The Finance Ministry, together with the health and justice ministries, is planning a major reform in the health maintenance organizations.
The Economics Arrangements Bill for 2007 contains a proposal to bring an end to the reign of the HMO managers, and pass control of the HMOs to representatives of the public.
Thus the public, for the first time, will have control over NIS 24 billion which it pays the HMOs every year. The HMOs are currently run by their managers with no supervision.
This is the fourth time in the last seven years that the treasury has proposed a reform of the HMOs. It hopes this time the reform will be approved, in the wake of the managerial collapse of the Meuhedet HMO. This collapse proves the need for structural reform is very great. The three previous times, the reform was not approved owing to the opposition of the HMOs' lobby in the Knesset.
Two people who stood to lose the most from the reform headed the lobby: Amir Peretz, who at the time headed the Histadrut labor federation, which would be finally and completely severed from the Clalit HMO, and Abraham Hirchson, who headed the National Workers Organization, which would finally lose its control over the Leumit HMO.
The finance, health and justice ministries assume that now these two have been appointed to senior cabinet positions, Peretz and Hirchson will no longer be able to block the reform, especially taking into account the dire state of Meuhedet.
As well as transferring control of the HMOs to the public, the reform would put an end to the tenure of their managers, including Leumit HMO chairman Michael Zoller and Meuhedet chair Rivka Sharir.
Zoller is an ally of Hirchson, and serves as chairman of the HMO on behalf of the National Workers Organization. Sharir has managed to create chaos in the Meuhedet management, after insisting on the appointment of her confidant Shmuel Muallem as CEO. The appointment was made in violation of regulations, without a search committee and in defiance of Health Minister Yacov Ben-Yizri, who intervened and stopped the appointment.
Since then, a search committee has been appointed, but it is suspected that the committee is a rubber stamp solely to approve Muallem's appointment. This affair is one of the reasons the treasury is promoting the reform.
The Clalit HMO has had no chairman since the death of Prof. Dan Michaeli.
Under the bill, two thirds of the HMOs' council members would be chosen by a public committee, headed by a judge. The other third would be chosen by the existing HMO managements. The bill also says a third of the directors would be representatives of the public, who would be chosen by a judge. The rest would be chosen by the council, in which, as mentioned above, the public representatives constitute a majority.
The bill also raises the requirements for chairmen and CEOs of HMOs, and for the first time imposes restrictions on these positions. The chair of an HMO would be a public representative, and would be chosen from among the public representatives on the board of directors. Additionally, the chairman would require the approval of the civil service appointments committee.
CEOs would only be chosen by a search committee, which would be a public committee headed by a judge. The judge would have a veto on the choice of CEO, who would also need the approval of the civil service appointments committee.
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