A few months ago, the director of the Maccabi Health Maintenance Organization, Ran Sa’ar, summoned Prof. Nachman Ash, then head of Maccabi’s health division, and currently the newly appointed head of the government’s efforts to fight the coronavirus, for a conversation. At that meeting on July 27, Sa’ar dismissed Ash from his position at Maccabi, where he had been for six years, accusing him of serious mismanagement of the division. It was a painful moment in the two officials’ relationship, which had reportedly been cloudy for years. Ash left the meeting surprised and hurt.
Sa’ar said he fired Ash because the latter had released thousands of coronavirus patients with Maccabi health insurance from quarantine: On July 22, a week before their meeting, the Health Ministry said that confirmed carriers could stop quarantining after 13 days if approved by a physician, with no need for a coronavirus test. Maccabi had to act quickly release the thousands of patients in quarantine, and Sa’ar claimed that the process was not carried out satisfactorily.
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There were other reasons for his dismissal, Sa’ar told Ash, among them Ash’s angry outbursts at other Maccabi executives on some occasions, his refusal to transfer workers from his division despite Sa’ar’s requests, and his responsibility for problems with Maccabi’s strategies and medical systems. Finally, Sa’ar said, Ash had no vision and mainly dealt with the ongoing operations of his division. Sources said that this claim, which Ash heard for the first time after six years in the position, shocked him.
A few days after the meeting, Ash sent Sa’ar a sharply worded letter in which he responded to Sa’ar’s complaints and listed some of his own, among them mistaken decisions and restrictions on his own work. Ash also claimed that Sa’ar had removed him from his position to appoint another executive he wanted for the job.
The conflict between the two stayed below media radar because the parties decided it would be better to settle the matter quietly with Ash’s voluntary retirement. According to sources, nothing revealed the tensions between the two at Ash’s retirement ceremony. “Although Sa’ar doesn’t tend to be emotional, he … related to Ash very warmly,” said Dr. Miri Mizrahi-Reuveni, who was deputy director general for strategy at Maccabi at the time.
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According to sources in the health care system, including within Maccabi, Ash’s actions during his tenure were impeccable and the HMO functioned well during the pandemic. They say that Ash fell victim to a longtime struggle within Maccabi’s leadership and there was no professional reason to fire him after six years at his post. But those same sources said that Ash also fell victim to some of his own character traits, which might serve him poorly in the leadership of a large organization.
‘An officer and a gentleman’
It’s hard to find anyone in the health care system who has anything but good things to say about Ash. People who spoke to Haaretz said he is professional, honest, a hard worker and works well in a system. “Maccabi jumped a few steps in many areas during his tenure – bringing Artificial Intelligence deep into service, advanced blood testing like the colon score for detecting colon cancer, bringing in the K Health system (“the robotic doctor”) and many other innovations that require leaving the comfort zone of classic medicine,” said a senior physician in community medicine.
Ash left the career army, where he has served as surgeon general, in 2011 and was appointed senior deputy director general for health informatics in the Health Ministry. From there he moved on to his position as head of Maccabi’s health division in 2014. “At first he was very strong in the HMO and some marked him as a replacement for Ran Sa’ar as director general. But in recent years that changed,” a source in the health care system said. According to the source, there were disagreements between Ash and Maccabi’s director general for finance, Zion Uliel, considered a strongman in the HMO. During the coronavirus crisis, at some meetings Ash angrily spoke out at Uliel when the latter suggested that Maccabi stop sending coronavirus tests to hospitals due to economic considerations. According to sources, over the past year the relationship between Ash and Uliel soured further.
In May, Ash applied for the position of director general at the Leumit HMO, and according to sources in the health care system, he was supported by officials within Maccabi. Some sources said this was seen as a way to show Ash the door at Maccabi. Others said that efforts at Maccabi to help Ash get the position at Leiumit were so obvious that some at Leumit wondered why, if he was so good, would Maccabi let him go. Another source said it’s natural to assist a person who has reached the ceiling in his current position to find a good position elsewhere. Ash made it to the last cut at Leumit, and then lost to Leumit’s CFO, Haim Fernandes. A source familiar with the details said he put up a good fight, “But in the end he fell because of his weaknesses, mainly his lack of charisma. He is greatly respected, he’s ‘an officer and a gentleman,’ but that’s not enough to be director of an HMO,” the source said.
A senior source in the health care system who knows Ash says of his appointment as coronavirus czar: “Nachman isn’t coming to the job out of distress, certainly not economic. He has his military pension and work in academia. Money or recognition don’t interest him, nor does media exposure. He’s not stupid and he knows this job will come with a lot of hard knocks. He comes out of a sense of public duty. A politician he’s not, for better or worse.”
Ash said in a statement: “I worked at Maccabi for six years as head of the health division. I got the most out of the position and I decided to continue to other roles. I thank Maccabi’s leadership and devoted employees for my period of service at Maccabi. Today, as Israel’s coronavirus czar, all my actions and thoughts are in one direction only – the national and most important challenge these days, dealing with the virus for the Israeli public.”