The highest levels of government have turned down a request by the
Hadassah Medical Organization (HMO) for a major financial gift to reduce
the group’s severe short- and long-term deficit, which totals NIS 1.6
At an unpublicized meeting in the Prime Minister’s
Office two weeks ago, senior government representatives suggested that
if the Hadassah Women’s Zionist Organization of America (HWZOA) – which
owns HMO’s two Jerusalem medical centers – were to forgo some of its
ownership of the hospitals and transfer their management to one of the
country’s four public health funds, a deal could be worked out, The Jerusalem Post has learned.
the meeting were Prime Minister Binyamin Netanyahu, Finance Minister
Yair Lapid, Health Minister Yael German, HMO director-general Avigdor
Kaplan, HWZOA national president Marcie Natan, and a number of senior
The world-renowned Hadassah hospitals,
while having a dedicated and talented staff of 5,000 doctors, nurses,
researchers and paramedical and support staff, are also known to have
hidden unemployment, or redundant workers, which makes the hospitals
less than efficient.
The government officials suggested that a
strategic partnership was necessary between one of the health funds and
HMO, whose board of directors includes a majority representing the New
York-based women’s organization.
As there is no mechanism or
precedent for the ongoing transfer of large sums to HMO, the officials
thought that having one of the public health insurers manage the two
hospitals would be preferable. The health funds already receive regular
funding from the government via health taxes and allocations.
to comment, the Prime Minister’s Office would neither confirm nor deny
that such a condition had been proposed. But it conceded that the
meeting had taken place and that the prime minister had instructed
German and Lapid to “establish a team they would head that would work
together with HMO management to implement an inclusive and comprehensive
recovery plan for the hospitals as soon as possible.”
German declined to comment when the Post
asked for a response, as did the Finance Ministry spokesman.
Although the Post
was told on Sunday that a senior HWZOA representative in Israel would comment, no response was forthcoming.
Health funds did not respond to queries either.
The only person involved who agreed to speak to the Post
Kaplan – a former director-general of Israel’s largest health fund,
Clalit Health Services, and chairman of the board of Clal Insurance
Enterprises Holdings until he was named HMO’s first non-physician
director-general a few months ago.
Kaplan said he had initiated the meeting with the prime minister.
favor business cooperation with a health fund – every health fund – on
health services in the community and medical services in the hospitals.
But we will not agree to merging with a health fund or for it to control
HMO or the hospitals.
We oppose that and would not forgo even partial ownership. Hadassah cannot be swallowed up by anybody,” he declared.
there were cooperation with a health fund... we would not close
departments or make dismissals as a result, but aim to improve and
expand our services,” he added.
Medical administrators have
suggested that the most efficient way of running hospital services in
Jerusalem would be to merge Hadassah’s 1,000-bed hospitals with the 850
beds of Shaare Zedek Medical Center, which the Treasury chose earlier
this year to run the bankrupt Bikur Cholim Hospital in the center of
This would allow the closing of redundant departments and units, and allow the consolidation of others.
while the city of Beersheba and the entire Negev, for example, make do
with a single hospital – Soroka University Medical Center – such an
arrangement is unlikely to be considered for Jerusalem because of
tradition going back more than a century, claims of monopolistic
practices, and the three medical centers’ status as employers of many
thousands in the city, among other reasons.
Asked about the claim
that HWZOA had given HMO $129 million less over the past five years for
maintaining its current level of operation, medical equipment and
research – excluding capital investments – Kaplan said that “over the
last seven years HWZOA has given HMO NIS 2.2b. for the new $360m.
hospitalization tower [at Hadassah University Medical Center, Ein Kerem]
and other infrastructure.”
But longtime former HMO
director-general Prof. Shlomo Mor-Yosef – who is now director-general of
the National Insurance Institute – was a popular fundraiser for HMO in
the US. Kaplan is said not to have the time, inclination or charisma to
do the same today.
Kaplan said the government could have
prevented HMO’s distressing financial straits, claiming the government
had “discriminated especially against Hadassah.
It should have given us money for ongoing costs and research.”
pressure from the health funds and inclusion in the Treasury’s
Arrangements Law, HMO is required to give the four public health funds a
25-percent discount on their bills for medical care their members
receive at the hospitals, compared to only 22% at Shaare Zedek and 16%
at government hospitals.
In addition, the “capping” mechanism the
government has set down forces Hadassah and Shaare Zedek to forgo
payment if they provide an “excess” of care to patients. This is meant
to prevent “overuse” and “superfluous care” on the part of the
hospitals, as this would cost the health funds more money.
health fund will take over the running of HMO hospitals. Hadassah is not
suitable for being run by a health fund,” Kaplan reiterated, though he
conceded that “the prime minister was not thrilled by my idea of the
government giving HMO a major grant.”
Still, HMO is “not a
sinking ship. We have not been given any indications that staffers want
to go elsewhere,” Kaplan insisted. “I urge the authorities not to throw
the baby out with the bathwater.
Sixty percent of inpatient and outpatient services in Jerusalem are provided by HMO.”
for which health fund would be capable of taking over the management of
HMO’s hospitals, it seemed clear that Meuhedet – the country’s
third-largest health fund and the second-most powerful in Jerusalem –
would not be up to it; the health fund remains disorganized a few years
after the state comptroller accused officials of corruption, leading to
the dismissal of one director-general and most of its senior management.
The Meuhedet board then dismissed the director-general who replaced
Asher Elhayani, although no charges were brought against him.
Holim Leumit is too small and is in deficit. Clalit has eight of its
own hospitals (excluding Jerusalem), making it unlikely to be considered
for running Hadassah’s two as well.
Maccabi might be the most
logical choice, because it is well-run and insures more than 25% of the
population. It is the second-largest health fund, though it is in
deficit like all the others. Maccabi is currently building – at state
expense, through its private subsidiary Assuta Medical Centers – a
general public hospital in Ashdod that no one else sought through the
But Maccabi also has its critics. Jerusalemites
may fear it would turn Hadassah’s medical centers into private medicine-
oriented institutions like Assuta.
The Ashdod hospital has
government approval for a significant chunk of its activities to consist
of private medical services (sharap) – an arrangement that has been
familiar to HMO and Shaare Zedek for decades, but subject to growing
criticism that it enables those who pay for it not only to choose their
own doctors, but also, in some cases, to jump the queue for operations
and other treatments.
Heads of the HWZOA are used to getting a warm welcome in the Prime Minister’s Office, one senior medical administrator told the Post
didn’t take no for an answer. But the women now understand that they
have to think differently,” the administrator said. “This time they left
the office depressed. The state doesn’t want to give a gift as a
one-time thing. It wants a more stable arrangement.”