian women the rate was 1.83 – a decline of 0.2 children in both population groups. In the Druse sector, the fertility rate dropped to 1.94 children per woman – a first-ever dip below 2.0 children – while in the Muslim sector fertility rates have steadily declined, reaching 2.99 in 2020. 

Surprisingly, the pandemic led to a rise in fertility rates among Jewish women in Israel, the opposite effect compared to many other countries where the crisis resulted in lower fertility rates. Jewish births up to December 2020 in Israel were the result of pre-pandemic conceptions, and the general fertility rate for Jewish and other women was below that of 2019, but by March 2021, the general fertility rate had climbed above the 2019 level, and between March and September 2021 there was a rise of six percent in the number of births to Jewish women. The general fertility rate for Arab Israeli women dropped until February 2021, after which it recovered slightly, but overall it has remained below the 2019 rate. Had the pandemic not erupted, the fertility rate of Arab Israeli women would likely have fallen even lower.

Immigration to Israel has grown in recent years. There has been a rise in the number of immigration files opened and on growing interest in Israeli real estate on the part of foreign buyers impressed by Israel’s relatively successful handling of the pandemic in its early stages. Likewise, no major wave of returning residents was observed in the wake of the pandemic.