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Management and Governing in Social Security Institutions in Israel and Other Countries (Health Care Systems, Pension Systems, National Social Security Systems) / ארגון ושליטה במוסדות הביטחון הסוציאלי בישראל ובעולם (בריאות, פנסיה וביטוח לאומי)

דב פלג and Dov Peleg
Social Security (Hebrew edition) / ביטחון סוציאלי
חוברת‎ 55 (סיון תשנ"ט, יוני 1999), pp. 40-64
Stable URL: http://www.jstor.org/stable/23273959
Page Count: 25
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Management and Governing in Social Security Institutions in Israel and Other Countries (Health Care Systems, Pension Systems, National Social Security Systems) / ארגון ושליטה במוסדות הביטחון הסוציאלי בישראל ובעולם (בריאות, פנסיה וביטוח לאומי)
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Abstract

Introduction. Management and governing are dedicated to serve the aims of society and its institutions of social security. This paper describes briefly the aims in the branches of social security mentioned above. The "players" who are active in these fields are: the workers who are insured and their representatives (trade unions); the employers and their organizations; the government through its relevant Ministries; the insured as consumers through their special organizations and the media. Every "player" has his own interests which sometimes contradict the general aims of the social security institutions. This complicated arena is discussed here with the help of interviews with some of the main leaders of the organizations and the "players", analysis of some official documents and the author's own experience as Chairman of the Social Security Department of the Histadrut. Alternatives of governance (According to the experience of the developed countries, particularly Israel, and the research studies and the experience in Israel): The Government by means of its Ministries or agencies, and according to legislation of the Knesset (Israel's Parliament), finances the social security system mainly through the general budget, the "Social Partners" (trade unions, employers' organizations, government), bodies active in the market. The connection between a mandatory or voluntary environment of social security and the alternatives to governance is discussed, as well as the links with privatization of public institutions or of part of their activities. Organization and governance in Israel. Concerning the health-care systems - prior to the legislation of mandatory governmental insurance in 1994 and its implementation in January 1995, the power was in the hands of the sick-funds and the political bodies which stood behind them. The reform by means of the mandatory insurance, gave more power to the State, canceled almost entirely the connection between "Kupat-Cholim Clalit" (General Sick Fund) and the Histadrut, leaving some empty political areas. With other sick funds the political connection has been retained. The legislation has not changed much regarding the power of the hospitals; there have been partial attempts to "institutionalize" the hospitals and thereby transfer more power to the local management and to top-level doctors. As to the pension systems, the reform of 1995 gave more opportunities to private insurance companies and to other private financial bodies to insure "new" entrants; "old" insured remained in the "old" funds with the same management and governance. The power of the government increased as it bailed out completely the "old" funds and issued strict rules for the "new" ones. The National Insurance Institute (NII) is managed and governed according to law by a Council comprised of delegates of the Histadrut (as representatives of the employees), delegates of the employers and self-employed organizations, officials of the relevant Ministries, and members of the executive board of the NII. The power of the Council is balanced by some authority of the relevant Ministries. Recommendations. Concerning the NII - to change nothing in the Law, to oppose any measure to unite the collection of "insurance contributions" with that of the income tax. Concerning the health-care systems - to retain the connection between the political institutions and the sick-funds and legislate their authority. As to the pension system - the author's recmmendation is to abolish the division between "old" and "new" funds and perform all activities by means of 3 or 4 big not-for-profit occupational funds, namely the big Histadrut funds. It is preferable to base the activity of the funds on the principals of DB (Defined benefits). The main change: to strengthen the involvement and responsibility of the employers in the governance of the funds, and to strive towards mandatory pension insurance. Another new suggestion: to elect a "Social Security Council of Israel" by means of a special law. Its main mandate should be to coordinate policy and financial issues of social security.

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