BGU | MY PATH, Haim Doron, MD

colleague, the chair of the Knesset finance committee, and they immediately passed an ordinance stipulating that an institution that received state funding couldn’t raise the earning power of its employees. Thus, they tied the hands of Clalit and in one stroke had abolished the sesión . Another problem with Clalit’s subordination to the Federation was that criticism of the Federation and the struggle against it led to unnecessary and undesirable criticism of Clalit. Such flak was reflected in part of a conversation I once had with Yitzhak Navon 127 in a visit at his house. We were on friendly terms, and Navon said to me, “You go to crazy lengths and invest great efforts in strengthening the Sick Fund, but the Sick Fund is ‘Federational’, and the Federation is hated by the public”. If I had to boil down Clalit’s subordinate status under the Federation to one sentence, I would say that Clalit was a non-governmental institution of almost governmental magnitude and outlook. That was the biggest inner contradiction why Clalit couldn’t remain forever and ever subordinate to the Federation. Bills to Legislate National Health Insurance Social insurance and national health insurance were always a central issue in my thoughts. The first commission that dealt with proposing a National Health Insurance Law was appointed in 1957. It was headed by Yitzhak Kenev; 128 and it presented its conclusions in 1959. The commission’s conclusions led to establishment of Israel’s National Insurance, or social security scheme, called Bituach Le’umi. Legislative proposals for health insurance then became a core political issue and one of the major differences in the platforms of the various parties. In the first decades after statehood, Ben-Gurion championed the “scaffolding doctrine”. He held that after establishment of the state there was a need to dismantle the scaffolds, and all systems needed to become state systems. Ben-Gurion dismantled the Jewish community’s leading pre state militia, the Palmach, to create one army, the Israel Defense Forces (IDF); established a state-run labor exchange; and abolished separate educational streams by putting in place a free state public education system. Ben-Gurion held the same position regarding a national health system. His outlook stood contrary to the interests of the Federation and “United Dues.” Over the years, there were various committees to propose health insurance legislation. Based on the identity of the chair and his or her political views, one could know what would be the conclusions. Persons from the right wing favored nationalization of medicine. For example, the 1977 committee was headed by Prof. Ezra Zohar, an internal medicine department head at the Sheba Medical Center with right wing views who championed nationalization of medicine. And so, it usually went. Yet, Victor Shem-Tov 129 was a Minister of Health who advanced the cause of a national health insurance law even though such a stance was contrary to his political affiliation as the leader of Mapam party. The crux of the differences among all these committees focused on the question of whether health insurance would be carried out through the existing sick funds, or ones that would be established for this purpose, or by nationalizing medicine along the lines of the National Health Service (NHS) in the United Kingdom. What was the difference between the two? The character of funding sources. In the United Kingdom there were not, and are not, multiple sick funds as service providers – only one monolithic state-run service, the NHS. In addition, the source of most of the NHS’s revenue comes from state budgets. In contrast, among sick funds in the western world operating within the framework of social insurance, financing is based in part on the insured and in part on the employer. 127 Yitzhak Navon (1921–2015) was an Israeli politician, diplomat, and author. He was a member of the center-left Alignment Party and served as the fifth President of Israel between 1978 and 1983. 128 Yitzhak Kenev (1896-1980), formerly Kenyevsky, was an Israeli economist, among the leaders of the Labor Federation, and a Mapai Party parliamentarian in the first Knesset. He served as chair of Clalit, director of the Labor Federation’s social research institute, and was among the architects of Israel’s National Insurance Institute. In 1962, he was awarded the Israel Prize in social sciences. 129 Victor Shem-Tov (1915–2014) was an Israeli politician who held several ministerial portfolios in the late 1960s and 1970s. Shem-Tov was from the most doctrinaire faction of the Ma’arach Labor Alignment Party and the Federation’s collectivist worker-owned economic and social entities.

74