The writer is the Dean of the Campus of the Ono Academic Campus
Earlier this week, I learned from a press release issued by the Gilour Committee that the intention of Welfare Minister Meir Cohen to appoint me as director general of the National Insurance Institute has not been approved. The committee (to be honest, I do not even know who the third member who sat next to the two permanent members of the committee) – I can not refer to it.
However, as someone who has been educating generations of law students since 1995 on the importance of protecting the rule of law institutions even if you do not agree with their decisions, because otherwise “each other’s life is swallowed up” – I presume the correctness of the procedure, and move on. I would like to share the main points of the plan I presented to the job search committee in March, because even without me (I do not write this in pious modesty) this is what is really important to do in order to make the institution what it should have been: the country’s social security arm. Adversity and poverty.
Accessibility for the entire population
Two preliminary remarks: The first is that in recent years we hear in the morning news media about “revolutions” at the institution. The inclusion of any new disease in the book of defects (a previously unpublished routine act) is externalized as a “reform”, any technical relief in the eligibility test is celebrated, etc. Without underestimating the importance of these welcome steps, they are in the power of “paracetamol” for a body that needs antibiotics and urgent surgery. They are just polishing the shortcomings of the method, and not changing it. The second note is that I did not write the program on my own, based on the professional experience I have gained in the 30 years I have worked with and with the institution, but together with dozens of experts – most of them Mossad retirees who have provided the internal perspective.
I called the program “from the Range Rover model to the bicycle model”, out of a perception that the Range Rover is a car that few can buy and even fewer are able to drive in difficult terrain conditions, while Social Security should be like an off-road bike. With a little help, anyone can buy them, and more importantly – anyone can ride them even in a disaster area. The bike can be easily adapted to different situations, just as Social Security should be accessible to everyone and tailor unique solutions to each situation.
The model was based on several key changes: The most important of all is a technological solution for data collection, which will enable a tailor-made policy for everyone in need. Today, the National Insurance Institute has dozens of separate computer systems, some of which are 50 years old, that do not “talk” to each other. The “Tevel” project, which began 12 years ago and consumed (as of 2020) more than NIS 800 million, was supposed to take care of it – but it is stuck. This is despite the fact that the State Comptroller sharply criticized it in 2019.
We saw the result in Corona: there was no way to know who needed immediate assistance, and to what extent, to survive. Therefore, the government had to distribute money to everyone in a destructive way. I was exposed to this when I advised Prime Minister Benjamin Netanyahu in real time to do so, because there was no knowledge that would allow for a selective and informed division. Connecting all the systems for the purpose of producing a comprehensive and accurate picture of the situation of each citizen, will enable the automation of the rights that will shorten procedures. Instead of a distressed citizen applying for a pension after he has understood his right at all, the National Insurance Institute will draw the data from time to time from other authorities’ computers – and the citizen will be notified of his eligibility directly for the institution’s unique application. This way is not only good for the citizen, but also very effective for the institution.
This can also be done with uncertainties, such as disabilities. For example, if a serious illness is discovered or surgery is performed, the institution will proactively and periodically draw the summaries of treatment from the hospitals – and will match the data found with it. At the end of the process, without a committee, the benefit will be sent to the citizen without delay. In this way it will be possible not only to streamline and alleviate the person himself, but also to the heavy burden of the medical committees. In addition, disabilities, chronic diseases and amputations will not require renewal from time to time. There is no reason to harass a citizen who suffers anyway.
Medical committees not in the institution
This leads to the second major change required: the removal of the medical committees from the National Insurance Institute to the National Medical Examinations Authority to be established. I have accompanied thousands of insureds to the medical committees, and I know the rage against them. The problem is not with the dedicated staff of the institution, but with the workload and the minority of specialist doctors. When an independent authority is established that will serve all the authorities, the number of experts will be increased, waiting times will be shortened and an independent decision will be guaranteed. The examining body and the body granting the allowance must not be one. It is not possible for the committee to include institutional officials and doctors who receive salaries from the institution on a regular basis.
The third change in its importance is beyond cheap preventive work, instead of expensive retrospective treatment. Today, medical committees are waiting for a worsening of the condition to increase assistance. It’s a mistake. Early eligibility should be given to prevent the aggravation that will prevent unnecessary suffering and save the budget. In this context, a social security mobility network will be re-established that will make the service accessible in the routine of life, a Case Manager will be appointed for multi-problem citizens, and more.
Structural changes
In fourth place are structural changes that need to be made in the National Insurance Institute. First, in the corporate governance established by law at the beginning of the state. The institution is managed by a council, most of whose members are representatives of the Histadrut and employers’ associations. That is, the duty of loyalty is towards another body and the potential for a conflict of interest is great. Thus, for example, the representative of the Histadrut and a representative of an employers’ organization sit on the institutional appointments committee. Imagine that the committee is discussing the promotion of a clerk who refused for professional reasons to comply with the demand of those employers. Is it appropriate for the same Histadrut representative to discuss the case of an official who is a member of a competing list of employees?
We learned from the workers ‘society in the 1980s that the workers’ union must not take part in management. The law must be changed so that the board will be composed of people without fiduciary duties and other interests. An example of another change is the establishment of an intermediate level of district managers between the branch managers and the CEO. The situation is now unlikely. The CEO with a small bureau is directly responsible for dozens of branches.
These are the main changes to the recovery of the institution that I presented to the search committee, which to my delight chose me unanimously. I had hoped to carry them out, but now it is not certain. And yet these are the moves that need to be made, we just have no other choice.