The military will again allow health maintenance organizations to compete over insuring soldiers serving on major bases in the country's central region.

The decision by Chief Medical Officer Dr. Nachman Esh follows orders on the matter from the Israel Defense Forces deputy chief of staff.

In April 2008, the IDF held its first tender for HMOs to offer their services to soldiers serving in the central region.

The move came as the military announced plans to close its clinics at the Kirya defense compound in Tel Aviv and at the Tel Hashomer conscription center.

The tender, however, was canceled amid Health Ministry concerns that outsourcing health care would upset the delicate balance between Israel's four HMOs.

Now, with full Health Ministry backing, the IDF Medical Corps will renew the tender under new conditions by which two HMOs will initially be chosen to offer health care to troops (each soldier will decide which of the two to use ).

After 18 months, all four HMOs will join the new arrangement.

The new regulations stipulate that the HMOs will offer a more comprehensive service basket than the one currently offered, including orthopedics and treatment for infectious diseases. They also call for creating an occupational therapy unit tasked with granting soldiers exemptions from certain army directives for various medical ailments.

Pilot program

The Medical Corps views the initiative as a pilot program, and should it prove successful, will consider expanding it to soldiers on bases around the country over the next few years.

The goal, army officials said, is to reduce the heavy patient load of on-base clinics while devoting more resources toward improving field medicine.

The program is also aimed at encouraging competition between HMOs, and letting patients switch between them to receive optimal service.

Last year just 1.5 percent of Israelis switched their health-care provider.

The Health Ministry said in response, "The IDF's original tender for allowing one HMO to offer medical services was frozen due to ministry opposition. The new formula, in which all four health-care providers will take part ... was suggested by the ministry as a compromise allowing the IDF to transfer responsibility for offering services to the HMOs, and at the same time not impede competition between providers."