The next health minister
For years, Israel’s health minister could have only one name: Ya’acov Litzman. Now it’s suddenly the other way around: the health minister can be anyone but the man who dominated that unglamorous agency for the better part of a decade.
Not that the hassid-in-chief’s performance made his boss unseat him; Benjamin Netanyahu couldn’t possibly afford this, ever since he turned ultra-Orthodoxy into the Likud’s strategic partner, and the health system into this political wedlock’s dowry.
Litzman is leaving on his own volition, and his undisclosed reasons no longer matter. What matters is that the ministry he is leaving has suddenly become the public sphere’s most important spot.
Whatever Litzman’s full record, it was clearly impacted by his sectarianism, at a time when he should have been guided by nothing but the national interest.
For that alone Litzman should have been removed, regardless of his inability to communicate with the general public at a time of supreme medical crisis, and even if he were not passive in his ministry’s board meetings during the plague, as reports claim he has been.
These intriguing questions are right now immaterial, because the question today is who will succeed Litzman and what he or she should do.
ONE GOOD candidate has already stepped aside, shamefully.
Blue and White’s No. 2, Gabi Ashkenazi, was a natural candidate not only because of his hierarchical position, but because of his managerial experience.
As commander of the IDF, he oversaw the largest workforce in Israel and launched long-term programs while analyzing changing strategic, technological and social trends. Moreover, as director-general of the Defense Ministry (in 2006-7) Ashkenazi managed a budget 30% bigger than the Health Ministry’s.
Ashkenazi, then, could have brought all the experience and charisma that Litzman so woefully lacked. It would have been the kind of move that Ariel Sharon made in 1990 when he agreed to be housing minister, in order to build thousands of apartments that those days’ migratory influx required.
Alas, the Health Ministry is beneath Ashkenazi, who resolved to be foreign minister. The Foreign Ministry, he apparently thinks, means big prestige, small effort, and even smaller risk. No one ever failed in that position. The Health Ministry, by contrast, means little prestige, huge effort, and these days also big-time risk. Ashkenazi therefore made the selfish, cowardly and antipatriotic choice.
Much has been said of Blue and White’s motivation in teaming with Netanyahu. As one of this controversial move’s defendants, this column is appalled by Ashkenazi’s refusal, which exposes him as the opportunist that Yair Lapid’s people now claim their former ally has been all along.
Fortunately, there are other candidates, some of whom we will soon suggest, but before that a few words about the task that awaits them.
THE PLAGUE did not expose the Israeli health system’s problems, and in fact unveiled its strengths. The uniquely Israeli combination of high birth rates, penchant for improvisation, and public experience with emergencies resulted in relatively low death and contagion rates.
Israeli demographics make the population relatively young, and therefore less vulnerable to COVID19; Israeli improvisation resulted in quick distribution of food for the quarantined and masks for all; and Israeli emergency instincts helped early imposition of, and public compliance with, social distancing’s decrees. Hence the potential conclusion, that the system is healthy. If only it were.
Anyone visiting an Israeli hospital knows the scene: patients crowded bedside to bedside and overflowing to corridors and even the kitchenettes at their ends. Fed by Israel’s high birth rates, the statistics behind such scenes are appalling.
The number of hospital beds per 1,000 people has plunged from 2.33 in 1995 to 1.78 two years ago, according to the Health Ministry, and less than half the comparable ratios in France (4.14) and Poland (4.95), according to economist Dan Ben-David of Tel Aviv University and the Shoresh Institution.
Israel’s average hospital occupancy rate is 94.3% as opposed, for instance, to Belgium’s 78.6%, France’s 75.2% and Holland’s 48.8%.
The crowded hospitals explain why Israel’s rate of deaths from infection and parasitic diseases is the highest in the developed world, soaring from 22 per 100,000 people in 1975 to 35 last decade, as opposed, for instance, to 16.8 in Chile, 13.5 in Holland, and 5.5 in Finland.
While the population grows and the hospitals brim, Israel’s production of medical staff is stagnating, with 15.8 nursing graduates per 100,000 people, the lowest in the developed world. So is the ratio of medical school graduates, 5.1 per 100,000 people, as opposed, for instance, to 7.5 in Canada, 11.5 in Finland, and 20.3 in Ireland, according to Ben-David.
These are all symptoms of severe ministerial neglect, whose treatment – by building hospitals, training more nurses, opening medical schools, and confronting on this front the medical establishment’s mandarins – is what the next health minister will have to do.
Who can it be?
It might have been MK Orna Barbivai, the former commander of the IDF’s personnel division, who brings the managerial and planning record this task requires. Unfortunately, she is trapped in Lapid’s fold, and is therefore unavailable.
Another candidate is Prof. Masad Barhoum, director of the Nahariya Medical Center and co-founder of
Bar-Ilan University’s medical school in Safed. However, as a nonpolitician he would lack the political tools that rebooting the health system demands.
There is another candidate: Isaac Herzog.
The 59-year-old Jewish Agency chairman would bring managerial skills like Barbivai’s, devotional leadership like Barhoum’s, the political savvy of a former head of the opposition, and all the compassion and humility that Ashkenazi evidently lacks, and Herzog, as welfare minister in 2007-11, displayed.
Herzog would be agreeable to both Netanyahu and Gantz. He would threaten no one, serve everyone, and hopefully restart everything.
www.MiddleIsrael.net The writer’s best-selling Mitz’ad Ha’ivelet Hayehudi (The Jewish March of Folly, Yediot Sfarim, 2019) is a revisionist history of the Jewish people’s leadership from antiquity to modernity.