Health Minister Ya'acov Ben-Yizri has paralyzed his ministry's supervision of the four public health funds because of a dispute with the ministry's deputy director-general, Yoel Lipschitz. The minister is furious with Lipschitz, an expert in medical technology assessment, for having subverted him in a letter earlier this month to a health fund director. Lipschitz had criticized Ben-Yizri's decision to cancel a supplementary health insurance policy providing lifesaving medications not included in the state's basket of health services. Ministry legal adviser Mira Huebner had said the restrictions set by the minister were much too severe. The incident reflects the chronic tension between the minister and his senior management that was exacerbated two weeks ago when Ben-Yizri agreed to cuts in subsidies to the health funds and provisions mandated by the Treasury that are opposed by Health Ministry professionals. Lipschitz sent the letter to Nissim Alon, director-general of Kupat Holim Leumit, who in a letter to Ben-Yizri had warmly praised the health minister for cancelling benefits for extra medications to members of Maccabi Health Services and Clalit Health Services. Leumit does not offer a supplementary policy that offers drugs outside the basket. When Ben-Yizri learned of Lipschitz's initiative, the minister, from the Gil Pensioners Party, sent a scathing letter to Lipschitz reading: "From this moment, all correspondence emanating from you or your branch that is meant for all senior management levels in the health funds, including the chairmen, boards of directors, directors-general, deputy directors-general and so on, on the matter of the health funds may be dispatched only if and when they receive prior approval in writing from the ministry's director-general [Prof. Avi Yisraeli]." Ben-Yizri added that a meeting with Lipschitz, in the presence of Yisraeli and Huebner, had been scheduled for Thursday after the minister returned from a vacation abroad. Ben-Yizri's wording of the letter to Lipschitz - a Brooklyn-born economics and law graduate who has worked for more than 10 years in the ministry - ignored the advice of Huebner, who wrote in a letter the next day that Ben-Yizri's missive was "exaggerated, excessive and needlessly interfering with the workings" of the ministry branch that supervises the health funds. Huebner said the minister's letter to Lipschitz could only be interpreted as "an error" and that "a corrected letter that represents the summation" she reached with the minister's office should be sent instead. Huebner wrote to Ben-Yizri that the version of the letter he had signed "was not the version coordinated with me." Her version, she said, would have required Lipschitz to forward letters for approval only if they were addressed to senior health fund officials and advocated amendment of legislation proposed by the government regarding supplementary health insurance. "This was the version read to me on the phone by your bureau chief, Ms. Levi. But the letter dispatched with your signature demands approval in advance (and in writing) 'on all health fund matters,'" Huebner said. The health funds' supplementary insurance policies were approved after months of negotiations between them and Lipschitz. Although Ben-Yizri agreed in April that first Maccabi and then Clalit would be allowed to provide lifesaving drugs outside the basket of health services to those who took out the expanded health insurance policies, the minister suddenly canceled them, saying they "discriminated" against the 20 percent of Israelis who haven't purchased such policies. Lipschitz's letter - which he wrote before Ben-Yizri acceded to pressure from the Finance Ministry and after protests from private health insurance firms that they were losing customers to Maccabi and Clalit - did not criticize the minister, but did take Alon to task for his views on the supplementary policies of two of Leumit's competitors. The expanded policies encouraged tens of thousands of Maccabi and Clalit members to purchase the expanded coverage, and hundreds of patients who could not get expensive drugs because they are not subsidized by the government began to get them. Ben-Yizri's personal spokesman Tal Harel told The Jerusalem Post Huebner had been asked to give her opinion before Ben-Yizri wrote the letter to Lipschitz, "but her view - while legitimate - was different from that of the minister, who decided nevertheless to send the version he himself had written. Mira Huebner is our legal adviser and does excellent work, but after the minister considered the matter, he decided to send his own version. It is completely legal." The minister's letter was "his prerogative to write, and we believe that the legal adviser will defend it," Harel said. The minister, said Harel, "hopes to sort out the matter in the Thursday meeting. Ben-Yizri is "very happy with Lipschitz's work with the health funds but not pleased about his statements" in the letter to the Leumit director-general, Harel added. Harel said Ben-Yizri "publicly admitted he made a mistake about approving the expansion of supplementary health insurance policies to include drugs not included in the basket. Few ministers admit errors." Asked whether the decision to cancel the extra coverage was a mistake, Harel said: "The public will decide." Asked whether the cancellation would force people to take out more expensive private insurance, Harel said: "People who can afford private insurance can go and purchase it. The responsibility for the public basket of health services is on the government and the health minister." Harel said he did not know if Lipschitz had yet sent letters addressed to health fund personnel to Yisraeli for preapproval as ordered by the minister, but added: "I hope he has." Health Ministry spokeswoman Einav Shimron-Greenbaum toldThe Post that "ministry management is not interested" in commenting further on the matter.