People don't understand billions. No one has ever seen a billion shekels and people can't conceive of its significance. On the other hand, everyone understands hundreds and thousands. They are used to thinking in those terms.
Prof. Cyril Northcote Parkinson cites an example of this in his book, "Parkinson's Law." The chairman of a budget committee presents two subjects for consideration. The first is a proposal to build a nuclear reactor to produce electricity at a cost of $9.5 billion. The committee members present are told the facility has received all the necessary scientific go-aheads, and because nobody understands the billions, or the subject, the debate lasts two and a half minutes, and the reactor is approved without the addition of even one comma.
The second subject on the agenda is the construction of a structure for holding bicycles. The cost, in our terms: NIS 3,350. This is a sum that everyone understands. Everyone has had a few thousand shekels in his or her hand at some time or another.
One person suggests a plastic roof instead of aluminum. Another says the structure isn't necessary at all - that bikes can lean against the wall. And so the debate drags on for two hours, with great passion, until finally it is decided that the contractor's proposal will be cut by NIS 400. The members of the budget committee come out very pleased with themselves over the savings they have effected.
Parkinson formulated the following law: "Time devoted to discussion of any element of the agenda will be in reverse proportion to the amount of money involved."
Parkinson's law is true in Israel as well. When the subject was disengagement, the cabinet had a short debate and allocated NIS 5.4 billion to it. Later, in the Knesset, a committee headed by MK Avraham Shochat tacked on another NIS 1 billion for compensation to the settlers. Because, after all, what's a million shekels between friends, and who understands huge sums like that anyway?
Finance Minister Benjamin Netanyahu went even farther and agreed that the amount earmarked for disengagement in 2005 would not be cut from other ministries, but rather would come from an increase of 3 to 3.4 percent of the gross domestic product (GDP).
In contrast to the brief discussion of the billions, today the cabinet is to consider increasing the health basket by NIS 85 million. That is lower and more comprehensible than the billions, and therefore it has been debated for several months by a special 21-member committee headed by Prof. Bolislav Goldman.
Each committee member has an opinion. Some want to increase the budget for medicines, others say spending on technological procedures should increase, because it's better to diagnose heart disease (for example) among the whole population than to lengthen the lives of a few terminally ill individuals for a few weeks.
And on and on.
As opposed to his decisions concerning disengagement, Netanyahu is not willing to increase the deficit in this case. The increase would only be 0.01 percent (that is, the deficit would increase from 3.4 percent of the GDP to 3.41 percent). Netanyahu says we must keep our principles. But wait a minute - what about disengagement?
Increasing the health basket cannot be said to be an action that impairs growth or the desire to work. It is not an increase in benefits for income supplements, but rather an improvement in the treatment of the sick, which is the basic obligation of a country to its citizens.
True, rich people can always buy better medicine. That's the way of the world. But the state must provide all its citizens with a reasonable minimum, and updating the health basket is that minimum. It's inhuman to let people suffer and die just because they can't afford expensive medications. But if you add on funding for health, why not add on for the war on road accidents, for teenage girls at risk, for the war on drugs, for the police to fight violence? In other words, it is still better not to increase the deficit, but to find the money wherever possible.
For example, in research funds. Hospitals hold afternoon and evening activities by means of research funds, which total about NIS 1 billion annually. Can't some of this money be diverted to the health basket?
And shouldn't the Health Ministry be streamlined? No other Western country has the redundancy and waste that we have. No other country serving a population the size of the one in the Dan region has three cardiac departments: at Wolfson Medical Center in Holon, Sheba Medical Center in Tel Hashomer, and Ichilov in Tel Aviv. Jerusalem also has three cardiac units - at Shaare Zedek Medical Center, Bikur Holim and Hadassah University Hospital, Ein Karem. And there are other examples of redundancy: three ophthalmology units in Haifa, at the Carmel, Bnei Zion (Rothschild) and Rambam medical centers. In other words, there are places to streamline and save in the Health Ministry under Dan Naveh, and the money that is saved could be channeled to improve and update the health basket.
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