Although the cost of the basket of health services provided by the four health funds rose to more than NIS 32 billion last year, the erosion in public funding for updating the basket continues, according to a report published on Sunday.The report by the Health Ministry’s economics and health insurance branch was released 17 years after the National Health Insurance Law was introduced, ensuring basic health coverage for all. The data was compiled by Daniela Arieli, Dr. Tuvia Horev and Nir Kedar.Among its highlights are: • Clalit Health Services, the largest health insurer, continues to lose members to its three competitors. Compared to 63.2 percent of the population in 1,195, only 52.5% are members of Clalit today. Nevertheless, more Israeli residents joined Clalit last year than left it.• Despite numerous opportunities each year to switch health funds, only 1.3% of residents did so in 2011.• More than 45% of new immigrants decided to join the second- largest insurer, Maccabi Health Services.• Clalit is the largest health fund in all districts, except for the Tel Aviv metropolitan area, in which it has 45% of all residents as members. Kupat Holim Meuhedet, the thirdlargest, insures 37% of all Jerusalemites, and in the settlements, Leumit and Meuhedet are the most popular.• Maccabi members are more likely to be well-off financially than members of other health funds.• Seventy-four percent of all Israelis pay for supplementary health insurance from their health funds. This rate has been steady for the last few years, but higher than the rate between 1999 and 2008. The cost of supplementary health insurance is the average Israeli’s biggest expense (32%) for healthcare after annual health taxes deducted by the National Insurance Institute. The nextlargest household expense for health is dental care (24% of all health costs).• The top fifth of socioeconomic groups spend 3.1 times more on healthcare than the lowest fifth.• Health taxes cover 54% of national health expenditures; the Treasury covers only 39%. The rest is covered by copayments from residents, though the share of copayments has declined somewhat in the last few years.• The Treasury has allocated less for healthcare in recent years to make up for growth in the population, which was said to be just 28% between 1995 and 2009, even though actual growth was 50% during that period. In addition, the government does not increase its health allocations enough: Costs of healthcare rose 94% during this period, while health allocations rose only 72%.• The addition of new medical technologies at the Treasury’s expense rose 1.36% in 2010 and 2011, compared to only 1.1% between 1998 and 2009.Deputy Health Minister Ya’acov Litzman, in commenting on the report, said it showed that “we must continue reducing copayments.”The ministry, he said, “will continue to encourage competition among the health insurers.”Ministry director-general Prof. Ronni Gamzu added that the National Health Insurance Law of 1994 was a “revolution in the health system.” He said that more must be done to preserve the principles of the reform and prevent additional erosion of the health basket by getting more state funding for healthcare.The next major challenge is to reform geriatric nursing services so that members pay less and enjoy more benefits, Gamzu said.