Treasury Pushed Trajtenberg Panel to Write Glowing Report on Health System, Minutes Show

Finance Ministry director-general steered social-justice committee away from reaching conclusions, minutes show.

Ronny Linder
Ronny Linder
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Ronny Linder
Ronny Linder

The final report of the Trajtenberg Committee, which had been set up to identify and suggest solutions for various Israeli social ills, didn't have much to say about the health care system, to the surprise oftop Health Ministry officials.

Despite problems in public medical care, the report praised the system as "one of the world's best."

Now, with the release of many of the minutes of the committee's meetings, there is an explanation for the panel's purported neglect of the health care issue. It turns out that the Finance Ministry staged a coup over the committee's discussion of the health system.

The minutes reveal that Gal Hershkovitz, the state budget director at the treasury, dominated the debate and steered the committee away from reaching any decisions.

When committee members were shown data demonstrating that Israel spends less on health proportionately than other developed countries, Hershkovitz said this was due to the lower proportion of elderly people in Israel. Taking that into account, Israel spends more than other developed countries per capita, he contended.

The committee's deliberations coincided with a nationwide doctors' strike. Striking physicians drew inspiration from the 2011 social protests, leading to mass resignations and abandoning of hospital wards. During the committee discussions, when somebody pointed out that the doctors would tend to disagree with him, Hershkovitz'cynically replied that they want to narrow social gaps but refuse to compromise in their negotiations.

In reply to further questions, Hershkovitz stated that resident physicians gross NIS 19,000 a month, placing them in the upper decile. When told that this includes overtime, he agreed that they work long hours, as do many in other professions.

In other discussions of central issues such as education and cuts in defense spending, health issues were always relegated. Hershkovitz implied that health issues were secondary to the main issues at hand. He also refused to entertain discussion of reform in subsidies for health care, as proposed by Deputy Health Minister Yaakov Litzman following the raising of the health tax. Only small changes were introduced in the end.

Overall, the Trajtenberg committee's health recommendations conformed to the wishes of the treasury and the National Insurance Institute. No Health Ministry official ever even appeared before the committee. The only health issue Hershkovitz was willing to address was a call for a firm commitment against any privatization of services in government hospitals. The final recommendations sang the praises of the system. The only operative recommendation was to improve regulation of private health insurance services and increase their transparency.

Gal Hershkovitz: Doctors are among the 10% of highest earners.Credit: Emil Salman
Israel's cabinet discussing the Trajtenberg Committee's recommendations on October 29, 2011.Credit: Mark Israel Salem